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Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of King’s College London (HR-17/18-5341; approval granted January 2018).
PMC9919979
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
PMC9919979
Data Availability Statement
Data available on request. The data presented in this study are available on request from the corresponding author. The data are not publicly available due to nature of consent obtained from participants.
PMC9919979
Conflicts of Interest
IBS, TG
AC was funded by a PhD studentship funded by Almond Board of California. ED has received an education grant from Alpro, research funding from the British Dietetic Association, the Almond Board of California, the International Nut and Dried Fruit Council and Nestec Ltd. and has served as a consultant for Puratos. TG sup...
PMC9919979
References
Consort diagram.Particle size distributions of masticated whole and ground almonds (Demographic characteristics of participants.Participant dentition.Data are number, Particle size distributions of masticated whole and ground almonds assessed by the mechanical sieving technique.Values are mean (SD) or mean difference (...
PMC9919979
Summary
PMC9860215
Background
POLIOMYELITIS
Type 2 circulating vaccine-derived polioviruses (cVDPV2) from Sabin oral poliovirus vaccines (OPVs) are the leading cause of poliomyelitis. A novel type 2 OPV (nOPV2) has been developed to be more genetically stable with similar tolerability and immunogenicity to that of Sabin type 2 vaccines to mitigate the risk of cV...
PMC9860215
Methods
diarrhoea, infection, vomiting, immunodeficiency disorder
ADVERSE EVENTS, INFECTION, IMMUNODEFICIENCY DISORDER
In this randomised, double-blind, controlled, phase 2 trial we enrolled newborn infants at the Matlab Health Research Centre, Chandpur, Bangladesh. We included infants who were healthy and were a single birth after at least 37 weeks' gestation. Infants were randomly assigned (2:1) to receive either two doses of nOPV2 o...
PMC9860215
Findings
ADVERSE EVENTS
Between Sept 21, 2020, and Aug 16, 2021, we screened 334 newborn infants, of whom three (<1%) were found to be ineligible and one (<1%) was withdrawn by the parents; the remaining 330 (99%) infants were assigned to receive nOPV2 (n=220 [67%]) or placebo (n=110 [33%]). nOPV2 was well tolerated; 154 (70%) of 220 newborn ...
PMC9860215
Interpretation
nOPV2 was well tolerated and immunogenic in newborn infants, with two doses, at birth and 4 weeks, resulting in almost 99% of infants having protective neutralising antibodies.
PMC9860215
Funding
Bill & Melinda Gates Foundation.
PMC9860215
Introduction
acute flaccid paralysis, poliomyelitis, vaccine-associated paralytic
POLIOMYELITIS, POLIO
Although live oral poliovirus vaccines (OPVs) are safe and effective and have led to the elimination of poliomyelitis from most of the world, in rare circumstances the attenuated viruses in OPVs can mutate and reacquire neurovirulence. This mutation can result in vaccine-associated paralytic polio in vaccine recipients...
PMC9860215
Research in context
infection
INFECTION, PARALYTIC POLIOMYELITIS, POLIO
Outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) are now the main cause of paralytic poliomyelitis worldwide. A novel, genetically more stable monovalent type 2 oral polio vaccine that was developed for use in outbreak control with less inherent chance of propagating more cVDPV2 has been studied in ...
PMC9860215
Methods
PMC9860215
Study design and participants
diarrhoea, infection, vomiting, immunodeficiency disorder
INFECTION, DISEASE, IMMUNODEFICIENCY DISORDER
We did a randomised, double-blind, phase 2 clinical study at the Matlab Health Research Center in Chandpur, rural Bangladesh. The protocol was approved by the research review committee and the ethical review committee at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b).Women in the third t...
PMC9860215
Randomisation and masking
Participants were randomly assigned (2:1) to either nOPV2 or placebo, using a block randomisation of size 6 or 12 generated by a statistician who was not otherwise involved in the study. The statistician prepared randomisation lists for study nurses or investigators who were masked to the allocation of the vaccine or p...
PMC9860215
Procedures
deaths, acute flaccid paralysis, vaccine-associated
VIRAL DISEASES, ADVERSE EVENTS, ENCEPHALITIS, POLIO, ASEPTIC MENINGITIS, ADVERSE EVENT, DISEASE, POLIO
Infants in the nOPV2 group received a vaccine (PT Bio Farma, Indonesia) composed of an attenuated serotype 2 poliovirus derived from a modified Sabin 2 infectious clone propagated in Vero cells.The first vaccine or placebo dose was given within a window of 0–3 days after birth and all participants received a second dos...
PMC9860215
Outcomes
ADVERSE EVENTS, DECAY, SECONDARY, VIRAL SHEDDING
The coprimary objectives were to assess the safety and tolerability, and the immunogenicity (measured by seroconversion rate) after one and two doses of nOPV2 when given 4 weeks apart in poliovirus vaccine-naive newborn infants. The secondary outcome was an assessment of the rate, duration, and extent of faecal viral s...
PMC9860215
Statistical analysis
We selected a sample size of 220 participants in the nOPV2 group, with a placebo control group with half that number of participants (n=110), to provide sufficient power to assess the immunogenicity of the candidate vaccines on the basis of previous studies. In a study done in India in 2008, before the cessation of OPV...
PMC9860215
Role of the funding source
MH
Four authors, KZ, JDC, AGR, and MH, were employees of the study sponsor, and one, ASB, is employed by the study funder, who were involved in study design, data collection, and writing of the study report.
PMC9860215
Results
pneumonia, hepatitis A/B, vomiting, watery diarrhoea, gastrointestinal disorders
PNEUMONIA, ADVERSE EVENTS, VIRAL SHEDDING, SECONDARY, GASTROINTESTINAL DISORDERS
Between Sept 21, 2020, and Aug 16, 2021, we screened 334 newborn infants, of whom three (<1%) were found to be ineligible and one (<1%) was withdrawn by the parents; the remaining 330 (99%) infants were assigned to the two study groups (220 [67%] assigned to nOPV2 and 110 [33%] to placebo; Trial profilenOPV2=novel oral...
PMC9860215
Discussion
VIRUS, ADVERSE EVENTS, EVENT, ADVERSE EVENT, EVENTS
We found similar tolerability profiles in the nOPV2 and placebo groups, with only mild solicited adverse events and no related serious adverse events or adverse events of special interest reported. Solicited adverse event rates after nOPV2 and placebo were higher after second doses than after first doses, representing ...
PMC9860215
Data sharing
Data for this study will be made available to others in the scientific community upon request. Standard criteria for making data available for valid research projects will be used, following application by suitably qualified researchers. For data access, please contact the Bill & Melinda Gates Foundationat
PMC9860215
Declaration of interests
ET is a full-time employee of the vaccine manufacturer, PT Bio Farma (Bandung, Indonesia). All other authors declare no competing interests.
PMC9860215
References
PMC9860215
Supplementary Material
PMC9860215
Supplementary appendix
PMC9860215
Acknowledgments
icddr,b acknowledges the commitment of the Bill & Melinda Gates Foundation to its research efforts. icddr,b is also grateful to the Governments of Bangladesh, Canada, Sweden, and the UK for providing core or unrestricted support. The authors are grateful to all the parents and guardians of the infants who were enrolled...
PMC9860215
Contributors
MH
KZ, MH, CG, MY, KMJ, JDC, AGR, BAM, ET, and ASB participated in the conception and design of the study and contributed to the writing of the protocol. RC and SACC provided scientific advice for the protocol and interpretation of the results. MH, MY, and KMJ were investigators treating participants. CG performed all sta...
PMC9860215
Background
GENERALISED CONVULSIVE STATUS EPILEPTICUS
Generalised convulsive status epilepticus (GCSE) is a medical emergency. Guidelines recommend a stepwise strategy of benzodiazepines followed by a second-line anti-seizure medicine (ASM). However, GCSE is uncontrolled in 20–40% patients and is associated with protracted hospitalisation, disability, and mortality. The o...
PMC9830759
Methods
seizure
ADVERSE EVENTS, SECONDARY
This was a multicentre, double-blind, randomised controlled trial in 244 adults admitted to intensive care units for GCSE in 16 French hospitals between 2013 and 2018. Patients received standard care of benzodiazepine and a second-line ASM (except VPA). Intervention patients received a 30 mg/kg VPA loading dose, then a...
PMC9830759
Results
A total of 126 (52%) and 118 (48%) patients were included in the VPA and placebo groups. 224 (93%) and 227 (93%) received a first-line and a second-line ASM before VPA or placebo infusion. There was no between-group difference for patients hospital-discharged at day 15 [VPA, 77 (61%)
PMC9830759
Supplementary Information
The online version contains supplementary material available at 10.1186/s13054-022-04292-7.
PMC9830759
Keywords
PMC9830759
Introduction
epileptic, seizures, convulsive seizure
EPILEPTIC, GENERALISED CONVULSIVE STATUS EPILEPTICUS
Generalised convulsive status epilepticus (GCSE) is a diagnostic and therapeutic emergency and is defined as a convulsive seizure lasting more than 5 min, or as consecutive seizures without recovery of consciousness between seizures [Experts therefore considered that interventions should be proposed as treatment adjunc...
PMC9830759
Methods
PMC9830759
Study design
STATUS EPILEPTICUS
VALSE (VALproic Acid in Status Epilepticus) is a multicentre, in parallel, randomised double-blind, controlled trial conducted in 16 French ICUs. It compared the addition of intravenous VPA with placebo in patients admitted to the ICU for GCSE, as well as to first- and second-line ASMs and standard ICU care. The overal...
PMC9830759
Eligibility criteria
status epilepticus, seizures, convulsive seizure
STATUS EPILEPTICUS
Adult patients were eligible if admitted to the ICU for GCSE, defined by 5 min or more of continuous or recurrent generalised convulsive seizure without recovery of consciousness between seizures [Main exclusion criteria were non-convulsive status epilepticus clinically characterised by altered mental status but with n...
PMC9830759
Randomisation and interventions
seizures
Eligible patients were randomly assigned in a 1:1 ratio to receive either VPA or placebo. Randomisation, with stratification according to site, age, and presence of acute brain injury, was performed with the use of a central concealed, Web-based, automated randomisation system. VPA treatment consisted of intravenous ad...
PMC9830759
Outcomes and assessment
super-refractory, abnormal movements, seizure
ADVERSE EVENTS, RECURRENCE
The primary outcome was the proportion of living patients discharged from hospital to their home or to a long-term care facility on day 15. The primary endpoint (i.e. hospital status at day 15) was collected by a local investigator, blinded to group assignment (Additional file Secondary outcomes were recurrence of seiz...
PMC9830759
Statistical analysis
REGRESSION, SECONDARY
The study was powered to detect an absolute increase of 20% in the rate of patients discharged alive at day 15 with a power of 90% and a two-sided 0.05 significance level, assuming a 50% rate in the control group. Accordingly, the sample size was 124 patients per group. To account for potential errors in the administra...
PMC9830759
Anti-epileptic administration
Eighty-three of the 103 (42%) patients who had not received a second-line ASM before being admitted to the ICU received it within the first 24 h after admission, mainly within the first 6 h (Fig. Timing of second-line anti-seizure medicine (ASM) (panel
PMC9830759
Secondary outcomes
SUPER-REFRACTORY STATUS EPILEPTICUS
The ICU, hospital, and day 90 mortality rates were similar between the two groups as well as the proportion of patients developing refractory and super-refractory status epilepticus (Table
PMC9830759
Adverse events
ADVERSE EVENTS
One or more adverse events of any grade of severity were declared by the investigators during hospital stay in 52 (44%) and 45 (36%) patients from the VPA and placebo groups, respectively (
PMC9830759
Discussion
epileptic, super-refractory
ADVERSE EVENTS, EPILEPTIC
In this multicentre, double-blind, randomised, controlled, and pragmatic trial, we found that the intravenous administration of VPA, in addition to first- and second-line ASMs, did not increase the proportion of patients discharged alive from hospital within the first 15 days. We also found that VPA did not increase th...
PMC9830759
Acknowledgements
Nawal Derridj-Ait-Younes, Yasmine Domingo-Saidji, Pierre Asfar, Raphaël Clere-Jehl
MARION, FRANCIS, HARLEY
We thank the members of the data and safety monitoring board (Nawal Derridj-Ait-Younes, Nabila Yasmine Domingo-Saidji, Abderraouf Hermez, Chanez Lazizi, Naima Imam-Sghiouar), Pr Philippe Aegerter for his support and advice in the early stages of the trial, and the trial participants who were willing to be randomly assi...
PMC9830759
Author contributions
HO
RECRUITMENT
TS was involved in conception of the work (PI), funding application, enrolment of participating centres, supervision of the data collection, participation in data analysis verification of the data and interpretation, writing of the manuscript, critical revision of the manuscript. HO and BC helped in conception of the w...
PMC9830759
Funding
MAY
Programme Hospitalier de Recherche Clinique 2010 of the French Ministry of Social Affairs and Health. VALSE ClinicalTrials.gov number, NCT01791868 registered May 2012. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report, or in the decision ...
PMC9830759
Availability of data and materials
MYASTHENIA GRAVIS
Data available: Yes. Data types: De-identified participant data. How to access data: De-identified patient data to reproduce results presented in the article when available: With publication Supporting Documents Document types: None. Who can access the data: Researchers whose proposed use of the data has been approved....
PMC9830759
Declarations
PMC9830759
Ethics approval and consent to participate
Ethics approval was granted by the French regulatory board (
PMC9830759
Consent for publication
Not applicable.
PMC9830759
Competing interests
RS
RS received grants from the French Ministry of Health, the French Society of Intensive Care Medicine (SRLF), and the European Society of Intensive Care Medicine (ESICM). All other authors declare no competing interests.
PMC9830759
References
PMC9830759
Background
hearing loss, Hearing loss
HEARING LOSS, AIDS, HEARING LOSS
Hearing loss is a growing health concern worldwide. Hearing aids (HAs) are the treatment of choice for hearing rehabilitation in most cases of mild-to-moderate hearing loss. However, many patients with hearing loss do not use HAs due to their high cost, stigma, and inaccessibility. Since smartphones are widely used, ma...
PMC10578122
Objective
We compared the audiological performance between an SHAA and a conventional HA in a prospective, multicenter randomized controlled trial.
PMC10578122
Methods
hearing loss
HEARING LOSS
Patients with mild-to-moderate hearing loss were prospectively enrolled from 2 tertiary hospitals and randomly assigned to either an SHAA (Petralex; IT4YOU Corp LLC) or a conventional HA (Siya 1 miniRITE; Oticon A/S). For the cross-over study design, participants used the alternate device and repeated the same 2-month ...
PMC10578122
Results
ADVERSE EVENTS
Overall, 63 participants were screened and 38 completed the study. In sound-field audiometry testing, the SHAA showed a 20- to 60-dB gain in the low-to-high frequencies of the hearing threshold level. The HA provided adequate gain in the middle-to-high frequencies (55, 65, and 75 dB in real-ear measurements), which is ...
PMC10578122
Conclusions
hearing loss
HEARING LOSS
The HA showed better performance than the SHAA in word recognition and the HINT. However, the SHAA was significantly better than unaided hearing in terms of amplification. The SHAA may be a useful hearing assistance device for patients with mild-to-moderate hearing loss when listening to soft sounds in quiet conditions...
PMC10578122
Trial Registration
ClinicalTrials.gov NCT05644106;
PMC10578122
Introduction
hearing amplification, hearing impairment, REMs, hearing loss, Hearing loss
HEARING LOSS, HEARING IMPAIRMENT, AIDS, HEARING LOSS
Hearing loss is a common and growing global health issue. The World Health Organization (WHO) reported that approximately 2.5 billion people will experience hearing loss and 700 million will need hearing rehabilitation by 2050 [Hearing rehabilitation improves audiological performance, daily activity functioning, and qu...
PMC10578122
Methods
PMC10578122
Study Design
sensorineural, hearing amplification, tinnitus, Hearing impairment, hearing loss
SENSORINEURAL HEARING LOSS, ADVERSE EVENTS, TINNITUS, HEARING IMPAIRMENT, HEARING LOSS
A prospective randomized controlled trial was conducted at 2 tertiary hospitals in South Korea (the Department of Otolaryngology, Seoul National University Hospital and the Department of Otolaryngology, The Catholic University of Korea, Seoul St. Mary’s Hospital) from August 2020 to November 2022. The inclusion criteri...
PMC10578122
Ethical Considerations
This study was registered in the clinical trials registry in South Korea (Clinical Research Information Service; KCT0005458) [
PMC10578122
Hearing Amplification Systems (HA and SHAA)
A pilot study that conducted behavioral evaluations of 3 SHAAs provided the evidence used to select an SHAA for this study [For the conventional HA, we used the Siya 1 miniRITE (Oticon A/S), coupled with two 85-dB receivers and single closed ear tips. The Siya 1 miniRITE is an essential-level HA, first introduced in 20...
PMC10578122
Sound-Field Audiometry and WRS Tests
WRS, hearing amplification
Sound-field audiometry (SFA) and WRS tests were performed using a calibrated Interacoustics AC40 (Interacoustics A/S). To determine the difference between the SHAA and the conventional HA, SFA was obtained at 0.25, 0.5, 1, 2, 3, 4, 6, and 8 kHz for both hearing amplification systems. Warble tone was used to avoid stand...
PMC10578122
REM Test
REMs
This test measures actual HA gain by comparing the difference between the HA target value and the sound pressure measured using a microphone probe tip in the ear canal. We used Affinity 2.0 software (version 2.6.0; Serif Ltd) to conduct the REMs. To validate the HA performance, the REMs were performed using speech stim...
PMC10578122
Hearing-in-Noise Test
The hearing-in-noise test (HINT) was developed to measure binaural speech recognition ability under quiet and noisy situations [
PMC10578122
Questionnaires
For the measurement of subjective satisfaction, the APHAB and IOI-HA were used. The APHAB consists of 4 items: ease of communication, reverberation, background noise, and aversiveness of sounds. Each item has 6 questions, and higher scores indicate greater disability. This survey can be used to evaluate the performance...
PMC10578122
Statistical Analysis
A sample size of 26 would achieve 90% power to detect noninferiority with a 1-sided significance level of .025, and a cross-over design would have a margin of noninferiority of −10%, a true mean difference of 0, and an SD of the paired differences of 15, based on the test results from a previous study for understanding...
PMC10578122
Results
PMC10578122
SFA and WRS Results
WRS
The SHAA showed a slightly lower gain at all frequencies than the conventional HA, with statistical significance at 1000 Hz (Sound-field (warble-tone) audiometry thresholds in the HA and SHAA groups. Error bars indicate the SD. db HL: decibel of hearing level; HA: hearing aid; SHAA: smartphone-based hearing aid app. *I...
PMC10578122
REM Results
In real-ear aided responses at 55 dB, the HA showed a larger gain at 1000, 2000, 3000, 4000, and 6000 Hz than the SHAA. The SHAA showed a larger gain at low frequencies (250 and 500 Hz) than the HA. Statistical significance was found at 500 Hz (Real-ear aided responses (REARs) of the hearing aid and SHAA groups measure...
PMC10578122
HINT Results
The mean SNRs (HINT performance) in the unaided, HA, and SHAA groups were 51.3 (SD 5.6), 47 (SD 3.4), and 56 (SD 6.4) dB, respectively, in a quiet situation (Hearing-in-noise test (HINT) in quiet, front noise, left noise, and right noise conditions for the unaided, hearing aid, and SHAA groups. Error bars indicate the ...
PMC10578122
Questionnaire Results
The mean score of the IOI-HA was 7 (SD 0), 23.4 (SD 4.0), and 16.3 (SD 4.9) in the unaided, HA, and SHAA groups, respectively (International Outcome Inventory for Hearing Aids (IOI-HA) items for the unaided, hearing aid, and SHAA groups. Error bars represent the SD. SHAA: smartphone-based hearing aid app. *In the ease ...
PMC10578122
Discussion
PMC10578122
Principal Findings
REMs, WRS
This study used a noninferiority study design to compare the audiological performance between an SHAA and a conventional HA. The SHAA did not show noninferiority to the HA in the WRS test, which was the primary measurement used in the original study. However, the SHAA showed feasibility in some users, especially in una...
PMC10578122
Strengths and Limitations
To the best of our knowledge, this is the first prospective, multicenter randomized controlled trial comparing an SHAA and a conventional HA. Hearing performance was evaluated for comprehensive objective functional gain and for subjective satisfaction.In this study, we enrolled Android users who used their own smartpho...
PMC10578122
Conclusion
hearing loss
HEARING LOSS
In our study, the SHAA demonstrated a significant benefit when compared to an unaided situation. Our results indicate that the SHAA could be a useful assistive device for patients with mild-to-moderate hearing loss in quiet conditions. In addition, people with poor access to hearing amplification devices can more easil...
PMC10578122
Abbreviations
Abbreviated Profile of Hearing Aid Benefithearing aidhearing-in-noise testInternational Outcome Inventory for Hearing Aidspersonal sound amplification productpure-tone audiometryreal-ear measurementsound-field audiometrysmartphone-based hearing aid appsignal-to-noise ratiosound pressure levelWorld Health Organizationwo...
PMC10578122
References
CONSORT-eHEALTH checklist (V 1.6.1).
PMC10578122
1. Introduction
deaths, death, premature illness
PROLIFERATION, DISEASE, DISEASES
Young children are particularly vulnerable to harms from tobacco smoke exposure (TSE). This study aimed to compare TSE: (1) between children who live in smoking families and those who do not; and (2) among children who live in smoking households with varying smoking locations. The data came from two studies that were c...
PMC9965201
2. Materials and Methods
PMC9965201
2.1. Study Design, Samples and Procedures
The data came from two studies that were conducted in Israel at the same time between 2016 and 2018. The first study (Study 1) was a randomized controlled trial (RCT), “Project Zero Exposure,” which included 159 families with at least one parent who smoked cigarettes living in the household. The RCT assessed an interve...
PMC9965201
2.2. Eligibility Criteria
Inclusion criteria included: (1) at least one smoking parent living in the household who smoked at least 10 cigarettes per week (Study 1) or no parents who smoked in the household (Study 2); (2) having a child aged up to 8 years; (3) the parent(s) were willing to provide a hair sample for research purposes; and (4) chi...
PMC9965201
2.3. Ethics and Registration
National Institute of Health (NIH) Clinical Trials Registry: NCT02867241. Ethical approval was obtained from the Helsinki Committee of Asaf Harofe Hospital (0143-16 ASF), the Israel Ministry of Health (920090057), and the Tel Aviv University Ethics Committee. All parents provided written consent for their children to p...
PMC9965201
2.4. Measures
PMC9965201
2.4.1. Primary Outcome
The primary outcome for this analysis was child exposure to tobacco smoke, measured by hair nicotine. Child hair nicotine was chosen because it reflects long-term exposure (approximately 1 cm of hair growth/month) [We analyzed TSE in two ways. First, we assessed TSE as a binary variable indicating “exposed” (yes, above...
PMC9965201
2.4.2. Independent Measures
Study 1 vs. Study 2: The independent variable for the first analyses was whether the children were from smoking or non-smoking families. Study 1: The independent variable for the second assessment was the location of smoking. We asked parents to show us where they usually smoked, with the question “Where does smoking u...
PMC9965201
2.5. Statistical Analyses
Descriptive statistics were used to describe the study samples.
PMC9965201
2.5.1. Analyses, Smoking Families vs. Nonsmoking Families (Study 1 vs. Study 2)
We compared child TSE (above the LOD: yes vs. no) between non-smoking and smoking families using a chi-squared test. We used a linear model to compare child exposure between non-smoking and smoking families as measured by log-hair nicotine (LHN) while controlling for laboratory batch. Because of the small number of par...
PMC9965201
2.5.2. TSE by Location of Home Smoking and Other Explanatory Variables (Study 1)
CPD
REGRESSION
We first assessed TSE by location of home smoking using the LOD (dichotomous outcome: exposed vs. not exposed) using a chi-squared test. We also tested the bivariate relationship between above-LOD exposure and each of the following variables: number of parental smokers (both or one), child sex, parental nationality, ma...
PMC9965201
3. Results
PMC9965201
3.2. Characteristics of Smoking and Non-Smoking Families
Among non-smoking families, 3 of the 20 families reported that smoking sometimes took place on porches, but none of them reported smoking occurring in any other setting.
PMC9965201
3.3. Laboratory Batch Results
For the ten batches analyzed, LOD (ng/mg) ranged from 0.014–0.18 (mean LOD: 0.034, median LOD: 0.038). One batch had an LOD of 0.18 and another of 0.09. All other batches had LODs between 0.01 and 0.05. A histogram of hair mass can be found in
PMC9965201
3.4. Child TSE in Smoking vs. Nonsmoking Families
REGRESSION
Of the 141 children from smoking families with sufficient hair, 68.8% (In the linear regression of LHN, which included a term for laboratory batch, the group variable was borderline significant (
PMC9965201
3.6. The Association between Child TSE and Other Variables in Smoking Families
The only variable to reach statistical significance in the bivariable comparisons of the proportion of children exposed (Model 1) was paternal education (
PMC9965201
4. Discussion
The purpose of this study was to compare tobacco smoke exposure [TSE] among children who live in smoking families versus those who do not, as well as among children who live in smoking households with varying smoking locations. We found that about a third of children of non-smoking parents were measurably exposed to to...
PMC9965201
Public Health Implications
In order to protect children from tobacco smoke exposure, consistent with current scientific evidence on smoke drift outdoors and indoors, smoking should not take place anyplace within at least 9 m [Parents will need substantial support to be able to make changes to better protect their children. We recommend intensive...
PMC9965201
5. Conclusions
Most children in participating smoking families were exposed to tobacco smoke regardless of whether the parents restricted smoking to a balcony, to designated indoor places such as “in the window,” or to the yard. To protect children from tobacco smoke in the Israeli setting, indoor home porches and outdoor porches tha...
PMC9965201