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Switching to Very Low Nicotine Content (VLNC) cigarettes reduces toxicant exposure and nicotine dependence, and may improve smoking cessation. However, non-compliance with VLNCs is often high, which may reduce their effectiveness. Here, we conducted secondary analyses of a pilot smoking cessation trial utilizing VLNCs to examine associations between pre-cessation VLNC compliance and changes in smoking rate, dependence, and abstinence self-efficacy, as well as quit outcomes. People who smoke daily (n=35) engaged in a 4-week pre-cessation intervention including VLNCs, transdermal nicotine patch, and behavioral counseling. After quit date, participants received 8 weeks of nicotine replacement therapy and 4 additional behavioral sessions, and were followed for 10 weeks to assess abstinence. Compliance with VLNCs was assessed biweekly during pre-cessation using timeline follow-back. Statistical analyses examined associations between VLNC compliance and a) changes in smoking rate, dependence and abstinence self-efficacy over the course of study cigarette use; and b) time to relapse, controlling for other smoking variables. Greater compliance during the second half of study cigarette use was associated with subsequent improvement in self-efficacy (p<.05). Increased self-efficacy and VLNC compliance both predicted lower likelihood of relapse. Nicotine dependence and cigarettes per day both decreased following study cigarette use, but were unrelated to compliance or relapse. Compliance with VLNCs prior to quitting increased abstinence self-efficacy and predicted better quit outcomes above and beyond baseline smoking characteristics. Although preliminary, these findings suggest that identifying strategies to promote exclusive use of VLNCs during a brief pre-cessation window may be beneficial. • Compliance with low nicotine cigarettes increases abstinence self-efficacy. • Increases in abstinence self-efficacy, in turn, predict better quit outcomes. • Poor compliance with low nicotine cigarettes predicts greater risk of relapse. [ABSTRACT FROM AUTHOR]

Although the smoking rate of human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) infected people was much higher than that of the general population, smoking cessation interventions have long been ineffective. We aimed to examine the estimates of prevalence, time-trend, and association of smoking among people living with HIV, HBV, or HCV. This cohort was composed of 32,115 individuals from the NHANES database (1999–2018) and they were collected in the US. The time trend analysis of smoking and quitting rates was conducted using different years of survey follow-up and different infected groups. Multivariable logistic regression analysis was used to identify the risk factors related to smoking behavior of these infected people. Compared to non-infected smokers, infected smokers were more likely to be older (aged 30–39, OR = 9.92, CI 6.07–16.21; aged 40–49,OR = 3.51, CI 2.49–4.94), males (1.99, 1.54–2.55), lower education and economic level (1.78, 1.39–2.29; 2.05, 1.59–2.65), unemployed (1.63, 1.21–2.20), suffering depression (1.35, 1.05–1.72), and drug users (7.65, 5.04–11.59). Taken together, our study showed that these complex psychosocial characteristics and unhealthy behavioral factors might be major independent risk factors for increasing smoking rate and decreasing smoking cessation rate among these infected people. [ABSTRACT FROM AUTHOR]

We examined the association between early childhood exposure to maternal smoking and behavioral issues at 8 years old using a large nationwide population-based longitudinal survey in Japan that began in 2001. We included 46,737 children with information about maternal smoking taken from the 6-month survey. We used logistic regression analysis to examine the hypothesis. Early childhood exposure to maternal smoking increased the risk of behavioral problems related to attention and aggressive or disruptive behavior. The adjusted odds ratios (95% confidence intervals) were 1.37 (1.22–1.54) for inability to wait their turn during play and 1.40 (1.27–1.55) for destroying toys and, compared with children of nonsmoking mothers. Children of mothers who were heavy smokers were more likely to develop behavioral problems than others. Stopping early childhood exposure to maternal exposure can protect children's neurodevelopment. [ABSTRACT FROM AUTHOR]

Objective: Ashkenazi‐Jewish (AJ) population‐based BRCA testing is acceptable, cost‐effective and amplifies primary prevention for breast & ovarian cancer. However, data describing lifestyle impact are lacking. We report long‐term results of population‐based BRCA testing on lifestyle behaviour and cancer risk perception. Design: Two‐arm randomised controlled trials (ISRCTN73338115, GCaPPS): (a) population‐screening (PS); (b) family history (FH)/clinical criteria testing. Setting North London AJ‐population. Population/Sample: AJ women/men >18 years. Exclusions: prior BRCA testing or first‐degree relatives of BRCA‐carriers. Methods: Participants were recruited through self‐referral. All participants received informed pre‐test genetic counselling. The intervention included genetic testing for three AJ BRCA‐mutations: 185delAG(c.68_69delAG), 5382insC(c.5266dupC) and 6174delT(c.5946delT). This was undertaken for all participants in the PS arm and participants fulfilling FH/clinical criteria in the FH arm. Patients filled out customised/validated questionnaires at baseline/1‐year/2‐year/3‐year follow‐ups. Generalised linear‐mixed models adjusted for covariates and appropriate contrast tests were used for between‐group/within‐group analysis of lifestyle and behavioural outcomes along with evaluating factors associated with these outcomes. Outcomes are adjusted for multiple testing (Bonferroni method), with P < 0.0039 considered significant. Outcome measures: Lifestyle/behavioural outcomes at baseline/1‐year/2‐year/3‐year follow‐ups. Results: 1034 participants were randomised to PS (n = 530) or FH (n = 504) arms. No significant difference was identified between PS‐ and FH‐based BRCA testing approaches in terms of dietary fruit/vegetable/meat consumption, vitamin intake, alcohol quantity/ frequency, smoking behaviour (frequency/cessation), physical activity/exercise or routine breast mammogram screening behaviour, with outcomes not affected by BRCA test result. Cancer risk perception decreased with time following BRCA testing, with no difference between FH/PS approaches, and the perception of risk was lowest in BRCA‐negative participants. Men consumed fewer fruits/vegetables/vitamins and more meat/alcohol than women (P < 0.001). Conclusion: Population‐based and FH‐based AJ BRCA testing have similar long‐term lifestyle impacts on smoking, alcohol, dietary fruit/vegetable/meat/vitamin, exercise, breast screening participation and reduced cancer risk perception. Jewish Pop BRCA testing increases vitamin use and has similar lifestyle impact as FH testing on diet, exercise, alcohol, breast screening. [ABSTRACT FROM AUTHOR]

Background: This study is a retrospective study. The purpose of this study is to construct and validate an early warning model of lung cancer through machine learning. Methods: The CDKN2A gene expression profile and clinical information were downloaded from The Cancer Genome Atlas (TCGA) database and divided into a tumor group and a normal group (n = 57). The top 5 somatic mutation-related genes were extracted from 567 somatic mutation data downloaded from TCGA database using random forest algorithm. Cox proportional hazard model and nomogram were constructed combining CDKN2A, 5 somatic mutation-related genes, gender, and smoking index. Patients were divided into high-risk and low-risk groups according to risk score. The predictability of the model in the prognosis of lung cancer was estimated by Kaplan–Meier survival analysis and receiver operating characteristics curve. Results: We constructed a prognostic model consisting of 5 somatic mutation-related genes (sphingosine 1-phosphate receptor 1 [S1PR1], dedicator of cytokinesis 7 [DOCK7], DEAD-box helicase 4 [DDX4], laminin subunit beta 3 [LAMB3], and importin 5 [IPO5]), cyclin-dependent kinase inhibitor 2A (CDKN2A), gender, and smoking indicators. The high-risk group had a lower overall survival rate compared to the low-risk group (hazard ratio = 2.14, P = 0.0323). The area under the curve predicted for 3-year, 5-year, and 10-year survival rates are 0.609, 0.673, and 0.698, respectively. The accuracy, sensitivity, and specificity of the model for predicting the 10-year survival rate of lung cancer are 76.19%, 56.71%, and 86.23%. Conclusion: The lung cancer early warning model and nomogram may provide an essential reference for patients with lung cancer management in the clinic. [ABSTRACT FROM AUTHOR]

Although many studies have been conducted on machine learning (ML) models for Parkinson's disease (PD) prediction using neuroimaging and movement analyses, studies with large population-based datasets are limited. We aimed to propose PD prediction models using ML algorithms based on the National Health Insurance Service-Health Screening datasets. We selected individuals who participated in national health-screening programs > 5 times between 2002 and 2015. PD was defined based on the ICD-code (G20), and a matched cohort of individuals without PD was selected using a 1:1 random sampling method. Various ML algorithms were applied for PD prediction, and the performance of the prediction models was compared. Neural networks, gradient boosting machines, and random forest algorithms exhibited the best average prediction accuracy (average area under the receiver operating characteristic curve (AUC): 0.779, 0.766, and 0.731, respectively) among the algorithms validated in this study. The overall model performance metrics were higher in men than in women (AUC: 0.742 and 0.729, respectively). The most important factor for predicting PD occurrence was body mass index, followed by total cholesterol, glucose, hemoglobin, and blood pressure levels. Smoking and alcohol consumption (in men) and socioeconomic status, physical activity, and diabetes mellitus (in women) were highly correlated with the occurrence of PD. The proposed health-screening dataset-based PD prediction model using ML algorithms is readily applicable, produces validated results, and could be a useful option for PD prediction models. [ABSTRACT FROM AUTHOR]

Smoking is one of the leading causes of premature deaths worldwide. The cigarette is the commonest form of tobacco smoking. This study investigated the factors associated with cigarette smoking among men in five South Asian countries. We analyzed nationally representative cross-sectional study (Demographic and Health Survey) data conducted in Afghanistan, India, Maldives, Nepal, and Pakistan from 2015–2018. Our study population was men aged between 15 and 49 years. The outcome variable was the prevalence of cigarette smoking. We performed both pooled and country-specific analyses using multivariable logistic regression. The prevalence of cigarette smoking among men is the highest (41.2%) in the Maldives and the lowest (20.1%) in Pakistan. Our pooled analysis found that higher age, lower education, lower wealth status, and involvement in any occupations were strongly associated with cigarette smoking (p-value <0.001). However, we did not find a significant association between age and wealth status in Afghanistan, occupations in Nepal and Pakistan, and education in Pakistan with cigarette smoking when country-specific analyses were performed. In this study, socioeconomic position, age, and urban area are strongly associated with cigarette smoking in South Asian countries. The country-specific circumstances should be considered in planning and designing national smoking control strategies and interventions. However, improving access to smoking cessation services could be an effective intervention for all studied countries, Afghanistan, India, Maldives, Nepal, and Pakistan. [ABSTRACT FROM AUTHOR]

Patients with non-small cell lung cancer (NSCLC) who have distant metastases have a poor prognosis. To determine which genomic factors of the primary tumor are associated with metastasis, we analyzed data from 759 patients originally diagnosed with stage I–III NSCLC as part of the AACR Project GENIE Biopharma Collaborative consortium. We found that TP53 mutations were significantly associated with the development of new distant metastases. TP53 mutations were also more prevalent in patients with a history of smoking, suggesting that these patients may be at increased risk for distant metastasis. Our results suggest that additional investigation of the optimal management of patients with early-stage NSCLC harboring TP53 mutations at diagnosis is warranted in light of their higher likelihood of developing new distant metastases. [ABSTRACT FROM AUTHOR]

This study aims at assessing the potential association between non-alcoholic fatty liver disease (NAFLD) and colorectal neoplasms (CRN). PubMed, Cochrane Library, and Embase were searched for cohort studies. 14 cohort studies with a total population of 38,761,773 were included for meta-analysis after selection. The results showed that NAFLD is related to an increased risk of CRN (OR = 1.23; 95% CI: 1.14-1.32; I² = 70.7%, p < 0.001). In the subgroup analysis, NAFLD were found to be the independent risk factor of colorectal adenoma (CRA) (OR = 1.29; 95% CI = 1.15-1.45; I² = 66.4%) and colorectal cancer (CRC) (OR = 1.13; 95% CI = 1.12-1.15; I² = 69.4%). There is no close correlation between smoking status of NAFLD patients and CRN. Interestingly, bioinformatics analysis revealed that there were overlap of dysregulated gene sets among NAFLD, CRC, and two recently identified regulated cell death types, ferroptosis and cuproptosis, respectively. Our meta- and bioinformatics analysis shows that NAFLD increases the risk of CRN. Ferroptosis and cuproptosis may be the critical links between NAFLD and CRN, respectively. These findings here support that NAFLD is necessary to be considered as an emerging risk factor for CRN. [ABSTRACT FROM AUTHOR]

A new smoking behavior recognition algorithm based on a weak supervision fine-grained structure and the EficientDet network is proposed in this study to solve the poor recognition effect and lack of data samples of smoking behavior in complex situations. The proposed algorithm uses the framework of a fine-grained two-level attention model with weak supervision. First, the feature edge of the image block is detected by a structured method, and the edge is screened by non-maximum suppression to form a candidate region block. Smoking behavior can then be recognized effectively by combining the results of the object-level filter for specific objects and the local-level filter for locating discriminant parts. Second, the object-level filter uses an improved EfficientDet network to classify prospective objects and candidate regions with strong features. The present smoking behavior recognition algorithm and coarse- and fine-grained algorithms are compared to verify the effectiveness of the algorithm. Experimental results show that the accuracy of the proposed algorithm is 93.10%, which is higher than that of the optimal smoking behavior detection algorithm by 1.7%, and the error detection rate is 3.6%. [ABSTRACT FROM AUTHOR]

There was a U-shaped association between sleep duration and cognitive function, including self-reported poor memory, self-reported memory decline, and poor cognition, based on the global cognition score. Moreover, poor memory and memory decline were also self-reported; thus, it is possible that those who had normal ageing-related memory decline reported themselves as having "poor memory", leading to an overestimation. The nonlinear association between sleep duration and poor cognition, self-reported poor memory, and self-reported memory decline is presented in Figure 1, after adjusting for age, gender, socioeconomic, and health-behaviour factors. Keywords: cognition; memory and memory decline; sleep duration; older population; socioeconomic factors EN cognition memory and memory decline sleep duration older population socioeconomic factors 1798 10 11/17/22 20221101 NES 221101 1. [Extracted from the article]

To investigate the effect of smoking on rates of progressive visual field (VF) damage over time in glaucoma. Retrospective cohort study. Five hundred eleven eyes of 354 patients with glaucoma followed up from multicenter glaucoma registries. In this longitudinal study, 354 patients with primary open-angle glaucoma with a minimum of 3 years of follow-up and 5 VF tests were enrolled from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Univariate and multivariate linear mixed models were used to investigate the effects of smoking on rates of 24-2 VF mean deviation loss. Visual field progression was defined using pointwise linear and significant negative VF mean deviation loss. Logistic regression was used to identify baseline factors and whether different levels of smoking intensity were associated with VF progression. Kaplan–Meier survival analysis and the log-rank test were used to compare the cumulative risk ratio of progression between smoker and never smoker groups. Visual field progression. Five hundred eleven eyes of 354 patients were included over the median follow-up of 12.5 years. Median baseline age was 64.8 years. Of the 354 patients, 124 (35%) were Black, and 149 (42.1%) and 168 (59.8%) had reported a history of smoking or alcohol consumption, respectively. In a multivariate model, higher smoking intensity was associated with faster VF loss (coefficient, –0.05 decibels (dB)/year per 10 pack-years; 95% confidence interval [CI], –0.08 to –0.01 dB/year per 10 pack-years; P = 0.010). Developing VF progression in eyes of heavy smokers (≥ 20 pack-years) was 2.2 times more than in eyes of patients without smoking history (odds ratio, 2.21; 95% CI, 1.02–4.76; P = 0.044). Statistically significant differences were found between heavy smokers (≥ 20 pack-years) and never smokers by Kaplan–Meier analysis (P = 0.011, log-rank test). Heavy smokers are more likely to sustain VF loss in eyes with glaucoma. The prospective longitudinal design of this study supports the hypothesis that levels of smoking may be a significant predictor for glaucoma progression. Additionally, this information can be used for clinically relevant tobacco prevention and intervention messages. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption and smoking have been reported to be associated with psoriasis risk. However, a conclusion with high‐quality evidence of causality could not be easily drawn from regular observational studies. Objectives: This study aims to assess the causal associations of alcohol consumption and smoking with psoriasis. Methods: Genome‐wide association study (GWAS) summary‐level data for alcohol consumption (N = 941 280), smoking initiation (N = 1 232 091), cigarettes per day (N = 337 334) and smoking cessation (N = 547 219) was obtained from the GSCAN consortium (Sequencing Consortium of Alcohol and Nicotine use). The GWAS results for lifetime smoking (N = 462 690) were obtained from the UK Biobank samples. Summary statistics for psoriasis were obtained from a recent GWAS meta‐analysis of eight cohorts comprising 19 032 cases and 286 769 controls and the FinnGen consortium, comprising 4510 cases and 212 242 controls. Linkage disequilibrium score regression was applied to compute the genetic correlation. Bidirectional Mendelian randomization (MR) analyses were conducted to determine casual direction using independent genetic variants that reached genome‐wide significance (P < 5 × 10–8). Results: There were genetic correlations between smoking and psoriasis. MR revealed a causal effect of smoking initiation [odds ratio (OR) 1·46, 95% confidence interval (CI) 1·32–1·60, P = 6·24E‐14], cigarettes per day (OR 1·38, 95% CI 1·13–1·67, P = 0·001) and lifetime smoking (OR 1·96, 95% CI 1·41–2·73, P = 7·32E‐05) on psoriasis. Additionally, a suggestive causal effect of smoking cessation on psoriasis was observed (OR 1·39, 95% CI 1·07–1·79, P = 0·012). We found no causal relationship between alcohol consumption and psoriasis (P = 0·379). The reverse associations were not statistically significant. Conclusions: Our findings provide causal evidence for the effects of smoking on psoriasis risk. What is already known about this topic?Alcohol consumption and smoking have been reported to be associated with psoriasis risk.Whether alcohol consumption and smoking have a causal effect on psoriasis risk remains unclear. What does this study add?This Mendelian randomization study shows a causal association between smoking, but not alcohol consumption, and the risk of developing psoriasis.Restricting smoking could be helpful in reducing the burden of psoriasis. [ABSTRACT FROM AUTHOR]

We propose an approach for the planning of longitudinal covariate measurements in follow‐up studies where covariates are time‐varying. We assume that the entire cohort cannot be selected for longitudinal measurements due to financial limitations, and study how a subset of the cohort should be selected optimally, in order to obtain precise estimates of covariate effects in a survival model. In our approach, the study will be designed sequentially utilizing the data collected in previous measurements of the individuals as prior information. We propose using a Bayesian optimality criterion in the subcohort selections, which is compared with simple random sampling using simulated and real follow‐up data. Our work improves the computational approach compared to the previous research on the topic so that designs with several covariates and measurement points can be implemented. As an example we derive the optimal design for studying the effect of body mass index and smoking on all‐cause mortality in a Finnish longitudinal study. Our results support the conclusion that the precision of the estimates can be clearly improved by optimal design. [ABSTRACT FROM AUTHOR]

Background: Current clinical classifications of olfactory function are based primarily upon a percentage of correct answers in olfactory identification testing. This simple classification provides little insight into etiologies of olfactory loss, associated comorbidities, or impact on the quality of life (QOL). Methods: Community-based subjects underwent olfactory psychophysical testing using Sniffin Sticks to measure threshold (T), discrimination (D), and identification (I). The cognitive screening was performed using Mini-Mental Status Examination (MMSE). Unsupervised clustering was performed based upon T, D, I, and MMSE. Post hoc differences in demographics, comorbidities, and QOL measures were assessed. Results: Clustering of 219 subjects, mean age 51 years (range 20-93 years) resulted in 4 unique clusters. Cluster 1 was the largest and predominantly younger normosmics. Cluster 2 had the worst olfaction with impairment in nearly all aspects of olfaction and decreased MMSE scores. This cluster had higher rates of smoking, heart disease, and cancer and had the worst olfactory-specific QOL. Cluster 3 had normal MMSE with relative preservation of D and I, but severely impaired T. This cluster had higher rates of smoking and heart disease with moderately impaired QOL. Cluster 4 was notable for the worst MMSE scores, but general preservation of D and I with moderate loss of T. This cluster had higher rates of Black subjects, diabetes, and viral/traumatic olfactory loss. Conclusion: Unsupervised clustering based upon detailed olfactory testing and cognitive testing results in clinical phenotypes with unique risk factors and QOL impacts. These clusters may provide additional information regarding etiologies and subsequent therapies to treat olfactory loss. [ABSTRACT FROM AUTHOR]

Risky behaviors (substance abuse, obesity, suicide, bullying, and others), many of which are indeed preventable, are common among high school students. The most important task in detecting, preventing, and intervening in risky behaviors in schools falls to the school guidance service and school psychological counselor. The main objective of this study is to determine the types and prevalence of risky behaviors observed among high school students and to analyze the practices performed by the school guidance service for such behaviors. This study was organized in accordance with the mixed research design for which qualitative and quantitative approaches were used together. In this context, quantitative (N1=566) and qualitative (N2=21) data collection processes were carried out with psychological counselors working in different types of high schools in 12 provinces. While statistical procedures were included for the quantitative data of the research, content analysis techniques were used for the qualitative data. The results showed smoking, peer bullying, cyberbullying, school dropout, obesity, delinquency, abuse, suicidal tendency and attempt, alcohol use, bonsai use, and other substance use as risky behaviors in high schools. The levels and frequency of these behaviors vary across school types. The preventive activities in the schools were generally based on informative seminars, and practical studies were limited. The research results also indicated that studies of risky behaviors were not sufficiently included in Ministry or school guidance framework programs. Furthermore, it was found that parents, teachers, and administrators gave limited support to the studies carried out within the scope of education and intervention for risky behaviors in schools. These results demonstrate that school psychological counselors encountered several personal, institutional, or legal obstacles in their studies on risky behaviors. [ABSTRACT FROM AUTHOR]

Summary: Prediction of building fire smoke spread behaviors plays an important role in the evacuation in an emergency to mitigate fire risk. Based on data assimilation, a cost‐effective approach was proposed to predict fire smoke spread behaviors under unknown mixed disturbances by combining a zone model (CFAST) and Ensemble Kalman Filter (EnKF). CFAST is used to predict fire smoke spread behaviors as a deterministic fire model. Sensor data of smoke temperature were assimilated into CFAST simulation by leveraging EnKF to estimate unknown heat release rate (HRR) and thus improving the prediction accuracy. The performance of the proposed approach was tested via a series of Observing Systems Simulation Experiments. Two series of cases were conducted for unknown single HRR change disturbance and unknown single‐window breakage disturbance, one series of cases was conducted for unknown mixed HRR change and window breakage disturbances. Result comparisons have been presented in figures to assess the approach performance qualitatively, and root mean square errors (RMSEs) have been calculated to assess the approach performance quantitatively. The RMSEs are within the range of 1.78–29.88 K. The results showed that it was a viable solution to set a larger perturbation range for unknown disturbances. The proposed approach could provide more accurate and reliable predictive information about fire smoke spread behaviors for risk mitigation, as well as other safety‐related applications. [ABSTRACT FROM AUTHOR]

Purpose: Identifying disease burden and risk factors of bladder cancer and projecting its epidemiological trend in China, which can provide reference data to formulate measures for its management and prevention. Methods: We analyzed the incidence, mortality, and disability-adjusted life-years (DALYs) data of bladder cancer in China from 1990 to 2019 and predicted to 2030 based on the Global Burden of Disease Study 2019. We also estimated the proportion of risk factors contributing to bladder cancer DALYs. The average annual percentage change (AAPC) in both sexes was calculated to quantify the temporal trends. Results: In China, the age-standardized incidence rate of bladder cancer increased from 3.3/100,000 in 1990 to 5.16/100,000 in 2019 (AAPC of 1.47), while the age-standardized mortality rate and age-standardized DALYs rate declined slightly (AAPC of − 0.58 and − 0.65, respectively). The burden of bladder cancer increased with age, which reached a peak over 85 years old. The main risk factor for bladder cancer was smoking, and the contribution of high fasting plasma glucose increased from 1990 to 2019, with an AAPC of 0.85 in males and 0.61 in females. We predicted total incident cases, deaths and DALYs will increase to 150,372 and 53,520 and 1043,688 in 2030, respectively. The disease burden of bladder cancer in males will consistently higher than that in females from 2020 to 2030. Conclusion: Although mortality and DALYs rates showed downward trends, the disease burden remained heavy in China at present. More effective and long-term health policies are needed to develop for early prevention and treatment of bladder cancer. [ABSTRACT FROM AUTHOR]

Objective: A network meta-analysis based on randomized controlled trials was conducted to investigate the effects of pharmacological interventions on smoking cessation. Methods: English databases were searched to obtain randomized controlled trials reporting the effect of pharmacological interventions on smoking cessation. The risk of bias for the included trials was assessed using Cochrane Handbook tool. Stata 15.1 software was used to perform network meta-analysis, and GRADE approach was used to assess the evidence credibility on the effects of different interventions on smoking cessation. Results: A total of 159 studies involving 60,285 smokers were included in the network meta-analysis. The analysis involved 15 interventions and which yielded 105 pairs of comparisons. Network meta-analysis showed that varenicline was more helpful for smoking cessation than other monotherapies, such as nicotine replacement therapy [Odds Ratio (OR) = 1.42, 95% confidence interval (CI) (1.16, 1.73)] and bupropion [OR = 1.52, 95% CI (1.22, 1.89)]. Furthermore, combined interventions were superior to monotherapy in achieving smoking cessation, such as varenicline plus bupropion over bupropion [OR = 2.00, 95% CI (1.11, 3.61)], varenicline plus nicotine replacement therapy over nicotine replacement therapy [OR = 1.84, 95% CI (1.07, 3.18)], and nicotine replacement therapy plus mecamylamine over naltrexone [OR = 6.29, 95% CI (1.59, 24.90)]. Finally, the surface under the cumulative ranking curve value indicated that nicotine replacement therapy plus mecamylamine had the greatest probability of becoming the best intervention. Conclusion: Most pharmacological interventions demonstrated a benefit in smoking cessation compared with placebo, whether monotherapy or combination therapy. Moreover, confirmed evidence suggested that some combination treatments, such as varenicline plus bupropion and nicotine replacement therapy plus mecamylamine have a higher probability of being the best smoking cessation in. [ABSTRACT FROM AUTHOR]

Sarcoma is a rare cancer, and little is known about the etiology, lifestyle epidemiology, and actual circumstances of treatment in hospitals in Japan. Understanding these issues is essential for the effective prevention and treatment of sarcoma. We therefore investigated the incidence of a personal and family cancer history in a total of 1320 sarcoma patients at the National Cancer Center Hospital. In addition, obesity, hypertension, dyslipidemia, diabetes mellitus, drinking, smoking, age and sex were compared in a descriptive study of 1159 of these sarcoma patients who were ≥ 20 years of age, and 7738 controls derived from the National Health and Nutrition Examination Survey in Japan. A total of 8% of sarcoma patients had a personal history of another cancer, and 30% of soft tissue sarcoma patients had a family cancer history in a first-degree relative (malignant peripheral nerve sheath tumor, 52%; leiomyosarcoma, 46%). A smoking habit was associated with the development of sarcoma (odds ratio [OR], 2.05; 95% confidence interval, 1.78–2.37; p < 0.01). According to the histology, the ORs for undifferentiated pleomorphic sarcoma (UPS) of bone, UPS of soft tissue, and liposarcoma were 5.71, 3.04, and 2.92, respectively. A family cancer history may be associated with certain soft tissue sarcomas, and a smoking habit was significantly associated with the development of sarcomas; however, further studies are necessary. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether significant associations exist between multicultural families and adolescent smoking risks in South Korea. Data from the Korea Youth Risk Behavior Web-based survey from 2016 to 2020 were analyzed. Participants were classified into four family types (South Korean mother–foreign father, South Korean father–foreign mother, both foreign parents, and both South Korean parents) according to their parents' country of birth and smoking was assessed using a self-reported questionnaire. A logistic regression analysis was used to examine the significance of the associations. Overall, 194,259 participants (boys: 94,793, girls: 99,466) enrolled in this study. Adolescents whose parents were born overseas were more likely to smoke than native South Korean adolescents (boys: odds ratio [OR] = 2.61, confidence interval [CI] = 1.79–3.81, girls: OR 3.94, CI 2.42–6.43). When the mother's country of birth was a developing country, there was an increased likelihood of girls smoking, and there was an increased likelihood of smoking among boys when the mother's country of birth was North Korea. When both parents were born abroad, and the mother's country of birth was a developing country, the likelihood of smoking risks among their multicultural teenage children increased. Policies and interventions need to be established and implemented to lower the smoking rate among multicultural teenagers. [ABSTRACT FROM AUTHOR]

The Philippine government significantly raised cigarette excise taxes in 2013, following passage of the landmark Sin Tax Reform Act of 2012. As a result, cigarette prices increased substantially. Given varying smokers' responses to the price increase, we examined underlying typologies of Filipino smokers and assessed how these typologies determine smoking intensity. We used cross-sectional data from the 2015 wave of the Philippine Global Adult Tobacco Survey (N = 1,651). To uncover typologies, random effects latent class modelling was used on six individual smoker responses (attempting to stop, thinking about quitting, decreasing sticks smoked, switching to cheaper brands, buying in bulk, and asking from others). Bivariate and multivariate analyses were employed to uncover determinants of typologies and smoking intensity. We found two typologies based on smokers' response. The first group, called "potential quitters" (62.62%), is composed of smokers who are more likely to consider quitting and decrease sticks smoked. The second group, called "unlikely to quit" (37.38%), have smokers who opt for price-minimization strategies like switching to cheaper brands, buying in bulk, or asking cigarettes from others. Potential quitters tend to be female, a student, and less nicotine dependent. They smoke up to three fewer sticks than those unlikely to quit, controlling for other factors. Nicotine dependence stood out as the most important predictor of being in the unlikely to quit group. The dominant role of nicotine dependence in determining a smoker's typology points to the need for non-price based measures, such as those targeted towards highly-nicotine dependent smokers, to complement tax-induced price increases and comprehensively address the smoking problem. [ABSTRACT FROM AUTHOR]

Background: Oral Cancer Is One Of The World's Most Common Types Of Cancer, With Delayed Diagnosis And Poor Prognosis. India Is Among The Leading Countries With A High Rate Of Oral Cancer Due To Its Increased Tobacco Use Rate. Aim: This Study Aims To Assess The Prevalence Of Oral Cancer Among Tobacco And Non-Tobacco Users In Tamil Nadu. Materials And Method: A Systematic Review Of Cross-Sectional Studies Were Performed. The Data Was Searched Using Electronic Databases, And 376 Articles Were Screened. The Intervention And Outcomes Were Assessed In The Studies Included In The Systematic Review. The Bias Assessment Done For The Article Was Based On The Newcastle-Ottawa Scale. Results: Overall Analysis Of The Studies Shows That The Prevalence Of Oral Cancer In Tamil Nadu Has Been Significantly Increasing And That Smokeless Tobacco Causes Oral Cancer Compared With Other Forms Of Tobacco. Conclusion: The Prevalence Of Oral Cancer In Tamil Nadu Is Increasing Significantly With The Usage Of The Increased Amount Of Tobacco, And Awareness Of The Ill Effects Of Tobacco Usage May Considerably Decrease The Rates. [ABSTRACT FROM AUTHOR]

Introduction: Gingival recession (GR) is a condition in which the gingival border is apical to the cementoenamel junction and the root is exposed to the oral environment. Tobacco use is one of the most important risk factors for the development of destructive types of periodontal disease, as well as a risk factor for GR. Aim: The aim of the present cross-sectional study was to assess the prevalence of gingival recession among patients visiting a university dental hospital setting who are using different forms of tobacco. Materials & Method: This study was conducted during the period of November 2019 to April 2020 in Saveetha Dental College and Hospitals in Chennai among patients with gingival recession who are under the usage of various forms of tobacco. The data were sorted and tabulated in Microsoft Excel and then entered in IBM SPSS software version 23 for descriptive statistics. Results And Discussion: According to the results there is a decline in tobacco users with increase in age, drastically so after the age of 50. Figure 3 shows us that there is a maximum prevalence of GR of 19.60% among the age group 40-50 years and also shows the gradual increase in the prevalence of GR with age in accordance with the number of participants belonging to each age group. There may be a higher chance of prevalence of GR among those who use both the forms of tobacco, i.e smokable and chewable than just a single form of useage. Conclusion: From this retrospective study we conclude that gingival recession is evident in patients who use various forms of tobacco with a prevalence rate of 68.40 %. Highest prevalence of gingival recession among the age groups is 19.60% of age group 40-50 years who majorly smoked and used chewable forms of tobacco. [ABSTRACT FROM AUTHOR]

Despite the relatively increased cancer incidence in the last few years in the Arab countries, it is still far from the figures reported from Western countries. Several mechanisms have been adopted to explain the significant decreased incidence of cancer in the Arab countries, among them fasting, food full of special recipes filled with spices, significant lower rates of smoking and alcohol drinking, and genetic predisposition. Clinical trials are warranted on a large population scales to study, discuss, and verify such mechanisms. [ABSTRACT FROM AUTHOR]

PURPOSE: Knowledge of thyroid eye disease (TED) is based on predominantly Caucasian populations. To date, no studies in the United States examine the presentation in Black and Hispanic patients. The purpose of this study is to introduce the presentation of TED in two previously undescribed populations. METHODS: This is a retrospective, cross-sectional, chart review study of patients with TED at a tertiary center using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. The main outcome measure for severity was the European Group on Graves' Orbitopathy 2016 Severity Scale. RESULTS: Of the 2905 charts reviewed, 99 met the inclusion criteria. The mean age was 51 (standard deviation 16) years with 78% women. Race was 49.4% Black, 39.1% Hispanic, 9.2% Caucasian, and 2.3% Asian. Smoking rates were 25% current smokers and 14% former smokers. Manifestations were proptosis (94% Hispanic and 91% Black), eyelid retraction (85% Hispanic and 79% Black), extraocular muscle (EOM) restriction (79% Hispanic and 63% Black), eyelid edema (41% Hispanic and 30% Black), chemosis (24% Hispanic and 14% Black), and optic neuropathy (18% Hispanic and 9% Black). Overall, disease severity was 22% mild, 65% moderate to severe, and 13% sight-threatening. Older patients had increased rates of optic neuropathy (P = 0.04). Younger patients had increased rates of proptosis (P = 0.02). Socioeconomic status was not associated with disease severity (P = 0.67). CONCLUSION: Hispanic and Black patients with TED presented with higher than previously established rates of proptosis, EOM restriction, and optic neuropathy. Including research of different races broadens understanding of presentation and management, improving patient outcomes. [ABSTRACT FROM AUTHOR]

Background and Objective: The incidence of type 2 diabetes has been steadily rising over the past few decades, which has contributed significantly to the rise in the prevalence of diabetes (DM). Statistics from the World Health Organization show that more than 422 million adults worldwide had diabetes in 2014, and an ongoing rise in DM prevalence is anticipated. This study aims to create a method that can use to predict and manage diabetes cases in light of the importance of statistical modeling in diabetes. Decision trees and ordinal regression were the two methods used in this study. With some modification and extension, both methods will be harmonized in the R syntax. Materials and Methods: In this paper, we developed a method for analyzing decision trees using R syntax and embedding classification predictions. The classification for prediction with accuracy will indicate a successful classification analysis. This study illustrated the development method using diabetes data consisting of one thousand observations. Before further testing, the clinical relevance and significance of each preselected variable will be assessed. The decision tree will be used to evaluate nine variables. The selected variables are body mass index, total cholesterol, diabetes status, glucose reading, high-density lipoprotein, patient height, hip circumference, hypertension status, smoking status, and triglycerides. The classification obtained will be used as an input for the ordinal regression modeling. Result: It has been discovered that the status of diabetes can be determined by the level of glucose during fasting, which is consistent with the most recent research that has been published. one variable was chosen and used for the input of the ordinal regression. The suggested variables will apply to the ordered logistic regression, and the developed syntax will be used to assess the goodness of measurement and the significance level is set at a 0.05 level. Conclusion: Our proposed method achieves the highest level of forecasting precision possible. The methodology offers a precise evaluation of the fit of the final model. The superior performance of the model resulted in improved outcomes and efficient decision-making management. [ABSTRACT FROM AUTHOR]

For over a century, a complex relationship between schizophrenia diagnosis and development of many cancers has been observed. Findings from epidemiological studies are mixed, with reports of increased, reduced, or no difference in cancer incidence in schizophrenia patients. However, as risk factors for cancer, including elevated smoking rates and substance abuse, are commonly associated with this patient population, it is surprising that cancer incidence is not higher. Various factors may account for the proposed reduction in cancer incidence rates including pathophysiological changes associated with disease. Perturbations of the adenosine system are hypothesized to contribute to the neurobiology of schizophrenia. Conversely, hyperfunction of the adenosine system is found in the tumor microenvironment in cancer and targeting the adenosine system therapeutically is a promising area of research in this disease. We outline the current biochemical and pharmacological evidence for hypofunction of the adenosine system in schizophrenia, and the role of increased adenosine metabolism in the tumor microenvironment. In the context of the relatively limited literature on this patient population, we discuss whether hypofunction of this system in schizophrenia, may counteract the immunosuppressive role of adenosine in the tumor microenvironment. We also highlight the importance of studies examining the adenosine system in this subset of patients for the potential insight they may offer into these complex disorders. [ABSTRACT FROM AUTHOR]

In this study, the cost structure and profitability of tobacco production were examined in the sample of Uşak province. Esme and Ulubey districts in Uşak were the districts with the highest tobacco production. It was determined that 71 tobacco farmers, calculated according to the stratified sampling method, should be interviewed in the villages of these districts. Data were obtained through face-to-face interviews with farmers in the producer survey. Tobacco farming is an important income activity in the region where the family workforce is utilised. Labour force, land rent, and machinery rent were determined as the most significant cost factors in tobacco production. We found that large-scale enterprises are more profitably. In addition, it was determined that the organisation of tobacco farmers was insufficient. With the organisation, farmers will be able to provide the inputs used in tobacco production under more favourable conditions, and the development of marketing opportunities will make a positive contribution. [ABSTRACT FROM AUTHOR]

Scientometric analysis of a disease is often conducted to recognize research hotspots and investigate latest trends. In this brief report, we provide a scientometric overview of oral cancer research in Taiwan and mainland China. There were 1924 and 3853 articles on oral cancer research originating from Taiwan and mainland China, respectively. In Taiwan, the risk factors including areca/betel quid chewing, tobacco smoking, and alcohol use were the distinctive keywords. For basic research, genotype, reactive oxygen, p53, mitochondria and caspase-9 were the distinctive keywords. In mainland China, experiment methods such as genetic transfection, gene silencing, colony formation, tumor xenograft were the distinctive keywords. Epithelial mesenchymal transition, long untranslated RNA, protein function, uvomorulin, and Bcl-2 were the distinctive keywords of basic research. Collectively, we hope that these scientometric characteristics will aid clinicians and researchers for obtaining information on oral cancer and can be of guidance for future studies. [ABSTRACT FROM AUTHOR]

Background and Objectives: The mental and physical functioning of an individual is partly determined by their health-related quality of life (HRQOL), which is a multifaceted component. Women who have recently given birth must have a good quality of life to provide proper care and development for their infant. The purpose of this study was to assess the relationship between postpartum depression (PPD) and HRQOL in Saudi Arabian women and to identify potential risk factors that could influence them. Methods: This study comprised 253 mothers aged 1-24 weeks postpartum from several health centers in Saudi Arabia, recruited by random purposive sampling. The study's questionnaire featured three sections: the first section had demographic information; the second and third sections contained the Edinburgh Postnatal Depression Scale (EPDS) scale and the HRQOL scale (SF-12), respectively. Data were analyzed using descriptive statistics, chi square analyses, independent samples t-tests and binary logistic regression analysis using IBM SPSS 25. Results: Results of current study indicate that 59.68% of the patients exhibited probable post-partum depression symptoms. Participants who were depressed had significantly lower mental component (MCS) and physical component scores than participants who were in good health. When compared to non-smokers, smokers have a 21-fold higher risk of developing depression. Similar to this, mothers who worked had a 3.98 times higher risk of depression, and patients with a history of depression had a 3.6 times higher chance of getting PPD. The probability of developing PPD was also significantly higher in those who lived outside the Riyadh region, had given birth more than twice before this time, and had experienced undesired pregnancies. Conclusion: Our study demonstrated an inverse correlation between postpartum depression and health-related quality of life scores. Treatment for depression, particularly among mothers, is crucial for improving their quality of life and, as a result, creating a favorable environment for the development of newborn babies. [ABSTRACT FROM AUTHOR]

In order to study the reaction growth process of insensitive JEOL explosive after ignition under cook-off, a series of cook-off tests were carried out on JEOL explosive using a self-designed small cook-off bomb system. A thermocouple was used to measure the internal temperature of the explosive, and a camera recorded macro images of the cook-off process. The temperature change law of JEOL explosive before and after ignition under different heating rates and the smoke ejection caused by the reaction in the slit were studied. The research results showed that the ignition time decreased as the heating rate increased, while the ignition temperature was not sensitive to the heating rate. When the heating rate was faster, the internal temperature gradient of the explosive was larger, and the ignition point appeared at the highest temperature position. As the heating rate decreased, the internal temperature gradient of the explosive decreased, the ignition point appeared random, and multiple ignition points appeared at the same time. The growth process of the ignition point could be divided into severe thermal decomposition, slow combustion, and violent combustion stages. When the heating rate reduced from 7 to 1 °C/min, the burning rate obviously increased. [ABSTRACT FROM AUTHOR]

Consistent tobacco consumption by large segments of the Indian population has resulted in a significant health burden for the country. Historical and cultural influences have influenced tobacco use to a considerable extent. As a general observation, its consumption is seen to be more prevalent among educated and working individuals. Despite the reduction in the prevalence of smoking, data shows that the proportion of male smokers aged 15–69 years has increased substantially over the last 15 years. The focus of the present study is on a state-level geo-spatial analysis of tobacco consumption and its cessation in working and non-working groups in the Indian population. Cross-sectional data from the Global Adult Tobacco Survey (2016–17) for India were used for analysis. Descriptive statistics and geo-spatial analysis were carried out. The findings show that substance use is higher in the hilly and coastal parts of the Indian states. Tobacco consumption was highest in Sikkim, the North-Eastern, Eastern and the Central states of India. However, on a positive note, the findings also show that, due to tobacco control or prevention programmes, more than 60% of the people from both working and non-working groups living in these high consumption states (excluding Karnataka Sikkim, Tripura, Nagaland and Manipur) were trying to quit the tobacco habit. Precisely targeted prevention and counselling services, nicotine replacement therapy, and medication are required to accelerate this trend. There is a need for more interventions to increase the present low levels of tobacco cessation. [ABSTRACT FROM AUTHOR]

The article reports a population-based cohort study to demonstrate a relationship between outdoor fine particulate air pollution (PM2.5) and mortality caused due to low concentrations. It discusses the new guidelines released by the World Health Organization (WHO) for outdoor fine particulate air pollution (PM2.5) recommended an annual average concentration. It indicates the importance of reducing outdoor air pollution around the world.

People with tuberculosis (TB) are at risk of major adverse cardiovascular events. We estimated the prevalence of cardiovascular risk (CVR) factors among people with active TB in Africa. This was a systematic review and meta-analysis of studies from Africa. We searched EMBASE, MEDLINE through PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, mRCTs, Clinical trials.gov, and International Clinical Trials Registry Platform from inception to 31st December 2021. Among 110 eligible studies, 79 (238,316 participants) were included in the meta-analysis for smoking, 67 (52,793 participants) for current alcohol use, 30 (31,450 participants) for hazardous alcohol use, 51 (37,879 participants) for diabetes mellitus (DM), 19 (18,211 participants) for hypertension and 18 (13,910 participants) for obesity. The pooled prevalence was 26.0% (95% confidence interval 22.0–29.0) for smoking, 30.0% (25.0–35.0) for any current alcohol use, 21.0% (17.0–26.0) for hazardous alcohol use, 14.0% (9.0–18.0) for hypertension, 7.0% (6.0–9.0) for DM, and 4.0% (2.0–5.0) for obesity. Cost-effective strategies are needed to screen for CVR factors among people with active TB in Africa. [ABSTRACT FROM AUTHOR]

Background: Smoking prevalence remains high in Malaysia. Primary care doctors have a good opportunity to motivate the smokers to quit smoking in view of the accessibility of primary healthcare clinics to the public. The objective of this study was to determine the practice of smoking cessation management among primary care doctors and its associated factors. Methods: A cross-sectional online survey was carried out among 383 medical officers and interns in all government primary healthcare clinics in the district of Petaling, Klang and Hulu Langat from June to August 2020. All doctors were involved in the care of patients for smoking cessation. The knowledge, attitude and practice of smoking cessation management were assessed using a 17-items validated questionnaire which covered the components of 5As (Ask, advise, assess, assist, arrange) and 5Rs (Relevance, risk, reward, roadblocks, repetition). The management of pre-contemplation phase included the components of ask, advise, assess and 5Rs. The management of the contemplation phase included the components of assist and arrange. Result: The majority of the respondents had poor score of knowledge (62.4%); attitude (58%) and practice (pre-contemplation management:50.9%; contemplation management:75.7%). Using multivariate logistic regression analysis, the significant factors associated with the poor practice of smoking cessation management in the pre-contemplation phase were poor (OR = 2.14, 95% CI 1.11–4.12, p <0.01) or moderate knowledge (OR = 2.50, 95% CI 1.19–5.26, p<0.01), poor attitude (OR = 2.16, 95% CI 1.39–3.37, p<0.01), lacks smoking cessation banners, brochures and leaflets in the clinic (OR = 2.01, 95%CI 1.26–3.19, p<0.01) and lack of nicotine replacement medications (OR = 2.27. 95%CI 1.27–4.06, p<0.01). No significant factors were shown associated with the practice of the contemplation phase. Conclusion: The majority of primary care doctors had poor knowledge, attitude and practice of smoking cessation management. Factors that had increased the odds of the poor practice of smoking management at the pre-contemplation phase were poor knowledge, poor attitude, and insufficient organizational support for health promotion materials and nicotine replacement medication. [ABSTRACT FROM AUTHOR]

Background: Clozapine is an effective antipsychotic medication for patients with treatment-resistant schizophrenia. Previous studies revealed that smoking, alcohol intake, and coffee consumption altered the metabolism of clozapine. However, causal associations between substance use and clozapine levels were not sufficiently established. Methods: Several genome-wide association studies provided genetic tools for six measures of substance use, including age of smoking, cigarettes per day, smoking cessation, smoking initiation, coffee consumption, and alcohol consumption (GWASs). Utilizing the CLOZUK consortium's dataset, their associations with clozapine and its metabolite concentrations were evaluated. All GWAS data were collected from the European population. Mendelian randomization (MR) estimations from each genetic test were combined using inverse variance weighted (IVW) meta-analysis in combination with complementing techniques (such as weighted median and MR Egger). We also analyze horizontal pleiotropy and heterogeneity using various sensitivity analyses. Results: Genetically predicted higher level of smoking initiation was significantly associated with reduced clozapine (b = -0.14, P = 4.53E-04) concentrations and norclozapine concentrations (b = -0.14, P = 3.33E-04), and increased coffee consumption was significantly associated with lower level of clozapine concentrations (b = -0.42, P = 1.70E-14), norclozapine concentrations (b = -0.27, P = 1.51E-07), and the metabolic ratio of clozapine to norclozapine (b = -0.15, P = 5.35E-07), survived after the Bonferroni correction (P = 0.05/6 = 0.008). In sensitivity analyses, the weighted median and MR Egger methods demonstrated directionally consistent effects. In addition, our sensitive test indicated no significant horizontal pleiotropy and heterogeneity (P > 0.05). However, other measures of substance use (age of initiation smoking, cigarettes per day, smoking cessation, and drinks per week) were not associated with clozapine metabolism. Conclusion: Our investigation revealed a correlation between greater smoking initiation and coffee consumption and reduced blood levels of clozapine and norclozapine. Providing clinicians with guidance on how to adjust clozapine levels for clozapine-treated patients. [ABSTRACT FROM AUTHOR]

Ca2+ signaling is altered substantially in many cancers. The ryanodine receptors (RYRs) are among the key ion channels in Ca2+ signaling. This study aimed to establish the mutational profile of RYR in cancers and investigate the correlation between RYR alterations and cancer phenotypes. The somatic mutation and clinical data of 11,000 cancer patients across 33 cancer types was downloaded from The Cancer Genome Atlas (TCGA) database. Subsequent data processing was performed with corresponding packages of the R software. Mutational profile was analyzed and its correlation with tumor mutational burden (TMB), patient prognosis, age and smoking status was analyzed and compared. All three RYR isoforms exhibited random mutational distribution without hotspot mutations when all cancers were analyzed together. The number of mutations in RYR2 (2388 mutations) far overweight that of RYR1 (1439 mutations) and RYR3 (1573 mutations). Linear correlation was observed between cumulative TMB and cumulative number of mutations for all RYR isoforms. Patients with RYR mutations exhibited significantly higher TMB than those without RYR mutations for most cancer types. Strong correlation was also revealed in the average number of mutations per person between pairs of RYR isoforms. No stratification of patient overall survival (OS) by mutational status was found for all three RYR isoforms when all cancers were analyzed together, however, significant stratification of OS by RYR mutations was revealed in several individual cancers, most strikingly in LUAD (P = 0.0067, RYR1), BLCA (P = 0.00071, RYR2), LUSC (P = 0.036, RYR2) and KIRC (P = 0.0042, RYR3). Furthermore, RYR mutations were correlated with higher age, higher smoking history grading and higher number of pack years. Characteristic mutation profile of RYRs in cancers has been revealed for the first time. RYR mutations were correlated with TMB, age, smoking status and capable of stratifying the prognosis of patients in several cancer types. [ABSTRACT FROM AUTHOR]

Background: More deprived populations typically experience higher cancer incidence rates and smoking prevalence compared to less deprived populations. We calculated the proportion of cancer cases attributable to smoking by socio-economic deprivation in England and estimated the impact smoking has on the deprivation gap for cancer incidence. Methods: Data for cancer incidence (2013–2017), smoking prevalence (2003–2007) and population estimates (2013–2017) were split by sex, age-group and deprivation quintile. Relative risk estimates from meta-analyses were used to estimate the population attributable fraction (PAF) for 15 cancer types associated with smoking. The deprivation gap was calculated using age-specific incidence rates by deprivation quintile. Results: Smoking-related cancer PAFs in England are 2.2 times larger in the most deprived quintile compared to the least deprived quintile (from 9.7% to 21.1%). If everyone had the same smoking prevalence as the least deprived quintile, 20% of the deprivation gap in cancer incidence could have been prevented. If nobody smoked, 61% of the deprivation gap could have been prevented. Conclusions: The majority of the deprivation gap in cancer incidence could have been prevented in England between 2013–2017 if nobody had smoked. Policy makers should ensure that tobacco control policies reduce overall smoking prevalence by tackling smoking inequalities. [ABSTRACT FROM AUTHOR]

Background: There is an increased burden of diabetes globally including in sub-Saharan Africa. The literature shows that glycaemic control among type 2 diabetes patients is poor in most countries in sub-Saharan Africa. Understanding the factors influencing glycaemic control in this region is therefore important to develop interventions to optimize glycaemic control. We carried out a systematic review to determine the prevalence and factors associated with glycaemic control in sub-Saharan Africa to inform the development of a glycaemic control framework in the Democratic Republic of the Congo. Methods: We searched five databases (African Index Medicus, Africa-Wide Information, Global Health, PubMed, and Web of Science) using the following search terms: type-2 diabetes, glycaemic control, and sub-Saharan Africa. Only peer-reviewed articles from January 2012 to May 2022 were eligible for this review. Two reviewers, independently, selected articles, assessed their methodological quality using Joanna Briggs checklists, and extracted data. A meta-analysis was performed to estimate the prevalence of glycaemic control. Factors associated with glycaemic control were presented as a narrative synthesis due to heterogeneity as assessed by the I2. Results: A total of 74 studies, involving 21,133 participants were included in the review. The pooled prevalence of good glycaemic control was 30% (95% CI:27.6–32.9). The glycaemic control prevalence ranged from 10–60%. Younger and older age, gender, lower income, absence of health insurance, low level of education, place of residence, family history of diabetes, longer duration of diabetes, pill burden, treatment regimen, side effects, use of statins or antihypertensives, alcohol consumption, smoking, presence of comorbidities/complications, and poor management were associated with poor glycaemic control. On the other hand, positive perceived family support, adequate coping strategies, high diabetes health literacy, dietary adherence, exercise practice, attendance to follow-up, and medication adherence were associated with good glycaemic control. Conclusion: Suboptimal glycaemic control is pervasive among patients with type-2 diabetes in sub-Saharan Africa and poses a significant public health challenge. While urgent interventions are required to optimize glycaemic control in this region, these should consider sociodemographic, lifestyle, clinical, and treatment-related factors. This systematic review and meta-analysis protocol is registered in PROSPERO under CRD 42021237941. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco use remains a global public health challenge. While studies report that smoking cessation reduces the risk of cancer and other NCDs, evidence is scarce in African region on socio-economic determinants of smoking cessation behavior. This study examined the socio-economic differentials of smoking cessation behavior among smokers in four African countries. Methods: The study was conducted through secondary analysis of Global Adult Tobacco Survey (GATS) data from four African countries (Ethiopia, Kenya, Senegal and Tanzania). Smoking cessation behavior was assessed using two variables i) intention to quit smoking in next 12 months and ii) previous quit attempts made within 12 months preceding the survey. The weighted percentages for intention to quit smoking and previous quit attempts were computed. The adjusted odds ratios were computed using multinomial logistic regression to identify the association between socio-economic factors and smoking cessation behavior. Results: Across the four countries studied, the previous quit attempts among smokers were in the range of 39.6% to 53.7%. Around 7.6% to 15.8% of the smokers tried to quit with an assistance. In Ethiopia over 76.5% of current smokers reported no intention to quit in next 12 months after survey, whereas the same was 50.4% in Senegal. While country specific differences were observed, females, those belonging to the poorest wealth index, unemployed and those without any formal education reported significantly lower odds of previous quit attempts or having an intention to quit smoking. Conclusion: The socio-economic vulnerabilities were found to compromise smoking cessation behavior among the smokers in countries studied. Targeted interventions, adherence to smokefree laws, and provision of cessation support are essential to improve quit rates and mitigate tobacco risks among socio-economically vulnerable population. [ABSTRACT FROM AUTHOR]

Objective. To investigate the efficacy of drug-coated balloon (DCB) combined with cutting balloon angioplasty (CBA) in the treatment of drug-eluting stent in-stent restenosis (DES-ISR) and to construct a predictive model for the occurrence of DES-ISR. Methods.According to the criteria of diagnosis, inclusion, and exclusion, DES-ISR patients who were treated in the outpatient and inpatient departments of cardiovascular medicine of Second People's Hospital of Guangdong Province from July 2021 to December 2021 were included. A total of 72 cases were planned to be enrolled, including 36 cases in the control group and 36 cases in the experimental group. The control group was treated with DCB, and the experimental group was combined with CBA. The treatment success rate, coronary angiography results before and after surgery, and the incidence of major adverse cardiovascular events during the follow-up period were compared between the two groups. Seventy-two DES-ISR patients were divided into ISR group and 59 non-ISR patients were divided into non-ISR group. The clinical data of the two groups were compared to analyze the risk factors affecting the occurrence of DES-ISR, and the prediction model was established. Results. The surgical success rate of the experimental group was 94.44% (34/36), which was higher than the 77.78% (28/36) of the control group (P < 0.05). The minimum lumen diameter (MLD) of the experimental group 6 months after operation was greater than that of the control group, the late lumen loss (LL) and lumen stenosis rate were higher than those in the control group, and the incidence of major adverse cardiovascular events was lower than that in the control group (P < 0.05). In the ISR group, the proportion of patients with abnormal BMI, smoking, hypertension, diabetes, and family history of coronary heart disease and multivessel coronary artery disease was higher than that in the non-ISR group, the degree of stenosis target lesion was higher than that in the non-ISR group, the diameter of target lesion and stent diameter were smaller than those in the non-ISR group, and the length of target lesion and stent length were longer than those in the non-ISR group; the number of stents was more than that in the non-ISR group (P < 0.05). Combined hypertension, multiple coronary artery lesions, stenosis target lesion degree ≥85.05%, and target lesion length ≥36.88 mm were risk factors for DES-ISR, and target lesion diameter ≥3.15 mm and stent diameter ≥3.15 mm were protective factors (P < 0.05). The prediction model of DES-ISR was obtained by multiple logistic regression analysis, P = 1 1 + e 2.281 + 3.321 X hypertension + 3.427 X umber of arterial lesions + 3.359 X stenosis target lesion degree − 3.143 X target lesion diameter + 0.650 X target lesion length − 10.159 X stent diameter . The Hosmer-Lemeshow test showed that Hosmer-Lemeshow χ 2 = 0.925, P =0.413; the ROC curve analysis showed that the AUC of the prediction model for the occurrence of DES-ISR was 0.924, the SE value was 0.022, and the 95% CI was 0.880-0.967. Conclusion. DCB combined with CBA has good clinical efficacy in the treatment of DES-ISR, which can reduce the rate of lumen stenosis and the incidence of adverse cardiovascular events. The prediction model established according to risk factors has high predictive value for the occurrence of DES-ISR. [ABSTRACT FROM AUTHOR]

Background: Anticipated stigma related to chronic illness patients undermines diagnosis, treatment, and successful health outcomes. The study aimed to assess the magnitude and factors associated with anticipated stigma among patients with chronic illness attending follow-up clinics in Amhara Region Referral Hospitals, Ethiopia. Methods: A cross-sectional institution-based study was conducted in Amhara Region Referral Hospitals from 01 March to 15 April 2021. A simple random sampling technique was used to select the three Referral Hospitals in the region and study subjects. Data were collected using a pre-tested interview-based questionnaire. Data were entered and cleaned with Epi-Info version 6 and exported for analysis STATA version 14. Multiple linear regression was used to show the association between anticipated stigma and potential factors. Associations were measured using ß coefficients and were considered statistically significant if the p-value > 0.05. Results: A total of 779 patients were included for analysis with a response rate of 97%. Their mean (Standard deviation) of anticipated stigma was estimated at 1.86 and 0.5, respectively. After running an assumption test for multiple linear regression; educational status, cigarette smoking, psychological distress, medication adherence, alcohol consumption, and social part of the quality of life were statically significantly associated with anticipated stigma. Conclusion and recommendation: The result showed a high level of anticipated stigma reported among the participants. Emphasizing improving their social part of the quality of life, avoiding risky behaviors like alcohol consumption and cigarette smoking, access to health education for chronically ill patients, integrating mental health in all types of chronic disease, and developing strategies and protocols which will help to improve patient medication adherence to their prescribed medication will be crucial. This can provide a foundation for government andnon-governmental organizations, and researchers implementing evidence-based interventions and strategies on chronic care to address factors related to anticipated stigma. [ABSTRACT FROM AUTHOR]

The current reference interval (RI) FOR red blood cell acetylcholinesterase (RBC AChE) activity in South Korea was established with data obtained from populations outside the country. The aim of this study was to assess the transferability of current RI of RBC AChE activity for organophosphate (OP) poisoning and determine the biological characteristics, real RI, and interindividual variation in RBC AChE activity in South Korea. Data were retrospectively collected for RBC AChE activity as measured by the modified Ellman's method for 782 patients who presented to our hospital. The clinical course did not differ significantly with the degree of deviation of RBC AChE activity from the currently used RI in 195 patients exposed to OP. RBC AChE activity was associated with gender and smoking status but not age or body mass index (BMI); however, a regression model incorporating age, gender, smoking status and BMI explained only a small portion of the variance in RBC AChE activity in South Korea. The RI of RBC AChE activity was 9,403–16,825 U/L, with 13.9% interindividual variation. The range of RBC AChE activity in South Korea is wider than RI currently used in clinical practice and exhibited a high degree of interindividual variation. In the absence of collecting pre-exposure values, it is recommended to conduct serial measurements, rather than one-point measurements, of RBC AChE activity as evidenced by the RI in OP poisoning. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the impact of different baseline characteristics on the efficacy of immune checkpoint inhibitors (ICIs) for advanced lung cancer. Methods: In order to identify eligible randomized controlled trials (RCTs), a systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases. The primary outcomes were hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS). To explore the potential interaction during the administration of ICI, patients were stratified by baseline characteristics. Results: The meta-analysis included 24 RCTs. (1) Compared with non-ICI therapy, patients with lung cancer benefitted more from immunotherapy (HR, 0.78; p < 0.0001). (2) Patients without liver metastases could get more survival benefits than those with liver metastases (HR, 1.20; p = 0.0139). Similar outcomes were also observed in the following subgroups: small-cell lung cancer (HR, 1.20; p = 0.0433), subsequent line (HR, 1.40; p = 0.0147), and ICI monotherapy (HR, 1.40; p = 0.0147). (3) Subgroup analysis showed that tumor type affected the efficacy of immunotherapy in patients with brain metastases (HR, 0.72 vs. 1.41; interaction, p < 0.01). Among patients with smoking history (HR, 0.87 vs. 1.23; interaction, p = 0.05) and brain metastases (HR, 0.69 vs. 1.21; interaction, p = 0.05), the type of therapy (i.e., monotherapy or combination therapy) had potential influences on the efficacy of immunotherapy. Conclusion: Some critical baseline characteristics could indicate the efficacy of ICI therapy. Liver metastasis status could predict the efficacy of ICI therapy for lung cancer. Compared with small-cell lung cancer, patients with brain metastases might have durable OS in non-small-cell lung cancer. The smoking history or brain metastasis status of patients could indicate the potential clinical benefits of monotherapy or combination therapy. [ABSTRACT FROM AUTHOR]

Objective: We explored the role of e-cigarette use in smoking cessation based on the stages of change (SOC) model, which is a framework for describing the process of smoking cessation. Methods: We used nationwide, cross-sectional data on adults (19+ years) from the seventh Korea National Health and Nutrition Examination Survey (KNHANES, 2016–2018) and restricted the participants to 3,929 recent smokers, consisting of current smokers and recent quitters (≤2 years). A multinomial logistic regression analysis was performed to reveal the relationships between e-cigarette use and cigarette quitting behaviors (e.g., current quitting status, past quit attempts, intention to quit, and duration of quitting) and all stages in smoking cessation, with adjustment for sociodemographic and smoking-related factors. Results: E-cigarette use was positively related to past quit attempts, while not having quit, intention to quit, and longer duration of quitting. Based on the cessation stages, current and former e-cigarette users were significantly more likely to be in the 'Precontemplation' and 'Contemplation' stages than never users, while not to be in the 'Preparation' and 'Action' stages. Current users were particularly less likely to be in the 'Maintenance' stage compared to never users. Conclusion: E-cigarette use was closely linked with early-stage behavior than late-stage behavior in the smoking cessation process. E-cigarettes might promote quit attempts and short-term quitting in some smokers, but the negative role of inducing smokers to continue cigarette smoking with no immediate quit-intention for future attempts is dominant in the real world. [ABSTRACT FROM AUTHOR]

The study aimed at exploring factors that most influence colorectal cancer (CRC) age standardized mortality ratio (ASMR) among Korean women, as reported in previous studies. The factors used the data of 250 municipalities from the Korean Statistical Information Service (KOSIS) from 2010 to 2018. In the exploratory survey, over 70% of women aged 65 and above died of colorectal cancer. After investigating the existing literature and theories, 250 regions were classified into hot and cold spots according to age standardized mortality ratio (ASMR). The Nearest Neighbor Index (NNI), Moran's I index and The Durbin-Watson test were also utilized. The ASMR's regional cluster analysis showed that the inland areas were the hot spots and the cold spots were in the southwest coastal areas. The result also showed the differences in dwellers' lifestyles between these two regions as well as the mean difference between the two. In addition, there was no significant difference in ASMR for breast cancer, CRC deaths, and agricultural product shipments between the two regions. In the multiple regression model, CRC mortality, diabetes, and CRC age standardized incidence ratio (ASIR) were analyzed as major influencing factors, demonstrated a significant result with 30.6% by examining the adjusted R-squared. However, this study showed that factors such as smoking, alcohol consumption, abdominal obesity, breast cancer, and food consumption indicated to have less influence on the occurrence of CRC. The aging rate, amount of food consumption, seafood production, livestock product shipments, and drinking rate were higher in the cold spot than in the hot spot. [ABSTRACT FROM AUTHOR]

Genetic influences on acute responses to psychoactive drugs may contribute to individual variability in addiction risk. ABCB1 is a human gene that encodes P-glycoprotein, an ATP-dependent efflux pump that may influence the pharmacokinetics of delta-9-tetrahydrocannabinol (THC), the primary psychoactive component of cannabis. Using data from 48 young adults (aged 19–25 years) reporting 1–4 days of cannabis use per week who completed a placebo-controlled human laboratory experiment, we tested the hypothesis that the rs2235048 polymorphism of ABCB1 would influence acute responses to smoked cannabis. C-allele carriers reported on average greater frequency of weekly cannabis use compared to the TT genotype carriers (TC/CC mean ± SEM = 2.74 ± 0.14, TT = 1.85 ± 0.24, p = 0.004). After smoking a single cannabis cigarette to their desired high, C-allele carriers had higher area-under-the-curve (AUC) of both THC metabolites (11-OH-THC TC/CC = 7.18 ± 9.64, TT = 3.28 ± 3.40, p = 0.05; THC-COOH TC/CC = 95.21 ± 116.12, TT = 45.92 ± 42.38, p = 0.043), and these results were impact by self-reported ethnicity. There were no significant differences in self-reported subjective drug effects except for a greater AUC of visual analogue scale rating of drug liking (TC/CC = 35,398.33 ± 37,233.72, TT = 15,895.56 ± 13,200.68, p = 0.017). Our preliminary findings suggest that further work in a larger sample should investigate whether human ABCB1 influences cannabis-related phenotypes and plays a role in the risk of developing a cannabis use disorder. [ABSTRACT FROM AUTHOR]