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Purpose: The high prevalence of COVID-19 has had an impact on the Quality of Life (QOL) of people across the world, particularly students. The purpose of this study was to investigate the social, lifestyle, and mental health aspects that are associated with QOL among university students in Lebanon. Methods: A cross-sectional study design was implemented using a convenience sampling approach. Data collection took place between November 2021 and February 2022, involving 329 undergraduate and graduate students from private and public universities. Quality of life was assessed using the Quality-of-Life Scale (QOLS). Descriptive statistics, Cronbach's alpha, and linear regression-based methods were used to analyze the association between QOL and socio-demographic, health-related, lifestyle, and mental health factors. The significance level for statistical analysis was predetermined at α = 0.05. Results: The study participants' average (SD) QOL score was 76.03 (15.6) with a Cronbach alpha of 0.911. QOL was positively associated with importance of religion in daily decisions (β = 6.40, p = 0.006), household income (β = 5.25, p = 0.017), general health ratings (β Excellent/poor = 23.52, p <0.001), access to private counseling (β = 4.05, p = 0.020), physical exercise (β = 6.67, p <0.001), and a healthy diet (β = 4.62, p = 0.026); and negatively associated with cigarette smoking (β increased = -6.25, p = 0.030), internet use (β ≥4 hours = -7.01, p = 0.005), depression (β = -0.56, p = 0.002) and stress (β = -0.93, p <0.001). Conclusion: In conclusion, this study reveals the key factors that positively and negatively influence students' quality of life (QOL). Factors such as religion, higher income, and a healthy diet improve QOL, while depression, stress, excessive internet use, and cigarette smoking negatively impact it. Universities should prioritize initiatives like physical activity promotion, affordable nutritious options, destigmatizing mental health, counseling services, and self-help interventions to support student well-being and enhance their QOL. [ABSTRACT FROM AUTHOR]

Purpose: Ischemic stroke (IS), a serious cerebrovascular disease, greatly affects people's health and life. Genetic factors are indispensable for the occurrence of IS. As a biomarker for IS, the MMP-9 gene is widely involved in the pathophysiological process of IS. This study attempts to find out the relationship between MMP-9 polymorphisms and IS susceptibility. Methods: A total of 700 IS patients and 700 healthy controls were recruited. The single nucleotide polymorphism (SNP) markers of the MMP-9 gene were genotyped by the MassARRAY analyzer. Multifactor dimensionality reduction (MDR) was applied to generate SNP-SNP interaction. Furthermore, the relationship between genetic variations (allele and genotype) of the MMP-9 gene and IS susceptibility was analyzed by calculating odds ratios (ORs) and 95% confidence intervals (CIs). Results: Our results demonstrated that rs2250889 could significantly increase the susceptibility to IS in the codominant, dominant, overdominant, and log-additive models (p < 0.05). Further stratification analysis showed that compared with the control group, rs2250889 was associated with IS risk in different case groups (age, female, smoking, and non-drinking) (p < 0.05). Based on MDR analysis, rs2250889 was the best model for predicting IS risk (cross-validation consistency: 10/10, OR = 1.56 (1.26-1.94), p < 0.001). Conclusion: Our study preliminarily confirmed that SNP rs2250889 was significantly associated with susceptibility to IS. [ABSTRACT FROM AUTHOR]

Background: Occupational respiratory diseases are major global public health problems, particularly for industry workers. Several studies have investigated occupational respiratory symptoms in various parts of Ethiopia. The findings have been inconsistent and inconclusive, and there is no nationally representative data on the subject. Therefore, this study aimed to estimate the pooled prevalence and factors associated with occupational respiratory symptoms among industry workers in Ethiopia (2010–2022). Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework Guidelines, search was conducted on several international databases including PubMed, CINAHL, African Journals Online, Hinari, Global Health, and Google scholar. The extracted data was analyzed using STATA 14. Random effect model was used to estimate the effect size. Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity, respectively among the reviewed articles. Results: The meta-analysis included a total of 15 studies with 5,135 participants, revealing a pooled prevalence of 51.6% (95% CI: 43.6–59.6) for occupational respiratory symptoms among industry workers in Ethiopia. The absence of personal protective equipment (OR = 1.97, 95% CI: [1.17–3.32]), lack of occupational health and safety training (OR = 3.04, 95% CI: [2.36–3.93]), previous dust exposure (OR = 3.17, 95% CI: [2.3–4.37]), poor working environment (OR = 2.4, 95% CI: [1.7–3.2]), work experience greater than five years (OR = 4.04, 95% CI: [1.61–10.16]), smoking (OR = 6.91, 95% CI: [2.94–16.2]), and previous respiratory illness (OR = 4.25, 95% CI: [2.44–7.42]) were found to associate with the symptoms. Conclusions: The high prevalence of occupational respiratory symptoms among industry workers in Ethiopia underscores the urgent need for effective interventions. The provision of personal protective equipment and improvement of working environments by the government, industry owners, and other stakeholders are crucial in reducing occupational respiratory symptoms. Additionally, prioritizing occupational health and safety training for industry workers can help prevent and mitigate the impact of occupational respiratory diseases. Registration: This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42022383745. [ABSTRACT FROM AUTHOR]

Background: Maternal exposures to environmental hazards during pregnancy are key determinants of birth outcomes that affect health, cognitive and economic status later in life. In Ethiopia, various epidemiological evidences have suggested associations between environmental exposures such as household air pollution, cigarette smoking, and pesticide exposure and pregnancy outcomes such as low birth weight, preterm birth, and birth defects. Objective: This review aimed at generating summarized evidence on the association between maternal exposure to environmental factors (household air pollution, cigarette smoking, and pesticide) and pregnancy outcomes (birth weight, preterm birth, and birth defects) in Ethiopia. Method: A systematic literature search was performed using PubMed, Google Scholar, and the Cochrane Library databases. All observational study designs were eligible for inclusion in the review. Quality assessment was conducted using the Newcastle-Ottawa Scale (NOS) quality assessment tools adopted for case-control and cross-sectional studies. The random-effects model was applied in computing the pooled estimates and their corresponding 95% confidence interval (CI). Funnel and Doi plots were used for detecting the potential publication bias. All statistical analyses were performed using comprehensive meta-analysis (CMA 2.0) and MetaXL version 5.3 software. Result: The pooled estimates revealed that prenatal biomass fuel use increased the risk of giving a low birth weight baby by twofold (OR = 2.10, 95% CI: 1.33–3.31), and has no separate kitchen increases the risk of having low birth weight baby nearly by two and half times (OR = 2.48, 95% CI: 1.25–4.92). Overall, using biomass fuel as the main energy source for cooking and /or having no separate kitchen from the main house is 2.37 times more likely to give low birth weight babies (OR = 2.37, 95% CI: 1.58–3.53). Active cigarette smoker women were 4 times (OR = 4.11, 95% CI: 2.82–5.89) more prone to have low birth weight babies than nonsmokers; and passive smoker women were 2.6 times (OR = 2.63, 95% CI: 1.09–6.35) more risked to give low birth weight babies. It was also estimated that active cigarette smoker women were nearly 4 times (OR = 3.90, 95% CI: 2.36–6.45) more likely to give preterm birth babies. Pesticide exposure during pregnancy also increases the risk of the birth defect 4 times (OR = 4.44, 95% CI: 2.61–7.57) compared with non-exposed pregnant women. Conclusion: Household air pollution from biomass fuel use, active and passive cigarette smoking, and pesticide exposures are significantly associated environmental risk factors for low birth weight, preterm birth, and birth defects in Ethiopia. Therefore, Pregnant and lactating women should be aware of these environmental hazards during pregnancy. Promoting clean energy and improved and efficient stoves at the household level will help to reduce household air pollution-related adverse health effects. Trial registration: PROSPERO 2022: CRD42022337140. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a mental illness, which is a notable public health problem that aggravates the global economic burden. This study aimed to investigate the causal relationship between education and MDD risk and the contributions of effects mediated by four modifiable factors. Materials and methods: Instrumental variables were screened from several large-scale genome-wide association study (GWAS) data (years of schooling with 766,345 participants, MDD with 59,851 cases and 113,154 controls, neuroticism with 329,821 individuals, smoking behavior with 195,068 cases and 164,638 controls, body mass index [BMI] with 336,107 individuals, and household income with 397,751 individuals). The data were used to evaluate the association of the four modifiable factors (neuroticism, smoking behavior, BMI, and household income) that mediate the effect of education on MDD risk via Mendelian randomization (MR) analysis. Results: Each standard deviation increase in years of schooling could reduce the risk for MDD by 30.70%. Higher neuroticism and BMI were associated with a higher risk of MDD. Non-smoking status and increased household income were protective factors for MDD. Notably, the mediator neuroticism, BMI, smoking behavior, and household income explained 52.92%, 15.54%, 31.86%, and 81.30% of the effect of years of schooling on MDD risk, respectively. Conclusions: Longer years of schooling have a protective effect on MDD risk. Reasonable interventions to reduce neuroticism, BMI, smoking, and increasing household income are beneficial for MDD prevention. Our work provides new ideas for the development of prevention strategies for MDD. [ABSTRACT FROM AUTHOR]

Beginning in May 2022, Mpox virus spread rapidly in high-income countries through close human-to-human contact primarily amongst communities of gay, bisexual and men who have sex with men (GBMSM). Behavioural change arising from increased knowledge and health warnings may have reduced the rate of transmission and modified Vaccinia-based vaccination is likely to be an effective longer-term intervention. We investigate the UK epidemic presenting 26-week projections using a stochastic discrete-population transmission model which includes GBMSM status, rate of formation of new sexual partnerships, and clique partitioning of the population. The Mpox cases peaked in mid-July; our analysis is that the decline was due to decreased transmission rate per infected individual and infection-induced immunity among GBMSM, especially those with the highest rate of new partners. Vaccination did not cause Mpox incidence to turn over, however, we predict that a rebound in cases due to behaviour reversion was prevented by high-risk group-targeted vaccination. An outbreak of Mpox in the UK began in May 2022 and peaked in July. In this modelling study, the authors show that the decline in cases was likely due to behavioural changes among high-risk populations, whilst vaccination could prevent a rebound. [ABSTRACT FROM AUTHOR]

Cigarette butt–littering behavior is common among most smokers. The present study aimed to determine the predictors of butt-littering behavior in a sample of Iranian male current smokers based on the Bandura's social cognitive theory variables. In this cross-sectional study, 291 smokers who throw their cigarette butts in public parks in Tehran city, Iran were selected and completed the study instrument. Finally, the data were analyzed. The average number of butts littered daily by the participants was 8.59 (± 8.661). The results of multiple Poisson regression showed that knowledge, perceived self-efficacy, positive and negative outcome expectations, self-regulation, and observational learning variables were statistically significant predictors of butt-littering behavior among the participants. It is concluded that Bandura's social cognitive theory is a suitable theoretical framework for predicting butt-littering behavior and might be used to develop theory-based environmental education efforts in this field. [ABSTRACT FROM AUTHOR]

Urban smoke exposure events from large wildfires have become increasingly common in California and throughout the western United States. The ability to study the impacts of high smoke aerosol exposures from these events on the public is limited by the availability of high-quality, spatially-resolved estimates of aerosol concentrations. Methods for assigning aerosol exposure often employ multiple data sets that are time consuming and expensive to create and difficult to reproduce. 5 As these events have gone from occasional to nearly annual in frequency, the need for rapid smoke exposure assessments has increased. The rapidfire R package (version 0.1.3) provides a suite of tools for developing exposure assignments using data sets that are routinely generated and publicly available within a month of the event. Specifically, rapidfire harvests official air quality monitoring, satellite observations, meteorological modeling, operational predictive smoke modeling, and low-cost sensor networks. A machine learning approach (random forests regression) is used to fuse the different data sets. Using rapidfire, 10 we produced estimates of ground-level 24-hour average particulate matter for several large wildfire smoke events in California from 2017-2021. These estimates show excellent agreement with independent measures from filter-based networks. [ABSTRACT FROM AUTHOR]

Background: Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer. While multiple risk factors for iCCA have been established, metabolic diseases (obesity, diabetes, NAFLD, dyslipidemia, and hypertension) and other risk factors, including smoking and drinking, are still controversial due to their potential confounders. Here, Mendelian randomization (MR) analysis was performed to identify the causal relationship between them. Method: In this study, we obtained GWAS data related to exposures from corresponding large genome-wide association studies. Summary-level statistical data for iCCA were obtained from the UK Biobank (UKB). We performed a univariable MR analysis to identify whether genetic evidence of exposure was significantly associated with iCCA risk. A multivariable MR analysis was conducted to estimate the independent effects of exposures on iCCA. Results: Univariable and multivariable MR analysis based on the large GWAS data indicated that there is little evidence to support the genetic role of metabolic factors, smoking, drinking, and NAFLD in iCCA development (P >0.05). In contrast to most current studies, their impact on iCCA development, if any, might be smaller than we thought. The previous positive results might be due to the comorbidities between diseases and potentially unavoidable confounding factors. Conclusion: In this MR study, we found no strong evidence to support causal associations between metabolic factors, NAFLD, smoking, drinking, and iCCA risk. [ABSTRACT FROM AUTHOR]

Background: To explore the relationship of peroxiredoxin6 (PRDX6) tag‐single nucleotide polymorphisms (SNPs) with susceptibility to chronic obstructive pulmonary disease (COPD) in the Chinese Han population. Methods: A total of 502 patients with COPD and 481 healthy controls from nine hospitals in China were enrolled in this study. The PRDX6 tag‐SNPs were identified by linkage disequilibrium (LD) analysis in 30 healthy controls. The associations between identified tag‐SNPs and COPD risk were further evaluated. Results: Four PRDX6 tag‐SNPs, including rs7314, rs34619706, rs33951697, and rs4382766, were identified in 30 healthy controls. Moreover, in the allele model, there was no statistical difference in locus in PRDX6 between patients with COPD and healthy controls (P > 0.05). However, in the recessive model, rs33951697 locus in PRDX6 gene carrier with T/T had an increased risk of COPD (odds ratio [OR] = 2.59, 95% CI = 1.06–6.33, P = 0.028). Furthermore, in the relevance analysis between genetic polymorphisms and smoking behavior and lung function indexes, we found that the number of smoked cigarettes per day and FEV1/FVC differed among different genotypes of PRDX6, rs4382766, and rs7314 (P < 0.05). Conclusion: PRDX6 gene polymorphism with smoking status may contribute to the etiology of COPD in the Chinese Han population. [ABSTRACT FROM AUTHOR]

Background: The purpose of this single-center study was to investigate the management and prevention of diabetic foot ulcers (DFUs) in 100 patients. Our study evaluated various factors impacting DFUs, such as demographics, lifestyle, medical history, medication use, and risk factors for DFU development. We found that older age, male sex, and a longer duration of diabetes were significantly associated with the development of DFUs. Additionally, lifestyle factors, such as smoking and poor nutrition, were associated with an increased risk of DFU development. We also found that medication use, including insulin, ACE inhibitors, and nonsteroidal anti-inflammatory drugs, were associated with an increased risk of DFU development. Our findings suggest that patients with diabetes should be closely monitored by their healthcare provider to identify and manage risk factors for DFU development. Furthermore, lifestyle modifications and improved glycemic control should be recommended to prevent the development of DFUs. Materials and Methods This single-center study conducted in department of Diabetes and endocrinology Hayatabad Medical Complex Peshawar from Jan 2021 to july 2021 six month of duration of study included 145 participants with diabetes and a diagnosis of a DFU. Demographic data, lifestyle factors, medical history, medication use, and risk factors for DFU development were collected using a structured questionnaire and chart review. Data was analyzed using descriptive statistics and logistic regression to explore associations between different factors and the development of DFUs. Results The mean age of the participants was 61.7 ± 10.6 years and 45% of the participants were male. The mean duration of diabetes was 11.9 ± 7.5 years. Older age (OR 1.04, 95% CI 1.01-1.07, p=0.01), male sex (OR 2.96, 95% CI 1.24-7.09, p=0.02), and a longer duration of diabetes (OR 1.06, 95% CI 1.03-1.09, p=0.001) were significantly associated with the development of DFUs. Lifestyle factors, such as smoking (OR 3.54, 95% CI 1.70-7.36, p=0.001) and poor nutrition (OR 2.08, 95% CI 1.15-3.75, p=0.013), were associated with an increased risk of DFU development. Medication use, including insulin (OR 3.08, 95% CI 1.45-6.54, p=0.003), ACE inhibitors (OR 2.51, 95% CI 1.14-5.50, p=0.02), and nonsteroidal anti-inflammatory drugs (OR 6.25, 95% CI 2.01-19.24, p=0.001), were associated with an increased risk of DFU development. Conclusion Our findings suggest that patients with diabetes should be closely monitored by their healthcare provider to identify and manage risk factors for DFU development. Furthermore, lifestyle modifications and improved glycemic control should be recommended to prevent the development of DFUs. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study to evaluation of processes of change related to trans theoretical model of enhancing behaviors of healthcare workers User electronic Hookah. Material: A simple random sample with probability of 56 males and 2 females health care workers(HCW) for the two group with different position . The sample was collected for the study group in Mosul General hospital that they was 58 Healthcare workers. Results: This study show the relationship for third axis (process of change) between pre, post1, post2 Mean, Standard deviation and P-value that has been measured by paired T test for study. For the study there is statistically significance at confidence interval 95% between pre and post-test1,pre and post-test 2 because P-value. Conclusions: This study concluded that the Sample chosen are in the younger age (25 years and more). Majority of them possess upper middle class of family income in study, however this increases the risk of smoking. [ABSTRACT FROM AUTHOR]

Introduction. The interest in the field of organ transplantation and the first attempts at making experimental transplant interventions in Romania date from the very beginning of the 20th century. Nevertheless, the evolution of the donating activity and of organ transplantation in Romania has been confronted with a certain inconsistency and a lack of resources necessary to the development of the system. Method. The aim of this study is to analyze the dynamics of the transplantation activity in Romania between 2000 and 2020. The study was accomplished through the analysis of available data corresponding to the above-mentioned period, which were published in the database of the National Transplant Agency, Eurostat and the Global Observatory on Donation and Transplantation. The data were processed using the MedCalc Statistical Software, version 14.8.1 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Results. The activity of donation and organ transplantation in Romania has been maintained at a low level, with a rate of 3.44 donators pmp and a transplantation rate of 12.55 pmp, as reported for the year 2020. Romania remains at a transplantation rate of under 6.6 pmp, despite the considerable increase in the number of patients on the waiting lists, a fact which describes the picture of a relatively weak system, incapable of providing surgical interventions to cover the minimum needs that emerge within a calendar year. Conclusions. Our study points to the fact that the transplantation system in Romania is confronted with a major deadlock. Romania holds the last-but-one place in the ranking of countries in the European Union on transplant activity. The major impediment is the donation rate, which continues to be way below the European average, in a society where the awareness of the necessity to donate is very low, bureaucracy is cumbersome and there is a high degree of mistrust in the medical system, where the equipment is lacking and the infrastructure is incapable of providing services adapted to the modern standards. [ABSTRACT FROM AUTHOR]

• A new fractional order age-specific smoke epidemic model is proposed. • The Banach fixed point theorem and the Krasnoselskiis type are used to analyze the model's existence and uniqueness. • The Lagrange interpolation is used to obtain the desired solution analytically. This paper presents a nonlinear fractional mathematical model for the smoke epidemic that includes two age groups. To solve the smoke epidemic, the Atangana-Baleanu-Caputo fractional derivative is used. The Banach and Krasnoselskii type fixed point theorem is used to determine existence and uniqueness. We explored model stability using the Hyers-Ulam form of stability. Using Lagrange interpolation, the behaviour of the smoke epidemic of the 2-age group model is generated. The numerical simulation shows that the model has potential for both groups, and that age-specific interventions can be used to reduce smoking rates in the general population. [ABSTRACT FROM AUTHOR]

Background To reduce the harmful health effects of combustible cigarette smoke (CS), some (CS) users attempt to substitute CS with electronic cigarettes (ECIG) and/or heated tobacco products (HTP). In this animal study, we evaluated the acute effects of substituting CS consumption with ECIG or HTP thus mimicking the dual users' approach, on the lungs of a mouse model. Methods C57BL/6 mice were divided into Control, ECIG, HTP, CS, ECIG + CS, HTP + CS, and HTP + ECIG groups. Animals were exposed for 3 hours in AM and PM sessions to either air, CS, ECIG, or HTP for seven days. Lung injury was assessed by: wet to dry (W/D) ratio, albumin concentration in bronchoalveolar lavage fluid, expression of IL-1β, IL-6, and TNF-α, histopathology examination, reactive oxygen species (ROS) production, and assessment of cellular apoptosis. Results W/D ratio was significantly increased in mice exposed to CS only. Albumin leak and expression of IL-1β, IL-6, and TNF-a were elevated in CS, ECIG + CS, and HTP + CS. Histological examination revealed significant inflammatory cells infiltration, as well as collagen deposit in CS, ECIG + CS, HTP + CS. ROS production was significantly increased in CS, ECIG + CS, HTP + CS. Finally, cell death was also significantly increased in CS, ECIG + CS, and HTP + CS. Conclusion In this animal model, substituting 50% of daily CS exposure by either ECIG or HTP exposure did not result in significant attenuation of acute lung injury. [ABSTRACT FROM AUTHOR]

Introduction Improving adherence to nicotine replacement therapy (NRT) in pregnancy may result in higher smoking cessation rates. Informed by the Necessities and Concerns Framework, we developed an intervention targeting pregnancy NRT adherence. To evaluate this, we derived the NRT in pregnancy necessities and concerns questionnaire (NiP-NCQ), which measures perceived need for NRT and concerns about potential consequences. Aims and Methods Here we describe the development and content validation of NiP-NCQ. From qualitative work, we identified potentially modifiable determinants of pregnancy NRT adherence and classed these as necessity beliefs or concerns. We translated these into draft self-report items and piloted items on 39 pregnant women offered NRT and a prototype NRT adherence intervention, assessing distributions and sensitivity to change. After removing poorly performing items, smoking cessation experts (N = 16) completed an online discriminant content validation (DCV) task to determine whether retained items measure a necessity belief, concern, both, or neither construct. Results Draft NRT concern items encompassed safety for the baby, side effects, too much or insufficient nicotine, and addictiveness. Draft necessity belief items included perceived need for NRT for short- and longer-term abstinence, and desire to minimize or cope without NRT. Of 22 out of 29 items retained after piloting, four were removed following the DCV task: three were judged to measure neither construct and one possibly both. The final NiP-NCQ comprised nine items per construct (18 total). Conclusions The NiP-NCQ measures potentially modifiable determinants of pregnancy NRT adherence within two distinct constructs and may have research and clinical utility for evaluating interventions targeting these. Implications Poor adherence to NRT in pregnancy may result from low perceived need and concerns about consequences; interventions challenging these beliefs may yield higher smoking cessation rates. To evaluate an NRT adherence intervention informed by the Necessities and Concerns Framework, we developed the NiP-NCQ. Through the content development and refinement processes described in this paper, we derived an evidence-based, 18-item questionnaire measuring two distinct constructs within two nine-item subscales. Higher concerns and lower necessity beliefs indicate more negative NRT beliefs; NiP-NCQ may have research and clinical utility for interventions targeting these. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco has been linked multiple times to many health implications. The relationship between periodontitis and tobacco was thoroughly investigated in this systemic review to evaluate if tobacco specifically smoking impacts the progression of periodontal through impairing vascular and immunity mediators processes. Materials and Methods: The manual and electronic literature searches up to 2020 in the databanks of the EMBASE, MEDLINE, PUBMED, and SCOPUS were conducted. The search terms were "periodontitis," "periodontitis diseases," "smoking," "tobacco use," "tobacco," and "cigarette, pipe, and cigar." The types of studies included were restricted to the original studies and human trials. Analyses of subgroups and meta-regression were used to calculate the heterogeneity. Results: 15 papers total were considered in the review, however only 14 of them provided information that could be used in the meta-analysis. Smoking raises the incidence of periodontitis by 85% according to pooled adjusted risk ratios (risk ratio 1.845, CI (95%) =1.5, 2.2). The results of a meta-regression analysis showed that age, follow-up intervals, periodontal disease, the severity of periodontitis, criteria used to determine periodontal status, and loss to follow-up accounted for 54.2%, 10.7%, 13.5%, and 2.1% of the variation in study results. Conclusion: Smoking has an undesirable impact on periodontal incidence and development. Therefore, when taking the history of the patients at the initial visits the information about the habit of smoking has to be thoroughly noted. [ABSTRACT FROM AUTHOR]

Our study identified multiple novel loci associated with bladder cancer susceptibility, bringing the number of independent markers at genome-wide significance to 24. Genetic susceptibility markers, coupled with lifestyle risk factors such as smoking, could guide future preventive measures and screening strategies for bladder cancer. Genomic regions identified by genome-wide association studies (GWAS) for bladder cancer risk provide new insights into etiology. To identify new susceptibility variants for bladder cancer in a meta-analysis of new and existing genome-wide genotype data. Data from 32 studies that includes 13,790 bladder cancer cases and 343, 502 controls of European ancestry were used for meta-analysis. Log-additive associations of genetic variants were assessed using logistic regression models. A fixed-effects model was used for meta-analysis of the results. Stratified analyses were conducted to evaluate effect modification by sex and smoking status. A polygenic risk score (PRS) was generated on the basis of known and novel susceptibility variants and tested for interaction with smoking. Multiple novel bladder cancer susceptibility loci (6p.22.3, 7q36.3, 8q21.13, 9p21.3, 10q22.1, 19q13.33) as well as improved signals in three known regions (4p16.3, 5p15.33, 11p15.5) were identified, bringing the number of independent markers at genome-wide significance (p < 5 × 10−8) to 24. The 4p16.3 (FGFR3/TACC3) locus was associated with a stronger risk for women than for men (p-interaction = 0.002). Bladder cancer risk was increased by interactions between smoking status and genetic variants at 8p22 (NAT2 ; multiplicative p value for interaction [ p M-I ] = 0.004), 8q21.13 (PAG1 ; p M-I = 0.01), and 9p21.3 (LOC107987026/MTAP/CDKN2A ; p M-I = 0.02). The PRS based on the 24 independent GWAS markers (odds ratio per standard deviation increase 1.49, 95% confidence interval 1.44–1.53), which also showed comparable results in two prospective cohorts (UK Biobank, PLCO trial), revealed an approximately fourfold difference in the lifetime risk of bladder cancer according to the PRS (e.g., 1st vs 10th decile) for both smokers and nonsmokers. We report novel loci associated with risk of bladder cancer that provide clues to its biological underpinnings. Using 24 independent markers, we constructed a PRS to stratify lifetime risk. The PRS combined with smoking history, and other established risk factors, has the potential to inform future screening efforts for bladder cancer. We identified new genetic markers that provide biological insights into the genetic causes of bladder cancer. These genetic risk factors combined with lifestyle risk factors, such as smoking, may inform future preventive and screening strategies for bladder cancer. [ABSTRACT FROM AUTHOR]

Bupropion is widely used for the treatment of major depressive disorder and for smoking cessation assistance. Unfortunately, there are no practical systems to assist clinicians or poison centres in predicting outcomes based on clinical features. Hence, the purpose of this study was to use a decision tree approach to inform early diagnosis of outcomes secondary to bupropion overdose. This study utilized a dataset from the National Poison Data System, a 6‐year retrospective cohort study on toxic exposures and patient outcomes. A machine learning algorithm (decision tree) was applied to the dataset using the sci‐kit‐learn library in Python. Shapley Additive exPlanations (SHAP) were used as an explainable method. Comparative analysis was performed using random forest (RF), Gradient Boosting classification, eXtreme Gradient Boosting, Light Gradient Boosting (LGM) and voting ensembling. ROC curve and precision–recall curve were used to analyse the performance of each model. LGM and RF demonstrated the highest performance to predict outcome of bupropion exposure. Multiple seizures, conduction disturbance, intentional exposure, and confusion were the most influential factors to predict the outcome of bupropion exposure. Coma and seizure, including single, multiple and status, were the most important factors to predict major outcomes. [ABSTRACT FROM AUTHOR]

Cardiac arrest is a severe heart anomaly that results in billions of annual casualties. Smoking is a specific hazard factor for cardiovascular pathology, including coronary heart disease, but data on smoking and heart death not earlier reviewed. The Heart Rate Variability (HRV) parameters used to predict cardiac arrest in smokers using machine learning technique in this paper. Machine learning is a method of computing experience based on automatic learning and enhances performances to increase prognosis. This study intends to compare the performance of logistical regression, decision tree, and random forest model to predict cardiac arrest in smokers. In this paper, a machine learning technique implemented on the dataset received from the data science research group MITU Skillogies Pune, India. To know the patient has a chance of cardiac arrest or not, developed three predictive models as 19 input feature of HRV indices and two output classes. These model evaluated based on their accuracy, precision, sensitivity, specificity, F1 score, and Area under the curve (AUC). The model of logistic regression has achieved an accuracy of 88.50%, precision of 83.11%, the sensitivity of 91.79%, the specificity of 86.03%, F1 score of 0.87, and AUC of 0.88. The decision tree model has arrived with an accuracy of 92.59%, precision of 97.29%, the sensitivity of 90.11%, the specificity of 97.38%, F1 score of 0.93, and AUC of 0.94. The model of the random forest has achieved an accuracy of 93.61%, precision of 94.59%, the sensitivity of 92.11%, the specificity of 95.03%, F1 score of 0.93 and AUC of 0.95. The random forest model achieved the best accuracy classification, followed by the decision tree, and logistic regression shows the lowest classification accuracy. [ABSTRACT FROM AUTHOR]

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Copyright of Journal of Chongqing University of Technology (Natural Science) is the property of Chongqing University of Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rationale: Currently used spirometry measures of airflow obstruction are influenced by demographics, predominantly by age, complicating selection of diagnostic thresholds for the presence of airflow obstruction. Objectives: To develop diagnostic thresholds for Parameter D, a new metric for detection of airflow obstruction, which quantifies the rate of rise of expiratory volume over time. Methods: We analyzed spirometry data of normal subjects enrolled in the 2007-2008, 2009-2010, and 2011-2012 NHANES (National Health and Nutrition Examination Survey) cohorts and calculated Parameter D using the expiratory volume-time curve. Relationships between demographics and lung function (forced expiratory volume in 1 second [FEV1], FEV1/forced vital capacity [FVC], and Parameter D) were tested using generalized linear models in NHANES and UK Biobank. The variation in lung function explained by demographics was estimated using R². A diagnostic threshold was developed for Parameter D using population-based percentiles. Based on concordance between the lower limit of normal (LLN) for FEV1/FVC and the Parameter D threshold, four groups were identified: normal (no airflow obstruction by either criterion), D1chronic obstructive pulmonary disease (D1COPD; positive by Parameter D only), D2COPD (positive by LLN only), and COPD (positive by both criteria), and associations with structural lung disease, exacerbations, and mortality were tested using multivariable analyses. Results: In contrast to FEV1 and FEV1/FVC, demographics cumulatively explained only 9% of the variance in Parameter D in NHANES (n = 4,945) and 3% in UK BioBank (n=109,623). In COPDGene (Genetic Epidemiology of Chronic Obstructive Pulmonary Disease) (n = 9,542), a diagnostic threshold of 23.15 resulted in the identification of an additional 10.8% of participants with airflow obstruction. A total of 3.7% had FEV1/FVC,LLN but were missed by the Parameter D threshold. Compared with subjects in the normal group, after adjustment for age, sex, race, body mass index, pack-years of smoking, and current smoking status, D1COPD was associated with worse structural lung disease (odds ratio [OR] for >5% emphysema, 1.71; 95% confidence interval [CI], 1.37-2.12; OR for functional small airway disease>15%, 2.1; 95% CI, 1.79-2.67) and significant symptoms (OR for modified Medical Research Council dyspnea score>2, 1.25; 95% CI, 1.07-1.47; OR for St. George's respiratory questionnaire>25, 1.31; 95% CI, 1.13-1.53), a greater frequency of exacerbations (incidence rate ratio, 1.26; 95% CI, 1.10-1.46), and higher mortality (hazard ratio, 1.32; 95% CI, 1.10-1.57). Over 5 years, 28% of the D1COPD group versus 8% of normal group progressed to COPD by traditional criteria. Conclusions: Parameter D is not affected by age, and a normal population-based diagnostic threshold results in the early identification of additional individuals with airflow obstruction with a substantial amount of structural lung disease and respiratory symptoms. [ABSTRACT FROM AUTHOR]

Lifecourse Mendelian randomization is a causal inference technique which harnesses genetic variants with time-varying effects to develop insight into the influence of age-dependent lifestyle factors on disease risk. Here, we apply this approach to evaluate whether childhood body size has a direct consequence on 8 major disease endpoints by analysing parental history data from the UK Biobank study. Our findings suggest that, whilst childhood body size increases later risk of outcomes such as heart disease (odds ratio (OR) = 1.15, 95% CI = 1.07 to 1.23, P = 7.8 × 10− 5) and diabetes (OR = 1.43, 95% CI = 1.31 to 1.56, P = 9.4 × 10− 15) based on parental history data, these findings are likely attributed to a sustained influence of being overweight for many years over the lifecourse. Likewise, we found evidence that remaining overweight throughout the lifecourse increases risk of lung cancer, which was partially mediated by lifetime smoking index. In contrast, using parental history data provided evidence that being overweight in childhood may have a protective effect on risk of breast cancer (OR = 0.87, 95% CI = 0.78 to 0.97, P = 0.01), corroborating findings from observational studies and large-scale genetic consortia. Large-scale family disease history data can provide a complementary source of evidence for epidemiological studies to exploit, particularly given that they are likely more robust to sources of selection bias (e.g. survival bias) compared to conventional case control studies. Leveraging these data using approaches such as lifecourse Mendelian randomization can help elucidate additional layers of evidence to dissect age-dependent effects on disease risk. [ABSTRACT FROM AUTHOR]

Presently, in the research processes involved in analysing the relationship between smoking and vital capacity, most researchers use statistical software to analyse, count the differences of vital capacity between different groups and carry out linear analysis or regression analysis. They cannot deeply analyse the relationship between the data, nor can they get the correlation of the data itself. Considering these limitations, this paper studies the influence of adolescent smoking on physical training vital capacity in eastern coastal areas. Based on the brief introduction of the research progress of data mining algorithm, and taking the teenagers in the eastern coastal area as the research object, the k-means algorithm and decision tree algorithm are applied to the data mining of vital capacity of physical training, after which we classify and reclassify the data, mine the rules between the data and put forward improvement strategies for the shortcomings of the algorithm itself. Finally, experiments are designed to analyse the accuracy, running time and reliability of the algorithm. The experimental results show that the improved k-means algorithm and decision tree algorithm shorten the running time and enhance the stability, and can realise the classification and mining of vital capacity data of physical training, so as to improve the reliability of experimental result analysis. [ABSTRACT FROM AUTHOR]

Major post-cessation metabolic changes include weight gain and hyperglycemia. However, the association of post-cessation change in fasting serum glucose (FSG) with risk of fatty liver remains unclear. A total of 111,106 participants aged 40 and above who underwent health screening at least once in two examination periods were extracted from the Korean National Health Insurance Service-National Sample Cohort. Fatty liver status was evaluated using the Korean National Health and Nutrition Examination Survey nonalcoholic fatty liver disease (K-NAFLD) score. Linear and logistic regression were used to calculate the adjusted mean (aMean) and adjusted odds ratio (aOR) with 95% confidence intervals. Compared to stable (aMean 0.10; 95% CI 0.03–0.18) and decline (aMean − 0.60; 95% CI − 0.71 to 0.49) groups, FSG elevation (aMean 1.28; 95% CI 1.16–1.39) was associated with higher K-NAFLD score even within different body mass index change groups. Risk of fatty liver was significantly reduced among participants with stable (aOR 0.38; 95% CI 0.31–0.45) and declined (aOR 0.17; 95% CI 0.13–0.22) FSG levels after smoking cessation compared to FSG elevation group. This study suggests that quitters with elevated FSG are associated with higher NAFLD risk and may benefit from careful monitoring of FSG levels and management of other cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Objectives: Interstitial lung disease (ILD) is frequent in patients with rheumatoid arthritis (RA) and is a potentially life-threatening complication with significant morbidity and mortality. This meta-analysis aims to systematically determine the factors associated with the development of rheumatoid arthritis–related interstitial lung disease (RA-ILD). Materials and methods: All primary studies which reported the factors associated with of RA-ILD were eligible for the review except case reports. The Cochrane Library, PubMed, Embase, Web of Science, Chinese Biological Medicine Database (CBM), China National Knowledge Infrastructure (CNKI), and WANFANG electronic databases were searched through to December 30, 2022, for studies investigating the factors associated with RA-ILD. The methodological quality assessment of the eligible studies was performed using the Newcastle-Ottawa Scale (NOS). 2 reviewers extracted relevant data independently. Then, weighed mean differences (WMDs) or pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were obtained for the relationships between the factors and RA-ILD. The statistical meta-analysis, subgroup and sensitivity analyses were performed using the Review Manager 5.3, and publication bias with Egger's test were performed using the Stata12.0 software. Results: A total of 22 articles were screened for a meta-analysis which involved 1887 RA-ILD patients and 8066 RA without ILD patients. Some identified factors that were associated with an increased risk of RA-ILD included male sex (OR = 1.92, 95% CI: 1.54–2.39; P < 0.00001), older age (WMD = 5.77 years, 95% CI: 3.50–8.04; P < 0.00001), longer duration of RA (WMD = 0.80 years, 95% CI 0.12–1.47; P = 0.02), older age at onset of RA (WMD = 6.41 years, 95% CI: 3.17–9.64; P = 0.0001), smoking (OR = 1.69, 95% CI: 1.30–2.18; P < 0.0001). Five factors of laboratory items associated with the development of RA-ILD were evaluated in the meta-analysis. Compared with RA without ILD patients, positive rheumatoid factor (RF) (OR = 1.72, 95% CI: 1.47–2.01; P < 0.00001) and positive anti-citrullinated protein antibodies (ACPA) (OR = 1.58, 95% CI: 1.31–1.90; P < 0.00001) increased the risk of RA-ILD. Meanwhile, RF titer (WMD = 183.62 (IU/mL), 95% CI: 66.94–300.30; P = 0.002) and ACPA titer (WMD = 194.18 (IU/mL), 95% CI: 115.89–272.47; P < 0.00001) were significantly associated with increased risk of RA-ILD. Elevated erythrocyte sedimentation rate (ESR) (WMD = 7.41 (mm/h), 95% CI: 2.21–12.61; P = 0.005) and C-reactive protein (CRP) (WMD = 4.98 (mg/L), 95% CI: 0.76–9.20; P = 0.02) were also significantly associated with the development of the RA-ILD, whereas antinuclear antibody (ANA) positive status was not significantly associated with increased risk of RA-ILD (OR = 1.27, 95% CI: 1.00–1.60; P = 0.05). Conclusions: This meta-analysis showed that male gender, older age, longer duration of RA, older age at onset of RA, smoking, positive RF, positive ACPA, elevated RF titer, elevated ACPA titer, higher ESR and higher CRP were associated with RA-ILD. [ABSTRACT FROM AUTHOR]

Abstinence rates among smokers attempting to quit remain low despite the wide availability and accessibility of pharmacological smoking cessation treatments. In addition, the prevalence of cessation attempts and abstinence differs by individual-level social factors such as race and ethnicity. Clinical treatment of nicotine dependence also continues to be challenged by individual-level variability in effectiveness to promote abstinence. The use of tailored smoking cessation strategies that incorporate information on individual-level social and genetic factors hold promise, although additional pharmacogenomic knowledge is still needed. In particular, genetic variants associated with pharmacological responses to smoking cessation treatment have generally been conducted in populations with participants that self-identify as White race or who are determined to be of European genetic ancestry. These results may not adequately capture the variability across all smokers as a result of understudied differences in allele frequencies across genetic ancestry populations. This suggests that much of the current pharmacogenetic study results for smoking cessation may not apply to all populations. Therefore, clinical application of pharmacogenetic results may exacerbate health inequities by racial and ethnic groups. This scoping review examines the extent to which racial, ethnic, and ancestral groups that experience differences in smoking rates and smoking cessation are represented in the existing body of published pharmacogenetic studies of smoking cessation. We will summarize results by race, ethnicity, and ancestry across pharmacological treatments and study designs. We will also explore current opportunities and challenges in conducting pharmacogenomic research on smoking cessation that encourages greater participant diversity, including practical barriers to clinical utilization of pharmacological smoking cessation treatment and clinical implementation of pharmacogenetic knowledge. [ABSTRACT FROM AUTHOR]

Introduction: Loss to follow-up (LTFU) and smoking during TB treatment are major challenges for TB control programs. Smoking increases the severity and prolongs TB treatment duration, which lead to a higher rate of LTFU. We aim to develop a prognostic scoring tool to predict LTFU among TB patients who smoke to improve successful TB treatment outcomes. Materials and methods: The development of the prognostic model utilized prospectively collected longitudinal data of adult TB patients who smoked in the state of Selangor between 2013 until 2017, which were obtained from the Malaysian Tuberculosis Information System (MyTB) database. Data were randomly split into development and internal validation cohorts. A simple prognostic score (T-BACCO SCORE) was constructed based on the regression coefficients of predictors in the final logistic model of the development cohort. Estimated missing data was 2.8% from the development cohort and was completely at random. Model discrimination was determined using c-statistics (AUCs), and calibration was based on the Hosmer and Lemeshow goodness of fit test and calibration plot. Results: The model highlights several variables with different T-BACCO SCORE values as predictors for LTFU among TB patients who smoke (e.g., age group, ethnicity, locality, nationality, educational level, monthly income level, employment status, TB case category, TB detection methods, X-ray categories, HIV status, and sputum status). The prognostic scores were categorized into three groups that predict the risk for LTFU: low-risk (<15 points), medium-risk (15 to 25 points) and high-risk (> 25 points). The model exhibited fair discrimination with a c-statistic of 0.681 (95% CI 0.627–0.710) and good calibration with a nonsignificant chi-square Hosmer‒Lemeshow's goodness of fit test χ2 = 4.893 and accompanying p value of 0.769. Conclusion: Predicting LTFU among TB patients who smoke in the early phase of TB treatment is achievable using this simple T-BACCO SCORE. The applicability of the tool in clinical settings helps health care professionals manage TB smokers based on their risk scores. Further external validation should be carried out prior to use. [ABSTRACT FROM AUTHOR]

Smoking is a risk factor for respiratory diseases, and it worsens sleep quality due to nicotine stimulation and sudden nicotine withdrawal during sleep. This can increase the severity of OSA through alterations upper airway inflammation and neuromuscular function, arousal mechanisms, and sleep architecture. Therefore, it may lead to sleep-disrupted breathing, particularly obstructive sleep apnea (OSA). Herein, this study aims to research the association between smoking and OSA through the STOP-Bang index. In this study, total sample of 3442 participants (1465 men and 1977 women) were analyzed. We used data from the Korea National Health and Nutrition Examination Survey in 2020 by classifying adults into current, ex-, and non-smokers. A multiple logistic regression analysis was used to investigate the association between smoking and OSA. Furthermore, multinomial regression analysis was used to investigate the effect of smoking cessation. For males, compared to the non-smokers, the odds ratios (OR) for the OSA were significantly higher in the ex-smokers (OR: 1.53, 95% confidence interval(CI) 1.01–2.32) and current smokers (OR: 1.79, 95% CI 1.10–2.89). In females, higher ORs were observed for OSA risk, similar to the non-smokers, smoking cessation, and pack-years. Among men, OSA was significantly associated with a moderate risk for ex-smokers (OR: 1.61, 95% CI 1.05–2.48) and a severe risk for current smokers (OR: 1.88, 95% CI 1.07–3.29). This study observed that smoking might contribute to OSA risk among adults. Smoking cessation can help to manage sleep quality properly. [ABSTRACT FROM AUTHOR]

The early stages of forest fires are usually accompanied by large amounts of smoke, so smoke identification and concentration inversion can effectively warn and locate the fire point. To achieve smoke identification and concentration inversion, this paper first analysed the spectral differences between smoke and underlying background features based on the samples selected from Landsat 8/OLI fire data of Qiqian forest in Inner Mongolia, China, andNew South Wales, Australia. Then, the sensitive band of smoke identification was screened and the relative smoke concentration indices were established. Finally, a mathematical model between the indices and smoke concentration level was constructed and the best inversion model was established by accuracy test based on samples in each background. The results show that (1) the reflectance increases with increasing smoke concentration in B1-B4 bands under different backgrounds (vegetation, water, bare ground), and the reflectance was significantly different between different concentrations of smoke; (2) the smoke concentration inversion model form is y = kx + b with R2 > 0.8 (x denotes the smoke concentration level, y denotes the relative smoke concentration index), and the visible brightness index (VBI = B1 + B2 + B3 + B4) was the best relative smoke concentration index under different background; (3) the model's accuracy was tested using each background smoke sample with a known level of smoke concentration, and the inversion accuracy was above 90%. The results show that the VBI can effectively reflect the spectral variation between different smoke concentrations and background features; the variation is closely related to smoke concentration which determines that the mathematical correlation model between VBI and relative smoke concentration can be established; the model is accuracy and can be used for the relative smoke concentration inversion of forest fire cases in different study areas. [ABSTRACT FROM AUTHOR]

The study highlighted that the presence of diabetes alone was not a strong risk factor for increased COVID-19 mortality; however, it was shown that the confounding of demographic characteristics (age) and diabetes represented major risk factors. For example, a study in France[14] revealed that COVID-19 mortality rate was associated with the physician's density, and a Yale study[15] found that the lack of ICU hospital beds was associated with excess COVID-19 deaths. Several issues related to the coronavirus pandemic have not yet been fully and unequivocally identified despite the attempts made in the literature to explain why COVID-19 case-fatality rates vary among countries and why in some developed countries, fatality rates were high. [Extracted from the article]

Introduction Smoking cessation is more than 50% heritable. Genetic studies of smoking cessation have been limited by short-term follow-up or cross-sectional design. Aims and Methods This study tests single nucleotide polymorphism (SNP) associations with cessation during long-term follow-up throughout adulthood in women. The secondary aim tests whether genetic associations differ by smoking intensity. Associations between 10 SNPs in CHRNA5 , CHRNA3 , CHRNB2 , CHRNB4 , DRD2 , and COMT and the probability of smoking cessation over time were evaluated in two longitudinal cohort studies of female nurses, the Nurses' Health Study (NHS) (n = 10 017) and NHS-2 (n = 2793). Participant follow-up ranged from 2 to 38 years with data collected every 2 years. Results Women with the minor allele of either CHRNA5 SNP rs16969968 or CHRNA3 SNP rs1051730 had lower odds of cessation throughout adulthood [OR = 0.93, p -value =.003]. Women had increased odds of cessation if they had the minor allele of CHRNA3 SNP rs578776 [OR = 1.17, p -value =.002]. The minor allele of DRD2 SNP rs1800497 was associated with lower odds of cessation in moderate-to-heavy smokers [OR = 0.92, p -value =.0183] but increased odds in light smokers [OR = 1.24, p -value =.096]. Conclusions Some SNP associations with short-term smoking abstinence observed in prior studies were shown in the present study to persist throughout adulthood over decades of follow-up. Other SNP associations with short-term abstinence did not persist long-term. The secondary aim findings suggest genetic associations may differ by smoking intensity. Implications The results of the present study expand on previous studies of SNP associations in relation to short-term smoking cessation to demonstrate some of these SNPs were associated with smoking cessation throughout decades of follow-up, whereas other SNP associations with short-term abstinence did not persist long-term. The rate of relapse to smoking remains high for several years after quitting smoking, and many smokers experience multiple quit attempts and relapse episodes throughout adulthood. Understanding genetic associations with long-term cessation has potential importance for precision medicine approaches to long-term cessation management. [ABSTRACT FROM AUTHOR]

Introduction Genetic variation in Cytochrome P450 2A6 (CYP2A6), the major nicotine metabolizing enzyme, is associated with nicotine dependence and smoking cessation. Nicotine dependence severity also predicts smoking cessation. Our goals were to determine how CYP2A6 variation and nicotine dependence alter smoking cessation, and whether dependence could refine CYP2A6 -based treatment recommendations. Aims and Methods Adult smokers treated for 12 weeks with placebo, nicotine patch, or varenicline (NCT01314001) were grouped as CYP2A6 normal (n = 567) or slow (n = 432) nicotine metabolizers based on a CYP2A6 weighted genetic risk score. Fagerström test for nicotine dependence scores were measured at baseline and biochemically verified smoking cessation was assessed at end of treatment. Results Dependence neither mediated nor moderated an association between CYP2A6 variation and smoking cessation overall, within any treatment arm, or after stratifying by ancestry (n = 591 European, n = 408 African ancestry) or sex (n = 444 women, n = 555 men). In within-treatment analyses, the mediation effect odds ratio (OR) ranged from 0.95 to 1.00 and the bias-corrected 95% confidence interval contained 1. Moderation (i.e. interaction) effect ORs ranged from 0.88 to 1.61 (p =.397–.828). For CYP2A6 normal metabolizers, quit rates on varenicline were similar for those with high (41.1%) and low (43.4%) dependence, while quit rates were lower for those with high versus low dependence on both patch (16.5 vs. 29.7%) and placebo (8.9 vs. 18.5%). CYP2A6 slow metabolizers with high versus low dependence had lower quit rates in all three treatment arms. Conclusions Although nicotine dependence severity neither mediated nor moderated CYP2A6 associations with smoking cessation, incorporating information on dependence may optimize the choice of smoking cessation treatment aid in CYP2A6 normal and slow metabolizers. Implications Variation in CYP2A6 and nicotine dependence severity alter smoking cessation success. Our findings suggest that while nicotine dependence severity is unlikely to mediate or moderate CYP2A6 associations with cessation, incorporating patient information on both CYP2A6 and nicotine dependence severity may lead to improved smoking cessation strategies. [ABSTRACT FROM AUTHOR]

Precision medicine describes health care where patient‐level data are used to inform treatment decisions. Within this framework, dynamic treatment regimes (DTRs) are sequences of decision rules that take individual patient information as input data and then output treatment recommendations. DTR estimation from observational data typically relies on the assumption of no interference: i.e., the outcome of one individual is unaffected by the treatment assignment of others. However, in many social network contexts, such as friendship or family networks, and for many health concerns, such as infectious diseases, this assumption is questionable. We investigate the DTR estimation method of dynamic weighted ordinary least squares (dWOLS), which boasts of easy implementation and the so‐called double‐robustness property, but relies on the assumption of no interference. We define a network propensity function and build on it to establish an implementation of dWOLS that remains doubly robust under interference associated with network links. The method's properties are demonstrated via simulation and applied to data from the Population Assessment of Tobacco and Health (PATH) study to investigate cigarette dependence within two‐person household networks. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Railway Science & Engineering is the property of Journal of Railway Science & Engineering Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rationale: Emerging research suggests that e-cigarette (EC) use may have detrimental health effects, increasing the burden on healthcare systems. Objectives: To determine whether young EC users had increased asthma, asthma attacks, and health services use (HSU). Methods: This cohort study used the linked Canadian Community Health Survey (cycles 2015–16 and 2017–18) and health administrative data (January 2015–March 2018). A propensity score method matched self-reported EC users to up to five control subjects. Matched multivariable logistic and negative binomial regressions were used to calculate odds ratios, rate ratios (RRs), and 95% confidence intervals (CIs) with EC use as the exposure and asthma, asthma attacks, and all-cause HSU as the outcomes. Results: Analyses included 2,700 matched Canadian Community Health Survey participants (15–30 yr), 505 (2.4% of 20,725 participants) EC users matched to 2,195 nonusers. After adjusting for confounders, EC users with asthma had over twofold higher odds of having an asthma attack in the last 12 months (odds ratio, 2.30; 95% CI, 1.29–4.12). Dual EC and conventional tobacco users had a twofold increased all-cause HSU rate compared with nonusers who never smoked tobacco (RR, 2.13; 95% CI, 1.53–2.98). This rate was greater than that for EC users who never smoked tobacco (RR, 1.73; 95% CI, 1.00–3.00) and non-EC users who regularly smoke tobacco (RR, 1.72; 95% CI, 1.29–2.29). Compared with male nonusers, female EC users had the highest increased all-cause HSU (RR, 1.94; 95% CI, 1.39–2.69) over male EC users and female nonusers (RR, 1.13; 95% CI, 0.86–1.48; RR, 1.41; 95% CI, 1.16–1.71, respectively). Conclusions: Current EC use is associated with significantly increased odds of having an asthma attack. Furthermore, concurrent EC use and conventional cigarette smoking are associated with a higher rate of all-cause HSU. The odds of asthma attack and all-cause HSU were highest among women. Thus, EC use may be an epidemiological biomarker for youth and young adults with increased health morbidity. [ABSTRACT FROM AUTHOR]

Hyperbaric oxygen therapy (HBOT) is known to be associated with pulmonary oxygen toxicity. However, the effect of modern HBOT protocols on pulmonary function is not completely understood. The present study evaluates pulmonary function test changes in patients undergoing serial HBOT. We prospectively collected data on patients undergoing HBOT from 2016–2021 at a tertiary referral center (protocol registration NCT05088772). Patients underwent pulmonary function testing with a bedside spirometer/pneumotachometer prior to HBOT and after every 20 treatments. HBOT was performed using 100% oxygen at a pressure of 2.0–2.4 atmospheres absolute (203–243 kPa) for 90 minutes, five times per week. Patients' charts were retrospectively reviewed for demographics, comorbidities, medications, HBOT specifications, treatment complications, and spirometry performance. Primary outcomes were defined as change in percent predicted forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and forced mid-expiratory flow (FEF25-75), after 20, 40, and 60 HBOT sessions. Data was analyzed with descriptive statistics and mixed-model linear regression. A total of 86 patients were enrolled with baseline testing, and the analysis included data for 81 patients after 20 treatments, 52 after 40 treatments, and 12 after 60 treatments. There were no significant differences in pulmonary function tests after 20, 40, or 60 HBOT sessions. Similarly, a subgroup analysis stratifying the cohort based on pre-existing respiratory disease, smoking history, and the applied treatment pressure did not identify any significant changes in pulmonary function tests during HBOT. There were no significant longitudinal changes in FEV1, FVC, or FEF25-75 after serial HBOT sessions in patients regardless of pre-existing respiratory disease. Our results suggest that the theoretical risk of pulmonary oxygen toxicity following HBOT is unsubstantiated with modern treatment protocols, and that pulmonary function is preserved even in patients with pre-existing asthma, chronic obstructive lung disease, and interstitial lung disease. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021. Methods: Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression. Results: Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8–9.4%, p < 0.001). Smokers with high educational level were more likely to decrease their tobacco consumption from 2018 to 2021 compared to low educated smokers (aOR = 2.72 [1.26;5.89]). Conclusion: Current findings showed a widening of the social inequality gap in relation to smoking rates, underscoring the increased vulnerability of persons with low educational level to smoking and the likely inadequate focus on social inequalities in relation to tobacco control policies during the pandemic. [ABSTRACT FROM AUTHOR]

Aim: We aimed to examine the association of oxidative stress, programmed cell death, smoking, and the GSTM1 gene in the risk of lung carcinogenesis. The twostep Mendelian randomization will reveal evidence supporting the association of the exposure and mediators with the resulting outcome. Methods: In step 1, we estimated the impact of smoking exposure on lung carcinogenesis and programmed cell death. Our study involved a total of 500,000 patients of European ancestry, from whom we obtained genotype imputation information. Specifically, we genotyped two arrays: the UK Biobank Axiom (UKBB) which accounted for 95% of marker content, and the UK BiLIEVE Axiom (UKBL). This allowed us to unmask the association between smoking exposure and the incidence of lung carcinogenesis. In step 2, we further examined the effects of smoking on oxidative stress, programmed cell death, and the incidence of lung carcinogenesis. Results: Different outcomes emerged from the two-step Mendelian randomization. The GSTM1 gene variant was found to be critical in the development of lung carcinogenesis, as its deletion or deficiency can induce the condition. A GWAS study on participant information obtained from the UK Biobank revealed that smoking interferes with the GSTM1 gene, causing programmed cell death in the lungs and ultimately leading to lung carcinogenesis. The relative risk of developing lung carcinogenesis associated with oxidative stress was significantly high among current smokers (a hazard ratio of 17.8, 95% confidence interval of 12.2-26.0) and heavy smokers (a hazard ratio of 16.6 and a 95% confidence interval of 13.6-20.3) compared to individuals who never smoked. The GSTM1 gene polymorphism was found to be 0.006 among participants who have never smoked, <0.001 among ever-smokers, and 0.002 and <0.001 among current and former smokers, respectively. We compared the effect of smoking within two particular time frames, 6 years and 55 years, and found that smoking's impact on the GSTM1 gene was highest among participants who were 55 years old. The genetic risk peaked among individuals aged 50 years and above (PRS of at least 80%). Conclusion: Exposure to smoking is a significant factor in developing lung carcinogenesis, as it is associated with programmed cell death and other mediators involved in the condition. Oxidative stress caused by smoking is also a key mechanism in lung carcinogenesis. The results of the present study highlight the association between oxidative stress, programmed cell death, and the GSTM1 gene in the development of lung carcinogenesis. [ABSTRACT FROM AUTHOR]

Stroke has become a significant threat to global public health, the ideal solution to which is primary prevention. Identification and management of determinants of stroke among various variables in different datasets are essential steps for its primary prevention. This study aimed to develop a flexible scoring model, which can easily modify different datasets. The public dataset containing 41,931 cases with 643 occurrences of stroke was randomly divided into training, validation, and test datasets comprising 25,158 (60%), 8,386 (20%), and 8,387 (20%) cases, respectively. Three continuous variables (age, body mass index, and average glucose level) and seven categorical variables (heart disease, hypertension, sex, married/smoking/work/residence status) in the dataset were converted using the weight of evidence method. The significant variables among 10 transformed variables were selected using multivariable logistic regression analyses. The scoring model for stroke occurrence was developed in the training and validation datasets, and performance was evaluated in the test dataset. Age, average glucose level, heart disease, and hypertension were significant variables of stroke occurrence. The scoring model was easily calculated using four determinants and indicates that the stroke occurrence ranged from 0.04 to 12.50%. The performance of the scoring model on the test dataset was similar to that on the validation dataset. This novel point scoring model is flexible enough to modify various datasets and can be used for determinant identification. Furthermore, its simplicity allows individuals to manage determinants by self-calculating stroke occurrence. Our model contributes to primary prevention using determinant identification and management. [ABSTRACT FROM AUTHOR]

Eight Gram-negative, aerobic, motile with paired polar flagella and rod-shaped bacteria were isolated from six tobacco fields in Yunnan, PR China. 16S rRNA gene sequence analysis revealed that all the strains belonged to the genus Ralstonia. Among them, strain 22TCCZM03-6 had an identical 16S rRNA sequence to that of R. wenshanensis 56D2T, and the other strains were closely related to R. pickettii DSM 6297T (98.34-99.86%), R. wenshanensis 56D2T (98.70-99.64%), and R. insidiosa CCUG 46789T (97.34-98.56%). Genome sequencing yielded sizes ranging from 5.17 to 5.72 Mb, with overall G + C contents of 63.3-64.1%. Pairwise genome comparisons showed that strain 22TCCZM03-6 shared average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) values above the species cut-off with R. wenshanensis 56D2T, suggesting that strain 22TCCZM03-6 is a special strain of the R. wenshanensis. Five strains, including 21MJYT02-10T, 21LDWP02-16, 22TCJT01-1, 22TCCZM01-4, and 22TCJT01-2, had ANI values >95% and dDDH values >70% when compared with each other. These five strains had ANI values of 73.32-94.17% and dDDH of 22.0-55.20% with the type strains of the genus Ralstonia individually, supporting these five strains as a novel species in the genus Ralstonia. In addition, strains 21YRMH01-3T and 21MJYT02-11T represent two independent species. They both had ANI and dDDH values below the thresholds for species delineation when compared with the type species of the genus Ralstonia. In strains 21YRMH01-3T and 21MJYT02-10T, the main fatty acids were summed features 3, 8, and C16:0; however, strain 21MJYT02-11T contained C16:0, cyclo-C17:0, and summed features 3 as major fatty acids. The main polar lipids, including diphosphatidylglycerol, phosphatidylglycerol, and phosphatidylethanolamine, were identified from strains 21YRMH01-3T, 21MJYT02-10T, and 21MJYT02-11T. The ubiquinones Q-7 and Q-8 were also detected in these strains, with Q-8 being the predominant quinone. Based on the above data, we propose that the eight strains represent one known species and three novel species in the genus Ralstonia, for which the names Ralstonia chuxiongensis sp. nov., Ralstonia mojiangensis sp. nov., and Ralstonia soli sp. nov. are proposed. The type strains are 21YRMH01-3T (=GDMCC 1.3534T = JCM 35818T), 21MJYT02-10T (=GDMCC 1.3531T = JCM 35816T), and 21MJYT02-11T (=GDMCC 1.3532T = JCM 35817T), respectively. [ABSTRACT FROM AUTHOR]

Wastewater-based epidemiology (WBE), as a rapid tool, is used to measure and monitor illicit drug consumption in the population. This method is also used to bridge biomarkers of exposure, contaminants, and human health. Smoking cigarettes and tobacco use are everyday habits in nowadays community. This systematic review and meta-analysis aimed to calculate nicotine consumption globally. The related studies were retrieved within international databases including Scopus, Google Scholar, and Web of Science, up to February 2021. It included twenty-one articles containing 87 measurements covering 275.3 million people with total wastewater samples of 2250. Results showed that the highest and lowest nicotine consumption rate (mg/1000 inh./day) was in Portugal (5860) and Vietnam (1201), respectively. The global pooled nicotine consumption rate was 2476 mg/1000 inh./day (95% CI (2289–2663). Based on WBE results, the average daily cigarette smoked per smoker is 14 (95% CI: 10–18 cigarettes/inh./day), close to the value of 14.2 reported by the survey and interview studies. Risk assessment of the nicotine consumption rate through WBE was calculated by the margin of exposure (MOE) approach. In total, 82% of nicotine consumption measurements were located in the "risk" level (MOE < 100), and 18% of the MOE values were between 100–1000. The results reveal that nicotine consumption risks need immediate global and local action strategies. Finally, these findings are helpful for healthcare agencies and policy-makers to take action against tobacco use prevalence. [ABSTRACT FROM AUTHOR]

Background: Stroke is a common cerebrovascular disease with great danger to public health. Educational inequality is a universal issue that influences populations' stroke risk. This study aimed to investigate the causal relationship between education and stroke risk and the contributions of effects mediated by four modifiable factors. Materials and methods: Public large-scale genome-wide association study (GWAS) summary data associated with educational attainment, hypertensive diseases, body mass index (BMI), smoking behavior, time spent on watching the television (TV), and stroke were obtained from European ancestry. The data were used to investigate the causal relationship among educational attainment, hypertensive disease, BMI, smoking, watching TV, and stroke risk. Inverse variance weighted (IVW) method was used as a primary algorithm for estimating causal direction and effect size in univariable and multivariable Mendelian randomization (MR) analyses. Results: Higher educational attainment was a causal protective factor, while hypertensive diseases, higher BMI, smoking, and longer time spent on watching the TV were all causal risk factors for the risk of stroke. Hypertensive disease, BMI, smoking, and watching TV were all mediators for linking the causal relationship between educational attainment and stroke risk. Hypertensive disease, BMI, smoking, and watching TV explained 47.35%, 24.74%, 15.72%, and 2.29% of the variance in educational attainment's effect on stroke risk, respectively. The explained proportion reached 69.32% after integrating the four factors. Conclusions: These findings support the causal effect of educational attainment on the risk of stroke, with a substantial proportion mediated by modifiable risk factors. Interventions on these modifiable factors would lead to substantial reductions in stroke cases attributable to educational inequality. [ABSTRACT FROM AUTHOR]

BACKGROUND: Recurrent lumbar disc herniation is an adverse event after percutaneous endoscopic lumbar discectomy. Accurately predicting the risk of recurrent lumbar disc herniation after surgery remains a major challenge for spine surgeons. OBJECTIVE: To investigate the risk factors for recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy, and to develop and validate an effective predictive model. METHODS: Clinical data from 365 patients with lumbar disc herniation who underwent percutaneous endoscopic lumbar discectomy at the Affiliated Hospital of Xuzhou Medical University from January 1, 2017 to January 1, 2020 were retrospectively collected. Predictors significantly associated with postoperative lumbar disc herniation recurrence were screened according to least absolute shrinkage and selection operator (LASSO) regression analysis, and a prediction model was established, followed by internal validation of the model using the enhanced Bootstrap validation method. The performance of the model was evaluated using receiver operating characteristic curve and calibration curves. Finally, the clinical utility of the model was analyzed using decision curves and clinical impact curves. RESULTS AND CONCLUSION: (1) Among the 365 patients included in this study, there were 33 recurrences (9.0%) after percutaneous endoscopic lumbar discectomy. (2) Six factors that were significantly associated with recurrence after percutaneous endoscopic lumbar discectomy were selected by LASSO regression, including age, operative segment, Modic changes, Pfirrmann classification, smoking history, and intense physical work. (3) The bias-corrected curve of the model fitted well with the apparent curve, with an area under the receiver operating characteristic curve of 0.909 and 95% confidence interval of (0.860-0.958). (4) The model has good clinical utility and is useful for clinicians to identify high-risk patients preoperatively and to individualize treatment. [ABSTRACT FROM AUTHOR]

Introduction: Ischemic stroke (IS) is an extremely complex disease caused by the combined action of multiple environmental and genetic factors. CYP1B1 is a member of the cytochrome P450 protein family, and it is an important human drug-metabolizing enzymes. We aimed to explore the association between CYP1B1 genetic variants and IS risk in Chinese Han population. Methods: We recruited 1,150 participants to conduct a "case-control" study. The assessment of association between candidate CYP1B1 genetic variants (rs2855658, rs10916, rs162560, rs2567206) and IS risk was performed by SNPStats online software. In addition, false-positive report probability analysis was used to detect whether the positive findings were just chance or noteworthy observations. Finally, the interaction of candidate SNPs in IS risk was evaluated by multifactor dimensionality reduction. Results: The results showed that CYP1B1-rs2855658 was a risk factor for IS among ≥60-year-old (dominant: p = 0.034; overdominant: p = 0.026), smoking (heterozygote: p = 0.009; dominant: p = 0.004; overdominant: p = 0.012; log-additive: p = 0.003), and drinking participants (homozygous: p = 0.036; dominant: p = 0.019; recessive: p = 0.012; log-additive: p = 0.006). CYP1B1-rs10916 also was a risk factor for IS patients among ≥60-year-old (heterozygote: p = 0.047; overdominant: p = 0.048), smoking (dominant: p = 0.050; overdominant: p = 0.049), and drinking participants (dominant: p = 0.019; overdominant: p = 0.038; log-additive: p = 0.013). Conclusion:CYP1B1-rs10916 and CYP1B1-rs2855658 can increase the IS risk in Chinese Han population who are ≥60 years old, smoking, or drinking alcohol. [ABSTRACT FROM AUTHOR]

Detecting pancreatic cancer at an earlier stage may contribute to an increased survival. Patients with stage I pancreatic cancer have a 5-year survival rate of 36%, while stage IV patients have a 5-year survival rate of 1% in Sweden. Research into novel blood-based biomarkers for pancreatic cancer is highly intensive and innovative, but has yet to result in any routine screening test. The aim of this study was to evaluate the specificity and sensitivity of a hypothetical blood test for pancreatic cancer used for screening purposes and the economic aspects of testing. A model of a screening test was created, with varying specificity and sensitivity both set at 80%, 85%, 90%, 95% or 99% and applied to selected risk groups. Excessive costs of false positive screening outcomes, QALYs, ICERs and total costs were calculated. Individuals with family history and genetic mutations associated with pancreatic cancer, new-onset diabetes ≥50 years of age and early symptoms had the highest positive predictive values and ICERs beneath the willingness-to-pay-level of EUR 100,000/QALY. Screening of the general population and smokers resulted in a high rate of false positive cases and extensive extra costs. General screening for pancreatic cancer is not cost-effective, while screening of certain high-risk groups may be economically justified given the availability of a high-performing blood-based test. [ABSTRACT FROM AUTHOR]