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ObjectivesIn this study, we used a discrete choice experiment (DCE) conducted August-October 2017 to examine electronic nicotine delivery systems (ENDS) product preferences in a national sample of adult smokers (N = 1154) who were also using ENDS or had not ruled out future use.MethodsThe DCE evaluated 5 ENDS attributes: relative harm; effectiveness for helping smokers quit; nicotine strength; flavor; and price. We asked participants to choose among their own cigarettes, 2 ENDS products whose attributes varied across tasks, or none. We analyzed ENDS preferences using multinomial, nested, and mixed logit regressions.ResultsSmokers preferred ENDS that are less harmful than cigarettes, are effective in helping smokers quit, are lower priced, and are not menthol-flavored. The marginal willingness to pay for an ENDS product was $8.40 when less harmful than cigarettes, $4.13 when of unknown effectiveness in helping quitting ($13.90 when effective), and $3.37 when ENDS are not menthol-flavored. Furthermore, the overall flavor preference is driven by tobacco smokers, not by menthol cigarette smokers who do prefer menthol-flavored ENDS.ConclusionsPolicies that affect perceptions of ENDS effectiveness in promoting cessation and their relative harm may alter smokers' ENDS preferences. Regulating flavors and price also may influence adult smokers' ENDS preference.

Tumor cell-induced platelet aggregation (TCIPA) is a mechanism for the protection of tumor cells in the bloodstream and the promotion of tumor progression and metastases. The platelet C-type lectin-like receptor 2 (CLEC-2) can bind podoplanin (PDPN) on a cancer cell surface to facilitate TCIPA. Selective blockage of PDPN-mediated platelet–tumor cell interaction is a plausible strategy for inhibiting metastases. In this study, we aimed to screen for aptamers, which are the single-stranded DNA oligonucleotides that form a specific three-dimensional structure, bind to specific molecular targets with high affinity and specificity, bind to PDPN, and interfere with PDPN/CLEC-2 interactions. The systematic evolution of ligands by exponential enrichment (SELEX) was employed to enrich aptamers that recognize PDPN. The initial characterization of ssDNA pools enriched by SELEX revealed a PDPN aptamer designated as A1 displaying parallel-type G-quadruplexes and long stem-and-loop structures and binding PDPN with a material with a dissociation constant (Kd) of 1.3 ± 1.2 nM. The A1 aptamer recognized both the native and denatured form of PDPN. Notably, the A1 aptamer was able to quantitatively detect PDPN proteins in Western blot analysis. The A1 aptamer could interfere with the interaction between PDPN and CLEC-2 and inhibit PDPN-induced platelet aggregation in a concentration-dependent manner. These findings indicated that the A1 aptamer is a candidate for the development of biosensors in detecting the levels of PDPN expression. The action by A1 aptamer could result in the prevention of tumor cell metastases, and if so, could become an effective pharmacological agent in treating cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: The thulium fiber laser (TFL) generates a focused beam, which can be transmitted to laser fibers with small core diameters and may facilitate in situ lower-pole lithotripsy. This study compares lithotripsy performance of the 150 and 200 µm TFL in a lower pole benchtop kidney model. Materials and Methods: Using a 3D model printed from an actual kidney, in situ laser lithotripsy was performed on 1 cm lower-pole BegoStones (calcium oxalate monohydrate consistency) using four different settings (all 20W) and two fiber sizes (150 and 200 µm). Procedure time, laser time, total pulse energy, and fiber stripping were compared between the two fibers using an ANOVA or independent t-test. Results: The 150 µm fiber at 0.2 J × 100 Hz had the shortest lasing and procedure time (17.3 and 18.5 minutes) and lowest total pulse energy (20.75 kJ) compared with other study arms (p < 0.001). Overall procedure time, lasing time, and total pulse energy were significantly different between the 8 settings (p < 0.001 for all). At higher frequency (100 and 200 Hz), lasing time was significantly faster compared with 20 and 50 Hz (19.9 vs 27.3 minutes; p < 0.001). Furthermore, the average total procedure time was shorter with 150 µm compared with 200 µm regardless of settings (23.2 vs 29.8 minutes; p < 0.001). Conclusion: The 150 µm fiber results in shorter procedure and lasing time at lower total energy levels during lower-pole in situ lithotripsy. Overall, the fastest setting was 0.2 J and 100 Hz with the 150 µm fiber. Smaller laser fibers can potentially allow more efficient in situ laser lithotripsy with better irrigation and visibility at higher deflection angles. [ABSTRACT FROM AUTHOR]

This study investigated the effects of workplace clean indoor air law (CIAL) coverage on worksite compliance with CIALs, smoking participation among indoor workers, and secondhand smoke (SHS) exposure among nonsmoker indoor workers. This study improved on previous research by using the probability of a resident in a county covered by workplace CIALs, taking into account the state, county, and city legislation. The county-level probability of being covered by a CIAL is merged into two large nationally representative US surveys on smoking behaviors: Tobacco Use Supplement of the Current Population Survey (2001-2010) and Behavioral Risk Factor Surveillance System (2000-2006) based on the year of the survey and respondent's geographic location to identify respondents' CIAL coverage. This study estimated several model specifications of including and not including state or county fixed effects, and the effects of workplace CIALs are consistent across models. Increased coverage by workplace CIALs significantly increased likelihood of reporting a complete smoking restriction by 8% and 10% for the two different datasets, decreased smoking participation among indoor workers by 12%, and decreased SHS exposure among nonsmokers by 28%. Copyright © 2015 John Wiley & Sons, Ltd.

Aim Method Results Interpretation To evaluate the effectiveness of magic‐themed interventions in improving daily bimanual task performance in children with unilateral spastic cerebral palsy (CP) to and elucidate the variability in outcomes.This systematic literature review searched databases including Embase, MEDLINE, Scopus, Cochrane Central, and CINAHL. Outcome measures selected for the meta‐analysis included the Children's Hand‐use Experience Questionnaire, its three subscales, and the Besta subscale C. The overall efficacy of magic‐themed interventions was analysed using Hedges' g as the summary measure for these outcomes. Subgroup analysis compared the efficacy of different modes of training, and a meta‐regression investigated the impact of training duration.Analyses of four studies involving 78 children showed magic‐themed training significantly improved bimanual task performance (Hedges' g = 0.327, 95% confidence interval [CI] = 0.107–0.547, p = 0.004), especially in group settings (Hedges' g = 0.435, 95% CI = 0.176–0.693, p = 0.001), compared with non‐significant gains from video interventions (Hedges' g = 0.041, 95% CI = −0.380 to 0.462, p = 0.850). Additionally, training duration positively correlated with performance gains (coefficient = 0.0076 per hour, p = 0.001).Magic‐themed training, especially through group sessions and extended durations, enhances bimanual skills in children with unilateral spastic CP. [ABSTRACT FROM AUTHOR]

Introduction While retail sales and retailer inspection studies generally indicate high compliance with state sales restrictions on Nicotine Vaping Products (NVPs) within the restricted area, studies using survey data generally indicate that most users could readily continue gaining access to restricted NVPs. Our study bridges a gap in the current literature and investigates the potential role of cross-state border purchases to evade state emergency NVP sales restrictions in 2019. Aims and Methods The study sample was restricted to NVP sales from the states neighboring Massachusetts, Rhode Island, and Washington, three states that implemented all NVP or flavored NVP sales restrictions in 2019. Among these neighboring states, the 2019 weekly county-level NVP sales by flavors (tobacco, mint/menthol, and other flavors) were compiled using Nielsen Scanner data. A quasi-experimental, comparison group pre–post study design was used to study the impacts of NVP sales restrictions on cross-state border NVP purchases. Results Weekly NVP sales for border counties significantly increased in response to the MA, RI, and WA bans for tobacco flavored (56%, 45%, 14%, respectively), menthol/mint flavored (51%, 2%, 41%, respectively), and other flavored (79%, 3%, 4%, respectively) products, compared to sales for non-border counties (all p -values <.01). Conclusions Our study identified significant cross-state border NVP purchases in all studied states to circumvent NVP emergency sales restrictions in response to the EVALI outbreak. Policymakers should factor in these purchasing behaviors to evade sales restrictions when evaluating any future potential policies at the state or local levels. Implications While retail sales data and retailer inspections indicate high compliance with Nicotine Vaping Product (NVP) flavor sales restrictions from major retail outlets, survey data obtain mixed findings on the effects of sales restrictions on vaping behaviors. Our study identified a significant increase in cross-state border NVP purchases to circumvent NVP sales restrictions in 2019, consistent across all three settings of Massachusetts, Rhode Island, and Washington. Policymakers should factor in these cross-state border NVP purchases in response to sales restrictions when evaluating any future potential NVP sales restrictions. [ABSTRACT FROM AUTHOR]

There is a knowledge gap concerning the proper timing for COVID-19 vaccination in cancer patients undergoing chemotherapy. We aimed to evaluate the suitability of the guidelines that recommend waiting at least three months after undergoing chemotherapy before receiving a COVID-19 vaccine. This retrospective cohort study used aggregated data from the TriNetX US Collaboratory network. Participants were grouped into two groups based on the interval between chemotherapy and vaccination. The primary outcome assessed was infection risks, including COVID-19; skin, intra-abdominal, and urinary tract infections; pneumonia; and sepsis. Secondary measures included healthcare utilization and all causes of mortality. Kaplan–Meier analysis and the Cox proportional hazard model were used to calculate the cumulative incidence and hazard ratio (HR) and 95% confidence intervals for the outcomes. The proportional hazard assumption was tested with the generalized Schoenfeld approach. Four subgroup analyses (cancer type, vaccine brand, sex, age) were conducted. Sensitivity analyses were performed to account for competing risks and explore three distinct time intervals. Patients receiving a vaccine within three months after chemotherapy had a higher risk of COVID-19 infection (HR: 1.428, 95% CI: 1.035–1.970), urinary tract infection (HR: 1.477, 95% CI: 1.083–2.014), and sepsis (HR: 1.854, 95% CI: 1.091–3.152) compared to those who adhered to the recommendations. Hospital inpatient service utilization risk was also significantly elevated for the within three months group (HR: 1.692, 95% CI: 1.354–2.115). Adhering to a three-month post-chemotherapy waiting period reduces infection and healthcare utilization risks for cancer patients receiving a COVID-19 vaccine. [ABSTRACT FROM AUTHOR]

Background: Facing highly competitive and changing environment, cultivating citizens with problem-solving attitudes is one critical vision of education. In brief, the importance of education is to cultivate students with practical abilities. Realizing the advantages of web-based cooperative learning (web-based CL) and creative problem solving (CPS) for learners in various aspects, many scholars have dedicated themselves to the study of CPS and Web-based CL. However, from a review of relevant literatures, it can be discovered that only a few of studies focus on the integration of CPS and Web-based CL. Thus, this study tried to integrate CPS and Web-based CL to the subject of accounting and explore the effects of this innovative teaching instruction on students' problem-solving attitudes. Aims: The study aimed to explore the effect of applying an innovative teaching strategy--creative problem solving strategy on web-based cooperative learning environment in accounting course to promote students' problem-solving attitudes. Sample: Students in three classes of the 4-year hotel management program were selected as research subjects. One class was assigned to the experimental group 1 (EG1), which was treated with "creative problem solving" (CPS) strategy on web-based cooperative learning (Web-based CL) method; another was assigned to the experimental group 2 (EG2), with "Web-based CL" adopted; and the other was assigned to the control group (CG), with "traditional lecturing" method adopted. Method: The quasi-experimental method was conducted, and the collected data was analyzed by quantitative methods. Results: The major results showed that the differences among the three classes reached the significant levels, and the problem-solving attitudes of the EG1 were significantly better than that of the EG2 and CG. Conclusion: Before the experimental teaching, students in the three groups had significant differences in their problem solving attitudes. After the experimental teaching, the post-test results revealed that the difference among three groups in problem solving attitudes reached significant level. EG1 had the highest performance. Moreover, EG1 had significantly outperformed EG2 and CG. However, no significant difference was observed between EG2 and CG. (Contains 7 tables and 1 figure.)