Varenicline decreases alcohol consumption in heavy-drinking smokers

Rationale Emerging evidence suggests that the α4β2 form of the nicotinic acetylcholine receptor (nAChR) modulates the rewarding effects of alcohol. The nAChR α4β2 subunit partial agonist varenicline (Chantix™), which is approved by the Food and Drug Administration for smoking cessation, also decreases ethanol consumption in rodents (Steensland et al., Proc Natl Acad Sci U S A 104:12518–12523, 2007) and in human laboratory and open-label studies (Fucito et al., Psychopharmacology (Berl) 215:655–663, 2011; McKee et al., Biol Psychiatry 66:185–190 2009). Objectives We present a randomized, double-blind, 16-week study in heavy-drinking smokers (n = 64 randomized to treatment) who were seeking treatment for their smoking. The study was designed to determine the effects of varenicline on alcohol craving and consumption. Outcome measures included number of alcoholic drinks per week, cigarettes per week, amount of alcohol craving per week, cumulative cigarettes and alcoholic drinks consumed during the treatment period, number of abstinent days, and weekly percentage of positive ethyl glucuronide and cotinine screens. Results Varenicline significantly decreases alcohol consumption (χ 2 = 35.32, p < 0.0001) in smokers. Although varenicline has previously been associated with suicidality and depression, side effects were low in this study and declined over time in the varenicline treatment group. Conclusions Varenicline can produce a sustained decrease in alcohol consumption in individuals who also smoke. Further studies are warranted to assess varenicline efficacy in treatment-seeking alcohol abusers who do not smoke and to ascertain the relationship between varenicline effects on smoking and drinking.

The α5 neuronal nicotinic acetylcholine receptor subunits plays an important role in the sedative effects of ethanol but does not modulate consumption in mice

Alcohol use disorders (AUDs) are a major public health problem, and the few treatment options available to those seeking treatment offer only modest success rates. There remains a need to identify novel targets for the treatment of AUDs. The neuronal nicotinic acetylcholine receptors (nAChRs) represent a potential therapeutic target in the brain, as recent human genetic studies have implicated gene variants in the α5 nAChR subunit as high risk factors for developing alcohol dependence. Here, we evaluate the role of 5* nAChR for ethanol-mediated behaviors using α5+/+ and α5-/- mice. We characterized the effect of hypnotic doses of ethanol and investigated drinking behavior using an adapted Drinking-in-the Dark (DID) paradigm that has been shown to induce high ethanol consumption in mice. We found the α5 subunit to be critical in mediating the sedative effects of ethanol. The α5-/- mice showed slower recovery from ethanol-induced sleep, as measured by loss of righting reflex. Additionally the α5-/- mice showed enhanced impairment to ethanol-induced ataxia. We found the initial sensitivity to ethanol and ethanol metabolism to be similar in both α5+/+ and α5-/- mice. Hence the enhanced sedation is likely due to a difference in the acute tolerance of ethanol in mice deficient of the α5 subunit. However the α5 subunit did not play a role in ethanol consumption for ethanol concentrations ranging from 5% to 30% in the DID paradigm. Additionally, varenicline (Chantix®) was effective in reducing ethanol intake in α5-/- mice. Together, our data suggest that the α5 nAChR subunit is important for the sedative hypnotic doses of ethanol but does not play a role in ethanol consumption. Varenicline can be a treatment option even when there is loss of function of the α5 nAChR subunit.

The dual orexin/hypocretin receptor antagonist, almorexant, in the ventral tegmental area attenuates ethanol self-administration

Recent studies have implicated the hypocretin/orexinergic system in reward-seeking behavior. Almorexant, a dual orexin/hypocretin R1 and R2 receptor antagonist, has proven effective in preclinical studies in promoting sleep in animal models and was in Phase III clinical trials for sleep disorders. The present study combines behavioral assays with in vitro biochemical and electrophysiological techniques to elucidate the role of almorexant in ethanol and sucrose intake. Using an operant self-administration paradigm, we demonstrate that systemic administration of almorexant decreased operant selfadministration of both 20% ethanol and 5% sucrose. We further demonstrate that intraventral tegmental area (VTA) infusions, but not intra substantia nigra infusions, of almorexant reduced ethanol self-administration. Extracellular recordings performed in VTA neurons revealed that orexin-A increased firing and this enhancement of firing was blocked by almorexant. The results demonstrate that orexin/hypocretin receptors in distinct brain regions regulate ethanol and sucrose mediated behaviors.

Employment and industrial law in paramedic practice

This chapter will provide you with the some of the information you may need to make information on decisions in cases such as the one given above. In particular it will help you answer questions such as: 1. As Molly and Vikram are approaching the end of their shift, to attend will force them into overtime; could they refuse to attend the job on the basis of the refusal to do overtime outside of contracted hours? 2. Would their refusal be viewed as a breach of contract and therefore a disciplinary issue? 3. Why? 4. Does the need to attend this possibly gravely ill patient outweigh the demands of the paramedics to finish on time?

Analysis of indirect message injection for MAC generation using stream ciphers

This paper presents a model for generating a MAC tag with a stream cipher using the input message indirectly. Several recent proposals represent instances of this model with slightly different options. We investigate the security of this model for different options, and identify cases which permit forgery attacks. Based on this, we present a new forgery attack on version 1.4 of 128-EIA3. Design recommendations to enhance the security of proposals following this general model are given.

Corporate social responsibility and communication

Corporate activities are increasingly scrutinized for their effect on society and the environment. It is unthinkable that a corporation today will declare publicly that its only goal is to make money for its shareholders. Instead, corporations typically claim to balance the needs of society and the environment against the need to make a profit. That is, corporations say they practice corporate social responsibility (CSR). This edited volume explores the complexities of this seemingly simple claim.As such it is an essential resource to complement the latest academic thinking from management and communication research on how corporations communicate about CSR This chapter presents an overview of the book.

Public relations and corporate social responsibility

This study analyses trends and patterns in public relations literature about Corporate Social Responsibility (CSR) through a content analysis of articles published between 1998 and 2007. The current status of the literature suggests that public relations scholars have broadened their approach to CSR from one solely encompassing communication management, as proposed by Clark (2000), to one that incorporates the management function and relationship management components of contemporary public relations thinking. The findings of the literature review suggest that there are opportunities for social responsibility to be incorporated into public relations through a process approach, which would foster stronger links between organizations, stakeholders and society.

A general model for MAC generation using direct injection

This paper presents a model for generating a MAC tag by injecting the input message directly into the internal state of a nonlinear filter generator. This model generalises a similar model for unkeyed hash functions proposed by Nakano et al. We develop a matrix representation for the accumulation phase of our model and use it to analyse the security of the model against man-in-the-middle forgery attacks based on collisions in the final register contents. The results of this analysis show that some conclusions of Nakano et al regarding the security of their model are incorrect. We also use our results to comment on several recent MAC proposals which can be considered as instances of our model and specify choices of options within the model which should prevent the type of forgery discussed here. In particular, suitable initialisation of the register and active use of a secure nonlinear filter will prevent an attacker from finding a collision in the final register contents which could result in a forged MAC.

Slide attacks on the Sfinks stream cipher

Sfinks is a shift register based stream cipher designed for hardware implementation and submitted to the eSTREAM project. In this paper, we analyse the initialisation process of Sfinks. We demonstrate a slid property of the loaded state of the Sfinks cipher, where multiple key-IV pairs may produce phase shifted keystream sequences. The state update functions of both the initialisation process and keystream generation and also the pattern of the padding affect generation of the slid pairs.

State convergence in bit-based stream ciphers

Well-designed initialisation and keystream generation processes for stream ciphers should ensure that each key-IV pair generates a distinct keystream. In this paper, we analyse some ciphers where this does not happen due to state convergence occurring either during initialisation, keystream generation or both. We show how state convergence occurs in each case and identify two mechanisms which can cause state convergence.

Slid pairs in the initialisation of the A5/1 stream cipher

A5/1 is a shift register based stream cipher which uses a majority clocking rule to update its registers. It is designed to provide privacy for the GSM system. In this paper, we analyse the initialisation process of A5/1. We demonstrate a sliding property of the A5/1 cipher, where every valid internal state is also a legitimate loaded state and multiple key-IV pairs produce phase shifted keystream sequences. We describe a possible ciphertext only attack based on this property.