Background To reduce the global burden of tobacco use, clinical guidelines support behavioral therapy and pharmacotherapy as preferred interventions for tobacco cessation. The evidence-based behavioral interventions has consistently shown to be impactful in community settings; however, its efficacy has not been established in hospital settings. The current study aims to investigate impact of trans-theoretical-based behavioral intervention package on tobacco users suffering from non-communicable diseases attending tertiary care settings of North India. Methods/design A two-arm randomized controlled trial (RCT) in a tertiary healthcare hospital will be performed. A total of 360 tobacco users attending NCD clinics in four departments, cardiology, neurology, pulmonary medicine, and ENT (otolaryngology), will be recruited over a period of 3 months. After ascertaining the eligibility criteria, they will be followed up to 6 months (1, 3, 6) for their tobacco use status, readiness to quit, nicotine dependence, stage of behavior change, and self-reported and biochemical validation (urine cotinine) for tobacco abstinence. Assignment of intervention including allocation concealment, sequence generation, and blinding will be done as per SPIRIT guidelines for RCT protocols. Discussion As no strong evidence exists about the effectiveness of tobacco cessation intervention in tertiary settings, the current study will build evidence about the similar interventions in such settings. Trial registration CTRI/2019/09/021406.

In order to cater long distance optical network units (subscribers), optical networks with prolonged reach are needed. In this study, an optical back propagation (OBP) dual polarization (DP)-128 QAM-based system is proposed to cope with nonlinear impairments in wavelength division multiplexing (WDM) systems. In pre, post and symmetrical configurations, the OBP module consisting of the optical phase conjugator (OPC), Raman fiber amplifier (RFA) and erbium doped fiber amplifier (EDFAs) is examined. Using dispersion compensation fiber (DCF) as RFA with dual directional pumping, ideal OBP conditions are simulated. DP-128 quadrature amplitude modulation (QAM) system is proposed with symmetrical OBP and compared with single channel digital back propagation (DBP), wideband DBP, pre OBP-forward pumping, pre OBP with backward pumping, pre OBP with dual directional pumping, post OBP with dual directional pumping. It is observed that symmetrical OBP configuration with dual direction pumping provide enhanced results and successfully cover 6500 km at bit error rate (BER) 10−3.

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BackgroundDespite substantial progress in tobacco control in the last two decades, there is limited literature on the most effective tobacco cessation behavioral intervention. This network meta-analysis will compare various behavior change intervention for tobacco cessation and attempt to rank them to identify the best approach for cessation.MethodologyThe network meta-analysis will include randomized controlled trials on behavior change for tobacco cessation. The PICOS framework will be used while selecting the studies from various established scientific databases viz. Pubmed, Scopus, Embase, and other sources including Clinicaltrial.gov. The primary outcome for this review will be sustained or point prevalence tobacco abstinence at 6 months or 12 months. To graphically depict and document the studies Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines along with PRISMA Network Meta-Analysis extension statement will be used.ConclusionThe network meta-analysis will provide the rankings of behavior change interventions thus determining the most and least effective modality for tobacco cessation. The information obtained will be an important guide for policymakers, implementors, and researchers to choose the priority cessation intervention.RegistrationProtocol of this review and network meta-analysis was registered in PROSPERO: International prospective register of systematic reviews (registration number: CRD42020145768).