The Usefulness of a Smartphone App-Based Smoking Cessation Program for Conventional Cigarette Users, Heated Tobacco Product Users, and Dual Users: Retrospective Study.

BACKGROUND: Heated tobacco products (HTPs) are widespread in Japan, and smoking cessation of such products has become an important issue owing to the spread of harmful effects from HTPs. The efficacy of online digital therapy has been reported in smoking cessation treatment; however, we have limited evidence of online smoking cessation programs for HTP users. OBJECTIVE: In this study, we evaluate the usefulness of the Ascure program for HTP users (defined as exclusive HTP use or dual use of HTP and cigarettes) compared with exclusive cigarette users. METHODS: This was a retrospective study. We recruited adult smokers participating in the Ascure online smoking cessation program in Japan from June 2019 to February 2021. The Ascure smartphone app provided four elements: (1) educational video tutorials to enhance the understanding of nicotine dependence, (2) a personalized to-do list for behavior change, (3) a digital diary for record keeping, and (4) interactive chat sessions for relief from cravings or withdrawal symptoms. The primary outcome was the continuous abstinence rate (CAR) at weeks 21 to 24, biochemically validated using salivary cotinine testing. We considered those who dropped out of the program as smoking cessation failures. We analyzed the primary outcome using inverse probability weighting against tobacco product type estimated by multinomial propensity scores. We also assessed CAR at weeks 9 to 12 and program adherence. RESULTS: We analyzed data from 2952 participants, including 52% (1524/3478) in the cigarette group, 35% (1038/3478) in the HTP group, and 13% (390/3478) in the dual-use group, who had a mean age of 43.4 (SD 10.8) years and included 17% (513/2952) women. CAR at weeks 21 to 24 showed that exclusive HTP users were more likely to stop tobacco use than exclusive cigarette smokers (CAR 52.6% for cigarette users vs CAR 64.8% for HTP users; odds ratio [OR] 1.17, 95% CI 1.12-1.22; P<.001). There was no significant difference between the exclusive cigarette users and the dual users (CAR 52.6% for cigarette users vs CAR 48.7% for dual users; OR 0.99, 95% CI 0.93-1.05; P=.77). CAR at weeks 9 to 12 was 56.7% (95% CI 54.2%-59.2%) for the exclusive cigarette users, 68.3% (95% CI 65.5%-71.1%) for the exclusive HTP users, and 58.2% (95% CI 53.3%-63.1%) for the dual users. The program adherence rate at week 24 was 70.7% overall (68.4% for cigarette users, 75% for HTP users, and 67.9% for dual users). CONCLUSIONS: Exclusive HTP users had higher CARs and adherence compared with exclusive cigarette users, indicating a higher affinity for the Ascure online smoking cessation program. This program might be a useful smoking cessation option for HTP users, as well as for cigarette smokers.

First report of Pleistophora hyphessobryconis infection in medaka Oryzias latipes, an important ornamental and laboratory fish in Japan.

Medaka Oryzias latipes is a small freshwater fish widely distributed in Japan. It is a popular ornamental fish and now has been recognized as an important model organism in many areas of biological research. Here we report microsporidian infections for the first time in medaka, from 2 research facilities and a wild population. Infected medaka exhibited abnormal appearance with whitish trunk muscle, and microsporidian spores were detected from the affected tissue. The size of spores was similar in all the three cases: 7.0 µm in length and 3.7-4.2 µm in width. In the histological observation, numerous sporophorous vesicles containing spores or other developmental stages were observed within the myocytes of the trunk muscle. Nucleotide sequence of the ribosomal RNA gene was determined and it was identical among all three cases. A BLAST search revealed it shared 99.5-99.6% identity with Pleistophora hyphessobryconis, a microsporidian known to infect >20 freshwater fish species. Light microscopic observation of spores and histological features also indicated the microsporidian infection in medaka is caused by P. hyphessobryconis. This is the first record of the microsporidian species from medaka and from Japan.

Surgical management of a dermoid cyst with mandibular gland tissue in a Japanese Black calf.

A 131-day-old male Japanese Black calf presented with a swollen right cheek from birth. Imaging examination revealed a cyst under the right buccal area and debris-containing fluid inside the cyst, and puncture aspiration revealed a mildly cloudy fluid containing hair and tissue fragments. Histological examination of the excised cyst revealed stratified squamous epithelium with skin appendages in the cyst wall, which was diagnosed as a dermoid cyst. In addition, some submandibular gland tissue was found within the cyst wall. After removal of the cyst, there was swelling in the same area, which resolved with steroid administration. Surgical treatment of buccal dermoid cysts should be performed with caution to avoid damage to adjacent salivary gland tissue.