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Introduction Experts recommend integrating smoking-cessation treatments within U.S. mental health settings, but the population health benefits of doing so have not been estimated. This study simulates the impact of widespread cessation treatment for patients with depression under best-case treatment and maximum potential cessation scenarios. Methods Cessation interventions were simulated for U.S. adult smokers seeing a health professional for depression from 2020 to 2100. Interventions included (1) Any Treatment (behavioral counseling, pharmacological, combination) and (2) Pharmacological Treatment (including counseling), combined with increased mental health service utilization each. These were compared with a maximum potential cessation scenario where all patients with major depression quit smoking. Analyses were conducted in 2016–2020. Results Widespread uptake of Any Treatment among patients with depression would avert 32,000 deaths and result in 138,000 life-years gained by 2100; Any Treatment combined with 100% mental health service utilization would result in 53,000 and 231,000, respectively. Pharmacological Treatment would avert 125,000 deaths, with 540,000 life-years gained. Pharmacological Treatment combined with 100% mental health service utilization would result in 203,000 deaths averted and 887,000 life-years gained. Health gains under best-case treatment scenarios represent modest fractions of those projected under maximum potential cessation scenarios at current mental health service utilization levels (835,000 deaths averted, 3.73 million life-years gained) and at 100% utilization (1.11 million deaths averted, 5.07 million life years gained). Conclusions Providing smoking-cessation treatment to patients with depression and increasing mental health service utilization would reduce the toll of tobacco on this population. These gains would be considerably larger if cessation treatments were more effective.

A major barrier to clinicians referring service users with psychosis for psychological therapies is the belief that they will not engage. We investigated therapy receipt after discharge, in a sample of service users who had already demonstrated willingness to engage in psychological therapy during an inpatient admission. Only one-third of service users (33%; 16/48) received at least 1 session of evidence-based therapy at 6-month follow-up after discharge. Therapy receipt was more common for service users with (i) lower delusional distress at discharge, (ii) Black and Minority Ethnic (BME) background, and (iii) discharged to an Early Intervention (EI) service.

Ground-penetrating radar is becoming increasingly popular for use as a non-destructive assessment method for investigating reinforced concrete structures. The amount of data collected however can be very large and take a significant level of subjective experience to interpret. This study focuses upon the use of a neural network approach to automate and facilitate the post-processing of ground penetrating radar results. The radar data is reduced to a simplified data set by using an edge detection routine. Signal reflections from reinforcing bars displaying a hyperbolic image format are detected using a multi-layer perceptron (MLP) network with a single hidden layer containing 8 nodes to recognise a simplified hyperbolic shape. Training and testing of the network was carried out making use of an emulsion analogue tank, simulating the properties of concrete, and using real concrete specimens. The results showed that the use of a MLP neural network approach could be quite effective in automating the identification and location of embedded steel reinforcing bars from a radar investigation. Accurate estimation of depth, or cover, requires a reliable knowledge of the dielectric properties of the concrete, and recent work using a specially-developed wideband horn antenna for direct determination of in situ properties is also outlined.

Systematic measurements have been made of the E – J characteristics of a Nb 3 Sn wire over four decades of electric field (0.1–1000 μV m −1 ) and five decades of current density (10 3 –5×10 8 A m −2 ) as a function of magnetic field, temperature and strain. They were parameterised using the power law E = αJ n . At low magnetic fields n tends to a constant saturation value, which decreases at high compressive and tensile strains and increases with increasing electric field. In the high magnetic-field range, n is independent of E -field and can be approximated by a strain and temperature scaling law of the form n ( B , T , e )= G ( T )( B c2 * ( T , e )− B ), where B c2 * ( T , e ) is an effective upper critical field.

Systematic measurements have been made of the engineering critical current density ( J e ) and N -value (where E = αJ N ) of a jellyroll Nb 3 Sn wire as a function of magnetic field and strain at 4.2 K. Strain cycling to very high tensile strains at 4.2 K was used to investigate the reversibility of the wire's properties. The J e data were fully reversible up to 0.67% strain, and can be approximately parameterised by the scaling law F p (4.2 K ,B,e)=J e B=A[B c2 ∗ (4.2 K ,e)] 0.5 b 0.5 (1−b) 2 , where A=1.28×10 10 Am −2 T 0.5 . However it is noted that the maximum pinning force density is not a single-valued function of B c2 ∗ , so that highly accurate parameterisation requires that A depends on strain. The N -values are a strong function of strain, peaking at ∼0.33% with values nearly double the equivalent zero-strain values.

The family of wake profiles formed from the Falkner–Skan boundary-layer solutions with negative pressure gradient, m , was shown in (Woodley and Peake, 1997) to be inviscidly absolutely unstable. However, due to numerical difficulties, the limit m→0 was not considered there, although the results that were found appeared to indicate that the double Blasius profile ( m=0 ) is absolutely unstable. In this note we repeat those calculations using an alternative formulation, and show that in fact the absolute instability present for m becomes neutral as m→0 , so that the flat-plate wake is only convectively, and not absolutely, unstable. In addition, the effects of viscosity are included here using the Orr–Sommerfeld equation, and two sets of saddle points are now found, one set corresponding to the inviscid family, which can be either pinching or non-pinching depending on the values of m and the Reynolds number, and another set which is always pinching, but which is stable for m close to zero.

The signal importance of policy and regulation in the transport field is beyond dispute. Equally, it is said of transport issues that they are all too often at the mercy of policy innovations from cognate sectors (Hallsworth et al., 1998). In this paper we suggest that this is precisely the case in the courier services sector. In the past two decades the fast courier sector has been the fastest-growing sector of physical transportation—and it is perhaps most simply defined by reference to such key players as UPS, DHL and FedEx. The rise in the numbers of delivery-dedicated fleets of aircraft, vans and trucks has been inexorable—impacting on all facets of the “transport problem”. However, rather than concentrate on the wider effects of this important transport sector we choose in this paper to focus on the roots of the industry and the signal importance of policy in the form of market regulation and competition.

Artificial neural networks are now being extensively used in the area of marketing analysis, as they are well suited to this type of non-linear problem. A retail company planned to improve its performance by using neural networks to predict turnover, and data used in the experiment was provided by the company. The study compares the performance of a combination of neural networks to that of a single neural network. The results show that backpropagation neural networks are effective tools which can give good results in solving a non-linear prediction problem, even when data is poorly represented.

Background Regulators have issued warnings about the potential adverse effects of the smoking cessation medication varenicline. However, there is little evidence of the long-term effects of varenicline when prescribed in everyday clinical practice. We aimed to investigate the association of varenicline and nicotine replacement therapy (NRT) with adverse outcomes when prescribed in primary care. Methods Using the Clinical Practice Research Datalink (CPRD), we conducted an observational cohort study of electronic medical records and linked mortality and hospital admission data of 126 718 primary care patients in the UK prescribed varenicline (41 742) and NRT (84 976). We used three approaches to overcome potential residual confounding: multivariable adjusted regression, propensity score matching, and instrumental variable regression. The exposure was first prescription of varenicline or nicotine replacement therapy. The primary outcome was all-cause mortality 2 years after first prescription. Secondary outcomes were mortality from cardiovascular and respiratory disease, all-cause hospital admission and for cardiovascular and respiratory disease, incident primary care diagnosis of myocardial infarction or chronic obstructive pulmonary disease, and frequency of primary care attendance. Findings In multivariable adjusted analysis, mortality was lower among patients prescribed varenicline than in those prescribed NRT (OR 0·78, 95% CI 0·69 to 0·87; p Interpretation There was little evidence of a substantial increase in risk of adverse outcomes in patients prescribed varenicline as part of their standard clinical care. The regulatory warnings associated with varenicline do not accurately reflect the scientific evidence and should be reconsidered by policy makers and regulators. Funding The research described in this paper was funded by the Medical Research Council (MR/N01006X/1), the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme (project number 14/49/94). KHT is funded by a clinical lectureship award from the NIHR. RMM is supported by Cancer Research UK (programme grant C18281/A19169) (the Integrative Cancer Epidemiology Programme). TJ is supported by the NIHR Collaboration for Leadership in Applied Health Research and Care West, University Hospitals Bristol NHS Foundation Trust. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the abstract for submission.

A critical review of techniques used in the assessment of microleakage in dental restorations is presented. These techniques include the use of air pressure, bacteria, radioisotopes, electrochemistry, chemical tracers and dye penetration. Wide variations in methodologies are revealed.

Two reservoir cores and one synthetic alumina sample have been quantitatively studied by means of proton, spin-lattice relaxation of the bulk samples, and by 2D-FT slice selected imaging. T1 and M0 images of high quality have been obtained with reasonable data acquisition and data processing times. T1 and T2 relaxation processes have been shown to be correlated, and possible causes for the differences between average image T1 values and those measures for the bulk samples are discussed. Variation of T1 within the images is discussed in terms of the contributions from pore size and surface relaxation effects.

A number of streptavidin-linked reporter molecules at the endpoint of a five-step detection protocol for viral in situ hybridization using biotinylated probes were examined. DNA-DNA and RNA-RNA model systems were used. Streptavidin linked to either peroxidase or fluorescein was found to be optimal in terms of sensitivity and resolution within individual cells. All other reporter molecules labelled similar numbers of cells with low background reaction. However, streptavidin-5 nm gold followed by silver enhancement gave very high background staining making interpretation of positive signals very difficult.

To the Editor: In several recent papers, NMR results for gramicidin A have been compared with predictions based on various models for a right-handed channel. In particular, 2H quadrupolar splittings (Hing et al., 1990a,b; Prosser et al., 1991) or '5N chemical shifts (Chiu et al., 1991) from solid-state NMR spectra of labeled gramicidin A in oriented phospholipid multilayers have been compared to the values that would be predicted for a righthanded model derived from model-building considerations (Koeppe and Kimura, 1984) and to values predicted by a preliminary model based on 2-dimensional 1H NMR data for gramicidin in SDS (Arseniev et al., 1985). These latter authors have, however, published an updated model that was derived from their NMR data for gramicidin in SDS (Arseniev et al., 1986). This updated model was based upon additional experimental results and corrected many of the inconsistencies in the original Arseniev model. It would therefore be appropriate to use the 1986 Arseniev model in preference to the 1985 model for comparisons with experimental data. Stereo pictures of the updated Arseniev model for the right-handed gramicidin A channel and its mirror image have recently been published (Koeppe et al., 1992).

The analysis of human movement offers important detailed information to researchers in medicine and sports science. The kinematic variables of most interest are the displacement, velocity and acceleration patterns of identified joints and limb segments. Movement patterns are captured on film or video tape and the location of selected anatomical landmarks are established using a sonic digitizer interfaced with a Commodore 4032 with output facilities to either a printer or digiplot. The user has the facility to identify the limb segment(s) and/or selected phases of the movement pattern and a low pass digital filter is employed to ‘smooth’ the digitized data. An ‘over-plotting’ function provides a useful aid in data interpretation.

Citrinin, a nephrotoxic fungal metabolite produced by several species of Penicillium and Aspergillus , has been found to contaminate foods used by humans and animals. The present study investigated potential effects of this compound on the immune system. Male CD-1 mice received 0, 0.12, 0.6 or 3.0 mg of citrinin/kg i.p. every other day for 2-4 weeks. Food consumption and body or organ weights were not affected but kidneys were enlarged. Splenic cells from mice exposed to citrinin for 2 or 4 weeks were cultured with or without the mitogens, phytohemagglutinin (PHA), pokewecd mitogen (PWM) or lipopolysaccharide (LPS). Exposure to citrinin stimulated splenic lymphocyte proliferation. Antibody production by splenic cells in animals sensitized to sheep red blood cells (SRBC) increased in the two highest dose groups. Delayed hypersensitivity reaction, measured as a foot-pad swelling, in response to SRBC sensitization and subsequent challenge were not affected by citrinin treatment. In vitro addition of citrinin (>1 × 10-5M) to splenic lymphocytes was cytotoxic. These findings suggest that citrinin mildly stimulates the immune system but does not have consistent immunotoxic effects at the doses tested.

Cell-free extracts prepared from yeast cells have previously been shown to direct selective and accurate in vitro transcription of tRNA and 5 S RNA genes. We have further analyzed the transcription factors and DNA sequences required for in vitro transcription of the yeast 5 S RNA gene. Fractionation of a yeast extract has identified a 5 S RNA gene-specific factor required, in addition to the two previously described tRNA factors (Klekamp, M. S., and Weil, P. A. (1982) J. Biol. Chem. 257, 8432-8441), for accurate transcription of the 5 S RNA gene by RNA polymerase III. Transcription of variant 5 S RNA genes has indicated that a region of the gene extending from residue +57 to residue +99 is essential for directing specific initiation of transcription. Although the 5' flanking and initial coding sequence is not absolutely required for transcription of the gene, some of the variant genes which have substitutions in this region are less actively transcribed than the wild-type gene. Transcription initiates on some of the variant genes at a position equivalent to +1 in the substituted sequence, while on other variant genes transcription initiates further upstream.

The misplaced object test is one of a series of psychometric tests used in screening a sample of the elderly population of Liverpool in a community study of the incidence of psychiatric disorders in the elderly. It is a simple test of memory, and the subject is asked to place several objects in a schematic house. The subject is then retested after twenty minutes to test the consistency of the responses. A microcomputer version was developed by computer scientists in collaboration with a psychiatrist and a psychologist. A program was developed to administer the test directly to individual subjects. The program runs on a BBC Model B microcomputer, with a disc drive, and uses a light-pen for the user interface. Graphics capabilities of the machine are used in giving a high-resolution picture of the house and objects. Simple instructions are given to the subjects on the screen. The subjects are able to move the objects around the screen using the light-pen. When the test is complete the results are stored on disc. The two tests are scored using a simple scoring system. The initial pilot study examined the performance of a number of elderly patients and normal subjects on the test as administered by microcomputer. Some observations concerning the response of these subjects are made and further plans for the microcomputerized test indicated.

Concentrations of ovine placental lactogen (oPL) were measured in the peripheral plasma of six ewes after the removal of fetuses (in four ewes) or after the intrauterine death of one of twin fetuses (in two ewes). Concentrations of oPL decreased after fetectomy or intrauterine fetal death, indicating that a living fetus is essential to the sustained secretion of oPL.

The collection and manipulation of patient data from the earliest stage by microcomputer is a desirable goal as in this way valuable information is captured which can be used for the administration of hospital admissions and subsequent analysis of the data will provide the information required for surgical audit. We have implemented a system using a pair of Apple II microcomputers with specifically written software in UCSD PASCAL that has been used in the clinical environment with proven success.