Smoking Habits Research Articles

Identification of dietary patterns and their relationship with zinc intake in male and female workers

Objectives Deficiency of zinc, an essential trace element in the body, adversely affects taste, wound healing, and immunity. This study aimed to identify the dietary patterns of male and female workers using factor analysis and clarify the relationship between dietary patterns and zinc intake.Methods The participants were 395 municipal employees (193 men and 202 women) in Northern Kyushu aged 19-71 years. To obtain the dietary intake data, participants were asked to complete a lifestyle and health questionnaire and brief self-administered dietary history questionnaire. Zn intake was evaluated per 1,000 kcal (mg/1,000 kcal). The values were adjusted for energy using the density method, and multiple regression analysis was performed.Results Three dietary patterns were identified for each participant. Among men, "main and side dish type pattern" characterized by higher intakes of potatoes, legumes, vegetables, seafood, meat, and low for cereals, "snack type pattern" characterized by higher intakes of sweets and coffee, and "Mediterranean diet pattern" characterized by higher intakes of bread, pasta, fruits, eggs, and milk, and low for miso soup and rice were identified. For women, a "vegetarian diet type pattern" characterized by higher intakes of beans, vegetables, mushrooms, and seaweed, "main and side dish type pattern" characterized by low intake of rice, and "dinner-time drinking pattern" characterized by higher intakes of alcoholic beverages were identified. Zinc intake was positively associated with the "main and side dish type pattern" and "Mediterranean diet pattern" in men and "vegetarian diet" and "main and side dish type pattern" in women. Additionally, zinc intake was negatively associated with the "dinner-time drinking pattern" among women.Conclusion Despite adjusting for age, BMI, marriage, occupation, smoking habits, and exercise habits, the "main and side dish type pattern" and "Mediterranean diet pattern" were positively correlated with zinc intake in men and the "vegetarian diet" and "main and side dish type pattern" in women. The data suggest awareness of the dietary patterns that are conducive to ensuring zinc intake.

Metabolic dysfunction-associated steatotic liver disease (SLD) and alcohol-associated liver disease, but not SLD without metabolic dysfunction, are independently associated with new onset of chronic kidney disease during a 10-year follow-up period.

The new nomenclature of steatotic liver disease (SLD) including metabolic dysfunction-associated SLD (MASLD), MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD) has recently been proposed. We aimed to elucidate the relationship between each category of SLD and chronic kidney disease (CKD). We investigated the effects of various SLDs on the development of CKD, defined as estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 or positive for urinary protein, during a 10-year period in 12138 Japanese subjects (men/women, 7984/4154; mean age, 48years) who received annual health examinations including abdominal ultrasonography. The prevalences of SLD without metabolic dysfunction (SLD-MD[-]), MASLD, MetALD, and ALD were 1.7%, 26.3%, 4.9%, and 1.9%, respectively. During the follow-up period, 1963 subjects (16.2%) (men/women, 1374 [17.2%]/589 [14.2%]) had new onset of CKD. Multivariable Cox proportional hazard model analyses after adjustment of age, sex, eGFR, current smoking habit, diabetes mellitus, hypertension, and dyslipidemia showed that the hazard ratios (HR [95% confidence interval]) for the development of CKD in subjects with MASLD (1.20 [1.08-1.33], p=0.001) and those with ALD (1.41 [1.05-1.88], p=0.022), but not those with MetALD (1.11 [0.90-1.36], p=0.332), were significantly higher than the HR in subjects with non-SLD. Interestingly, subjects with SLD-MD[-] had a significantly lower HR (0.61 [0.39-0.96], p=0.034) than that in subjects with non-SLD. The addition of the novel classification of SLDs into traditional risk factors for the development of CKD significantly improved the discriminatory capacity. MASLD and ALD, but not SLD-MD[-], are independently associated with the development of CKD.

Breast Aesthetics, Motivational Factors in Surgery, and the Influence of Social Media and Pornography.

Breast image plays an important role in a woman's identity. Breast aesthetics has strong social, emotional, and cultural connotations. We aimed to understand one's breast satisfaction, what is seen as ideal, and the gap between these two facets. We also studied the influence of several factors on these conceptions, including clinical and demographic characteristics, self-esteem, social media use, and pornography. We also studied the motivational factors driving the recourse to surgery. An online questionnaire of 64 questions divided into 5 sections was shared on social media to all women over the age of 18. Three versions were available: French, Dutch, and English. The questionnaire was accessible for 45 days (from 12/18/2021 to 01/31/2022). A total of 382 complete responses were analyzed. The average age was 30.6 years; the most frequent breast size was a B cup (29.06%), while the size considered ideal was a C cup (49.48%). Social media and pornography seem to influence the conception of ideal breast; the subgroup that uses them tends to choose a larger breast size as ideal. Smoking and the education level also seem to influence this conception. Furthermore, 26.96% of women would benefit from breast surgery if they did not have to consider the financial aspect. The ideal breast concept is highly dependent on regional, cultural, and religious factors. It is interesting to note the influence that other less studied factors, such as pornography, smoking habits, and social media, may have. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Sex and population differences in the cardiometabolic continuum: a machine learning study using the UK Biobank and ELSA-Brasil cohorts

BackgroundThe temporal relationships across cardiometabolic diseases (CMDs) were recently conceptualized as the cardiometabolic continuum (CMC), sequence of cardiovascular events that stem from gene-environmental interactions, unhealthy lifestyle influences, and metabolic diseases such as diabetes, and hypertension. While the physiological pathways linking metabolic and cardiovascular diseases have been investigated, the study of the sex and population differences in the CMC have still not been described.MethodsWe present a machine learning approach to model the CMC and investigate sex and population differences in two distinct cohorts: the UK Biobank (17,700 participants) and the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (7162 participants). We consider the following CMDs: hypertension (Hyp), diabetes (DM), heart diseases (HD: angina, myocardial infarction, or heart failure), and stroke (STK). For the identification of the CMC patterns, individual trajectories with the time of disease occurrence were clustered using k-means. Based on clinical, sociodemographic, and lifestyle characteristics, we built multiclass random forest classifiers and used the SHAP methodology to evaluate feature importance.ResultsFive CMC patterns were identified across both sexes and cohorts: EarlyHyp, FirstDM, FirstHD, Healthy, and LateHyp, named according to prevalence and disease occurrence time that depicted around 95%, 78%, 75%, 88% and 99% of individuals, respectively. Within the UK Biobank, more women were classified in the Healthy cluster and more men in all others. In the EarlyHyp and LateHyp clusters, isolated hypertension occurred earlier among women. Smoking habits and education had high importance and clear directionality for both sexes. For ELSA-Brasil, more men were classified in the Healthy cluster and more women in the FirstDM. The diabetes occurrence time when followed by hypertension was lower among women. Education and ethnicity had high importance and clear directionality for women, while for men these features were smoking, alcohol, and coffee consumption.ConclusionsThere are clear sex differences in the CMC that varied across the UK and Brazilian cohorts. In particular, disadvantages regarding incidence and the time to onset of diseases were more pronounced in Brazil, against woman. The results show the need to strengthen public health policies to prevent and control the time course of CMD, with an emphasis on women.

Cardiovascular Risk Factors Predicting Cardiovascular and Cancer Deaths in a Middle-Aged Population Followed-Up for 61 Years until Extinction

Background and Aim. To study the relationships of cardiovascular risk factors with cancer and cardiovascular mortality in a cohort of middle-aged men followed-up for 61 years. Materials and Methods. A rural cohort of 1611 cancer- and cardiovascular disease-free men aged 40–59 years was examined in 1960 within the Italian Section of the Seven Countries Study, and 28 risk factors measured at baseline were used to predict cancer (n = 459) and cardiovascular deaths (n = 678) that occurred during 61 years of follow-up until the extinction of the cohort with Cox proportional hazard models. Results. A model with 28 risk factors and cancer deaths as the end-point produced eight statistically significant coefficients for age, smoking habits, mother early death, corneal arcus, xanthelasma and diabetes directly related to events, and arm circumference and healthy diet inversely related. In the corresponding models for major cardiovascular diseases and their subgroups, only the coefficients of age and smoking habits were significant among those found for cancer deaths, to which healthy diet can be added if considering coronary heart disease alone. Following a competing risks analysis by the Fine–Gray method, risk factors significantly common to both conditions were only age, smoking, and xanthelasma. Conclusions. A sizeable number of traditional cardiovascular risk factors were not predictors of cancer death in a middle-aged male cohort followed-up until extinction.

Comparing Level of Happiness and Depression Between Turkish and International Medical Students

This cross-sectional study was aimed to compare happiness and depression levels among group Turkish and international medical students in Istanbul, Turkey. Data were collected through an online survey that included demographic inquiries, the Oxford Happiness Scale, and Beck’s Depression Inventory II. Significant contrasts emerged in demographic and lifestyle factors between Turkish and international students. Turkish medical students displayed a higher prevalence of unhappiness, although this difference was not statistically significant (66.3% for Turkish students vs. 59.1% for international students; χ² = 2.472, p = 0.116). Conversely, no marked differences were observed in the severity of depression between the two groups (χ² = 0.028, p = 0.986). Conversely, no marked differences were observed in the severity of depression between the two groups (χ2 = 0.028, p = 0.986). Logistic regression analyses revealed noteworthy associations. Factors such as age, academic phase, family history of psychiatric illness, and prior psychiatry treatment were linked to heightened odds of experiencing unhappiness among students. Similarly, significant predictors of depression included a family history of depression and prior psychiatry treatment. However; gender, age, relationship status, accommodation, alcohol consumption, smoking habits, and repeated academic years did not exhibit significant associations with unhappiness among the sampled medical students. While the models demonstrated modest explanatory power, these findings emphasize the urgent need to address mental health issues among medical students. Tailored interventions targeting specific vulnerable subgroups are crucial and further research is needed to identify additional factors contributing to psychological distress in this demographic.

Multi-modal evaluation of respiratory diaphragm motion in chronic obstructive pulmonary disease using MRI series and CT images.

Chronic obstructive pulmonary disease (COPD), characterized by airflow limitation and breathing difficulty, is usually caused by prolonged inhalation of toxic substances or long-term smoking habits. Some abnormal features of COPD can be observed using medical imaging methods, such as magnetic resonance imaging (MRI) and computed tomography (CT). This study aimed to conduct a multi-modal analysis of COPD, focusing on assessing respiratory diaphragm motion using MRI series in conjunction with low attenuation volume (LAV) data derived from CT images. This study utilized MRI series from 10 normal subjects and 24 COPD patients, along with thoracic CT images from the same patients. Diaphragm profiles in the sagittal thoracic MRI series were extracted using field segmentation, and diaphragm motion trajectories were generated from estimated diaphragm displacements via registration. Re-sliced sagittal CT images were used to calculate regional LAVs for four distinct lung regions. The similarities among diaphragm motion trajectories at various positions were assessed, and their correlations with regional LAVs were analyzed. Compared with the normal subjects, patients with COPD typically exhibited fewer similarities in diaphragm motion, as indicated by the mean normalized correlation coefficient of the vertical motion component (0.96 for normal subjects vs. 0.76 for severity COPD patients). This reduction was significantly correlated with the LAV% in the two lower lung regions with a regression coefficient of 0.81. Our proposed evaluation method may assist in the diagnosis and therapy planning for patients with COPD.

An investigation into social determinants of health lifestyles of Canadians: a nationwide cross-sectional study on smoking, physical activity, and alcohol consumption

BackgroundHealth lifestyles exert a substantial influence on the quality of everyday life, primarily affecting health maintenance and enhancement. While health-related practices during the COVID-19 pandemic may have positively altered the health lifestyles of Canadians to a certain degree, government reports indicate that issues related to health behaviors, such as cigarette smoking, physical inactivity, and alcohol consumption, continue to pose challenges to the health of Canadians. Social determinants of these health behaviors thus hold significant academic value in the formulation of policy guidelines.ObjectiveThe aim of this study is to scrutinize the social determinants of health with respect to social factors that have may have impacts on the health-related behaviors of Canadians. We tested health behaviors including cigarette use, alcohol consumption, and participation in physical exercise, which are integral to the promotion and improvement of individual health.MethodsTo examine the social determinants of Canadians’ health lifestyles, we utilized nationally representative data from the 2017–2018 Canadian Community Health Survey annual component. Our data analysis involved the bootstrapping method with two-level mixed-effect logistic regressions, ordered logistic regressions, and negative binomial regressions. Additionally, we conducted several robustness checks to confirm the validity of our findings.ResultsThe findings show that demographic background, socioeconomic status, social connections, and physical and mental health conditions all play a role in Canadians’ smoking, physical activity, and drinking behaviors. Noticeably, the association patterns linking to these social determinants vary across specific health lifestyles, shedding light on the complex nature of the social determinants that may influence young and middle-aged Canadians’ health lifestyles. Moreover, in the context of Canada, the health-region level demographic, socioeconomic, and working conditions are significantly linked to residents’ health lifestyles.ConclusionsInvestigating the social determinants of health lifestyles is pivotal for policymakers, providing them with the necessary insights to create effective interventions that promote healthy behaviors among specific demographic groups. It is recommended that health education and interventions at the community level targeting smoking, physical inactivity, and alcohol consumption be introduced. These interventions should be tailored to specific subgroups, considering their demographic and socioeconomic characteristics, social networks, and health status. For instance, it is imperative to focus our attention on individuals with lower educational attainment and socioeconomic status, particularly in relation to their smoking habits and physical inactivity. Conversely, interventions aimed at addressing alcohol consumption should be targeted towards individuals of a higher socioeconomic status. This nuanced approach allows for a more effective and tailored intervention strategy.

The Relationship Between Smoking Habits and CO Levels of Adolescents in Middle Schools in Cinere District, Depok City, West Java, 2023

The Relationship Between Smoking Habits and CO Levels of Adolescents in Middle Schools in Cinere District, Depok City, West Java, 2023

Prevalence and factors associated with unhealthy metabolic status according to body mass index: analysis of a national nutritional survey

IntroductionAlthough obesity substantially influences public health owing to related comorbidities, it has been discovered that the incidence of such issues is not directly related to obesity but to the patient’s unhealthy metabolic status (MUS) independent of the body mass index (BMI).ObjectivesTo describe the prevalence of UMS overall and according to BMI and determine the factors associated with it.MethodsA cross-sectional analytical study was used based on the analysis of secondary databases called the Life Stage Nutritional Surveillance Survey (VIANEV). Participants were selected in two stages, finally obtaining 885 participants. UMS was defined based on the criteria of the Adult Treatment Panel III used to define metabolic status in a set of 5 parameters, if the subject presented two or more alterations it was considered UMS. Six groups were formed according to BMI: metabolically healthy, average weight (MHNW) and unhealthy (MUNW), metabolically healthy, overweight (MHOW) and unhealthy (MUOW), metabolically healthy, obese (MHO) and unhealthy (MUO).).ResultsThe total prevalence of UMS was 73.11%, with MUNW, MUOW, and MUO being 47.90%, 80.34%, and 96.44%, respectively. Only 5.31% did not present any metabolic alteration. The multivariable analysis found variations globally according to sex, age, marital status, geographical region, smoking habit, and altitude.ConclusionsA high prevalence of UMS was observed in Peru, indicating that BMI alone is not a sufficient indicator of metabolic status. These findings suggest that strategies should be prioritized to address the growing problem of UMS, considering the particularities of each subpopulation and using a multifaceted approach that addresses modifiable and non-modifiable risk factors.

Interaction of smoking and spicy habits modifies the risk of erectile dysfunction.

Having a spicy diet and smoking habit may be important factors causing erectile dysfunction (ED). The aim of this study is to investigate the impact of spicy diet and smoking habits on the risk of ED in men, with a focus on the interaction between these lifestyle factors. Our investigation was conducted as a retrospective analysis spanning from June 2017 to June 2023. Participants underwent interviews utilizing the Structured Interview on Erectile Dysfunction (SIEDY) to evaluate the degree of pathological factors. The International Index of Erectile Function-5 (IIEF-5) was employed as a metric for assessing ED. Additionally, the subjects were comprehensively questioned about their smoking history and dietary preferences, which included an inquiry into how often they consumed spicy meals. Our research involved 373 participants, with 67.6% being individuals with ED. Among the participants, 50.7% were non-smokers and 49.3% were smokers, totaling 188 and 185, respectively. There was no significant difference in the spicy food frequency consumption among smokers with ED. However, non-smokers who consumed spicy food more frequently experienced more severe ED (P=0.02). ED patients showed significant differences in body mass index (BMI), blood glucose and testosterone, which were linked to vascular damage (P=0.03, P=0.02, P=0.04, respectively). Additionally, non-smokers who consumed more spicy food had higher scores on the SIEDY 2 scale, indicating marital factors (P=0.004). In non-smoking participant, a high spicy ratio indicated an even higher risk of ED [odds ratio 2.58, 95% confidence interval: 1.27-5.26; P=0.008], while there was no significant impact on ED in smoking participants (data not shown). This retrospective study suggests that a considerable consumption of spicy foods is independently correlated with an elevated risk of ED, particularly among non-smoking men.

The Correlation Between Smoking Habits and Stroke Severity Among Patient with Stroke at General Public Hospital in Bandung, Indonesia

The Correlation Between Smoking Habits and Stroke Severity Among Patient with Stroke at General Public Hospital in Bandung, Indonesia

The Effects of Education on Tobacco Consumption: A Panel Data Analysis

This study tests the hypothesis that acquiring more education improves health by reducing smoking habits. The study investigates whether higher levels of education influence smokers' behaviour or not. A panel dataset from South Africa's National Income Dynamic Survey (2008–2017) was used as a data collection source. The study employs a logistic model to conclude that people in South Africa with more education are less likely to smoke than those without education. Also noteworthy is the discovery that individuals with mental health-related behavioural disorders are more likely to smoke as a form of self-medication. Our results are particularly significant for policymakers since they demonstrate that education reduces the likelihood of smoking. These findings indicate the need for increased government support for educational opportunities in South Africa. In the long run, the population health of a country may benefit from free public education. Programs aimed at reducing smoking ought to focus on individuals with lower levels of education, younger people, and city dwellers because they are more likely to be engaged in smoking.

Smoking Habits, Loneliness and Self-esteem Among Young Adults

This study explores the relationship between smoking habits, loneliness, and self-esteem among young adults. A sample comprising 144 non-smokers and 103 smokers was assessed using the Rosenberg Self-Esteem Scale, the UCLA Loneliness Scale, and the Fagerström Test for Nicotine Dependence (FTND). Statistical analysis revealed no significant differences in self-esteem and loneliness levels between smokers and non-smokers. These findings suggest that smoking status does not significantly impact loneliness or self-esteem in young adults, challenging common perceptions about the psychological correlates of smoking behavior. Further research is recommended to explore underlying factors and potential mediators in these relationships.

Possible pitfalls in the prediction of weight gain in middle-aged normal-weight individuals: Results from the NDB-K7Ps-study-2

BackgroundThe prevalence of obesity has not decreased worldwide and obesity-related morbidities have been increasing steadily. However, few studies have investigated factors contributing to weight gain in normal-weight individuals. Thus, in this community-based cohort study, we aimed to investigate factors contributing to weight gain in normal-weight participants. MethodsClinical variables and 10 % increase in weight over 10 years (10 %IBW10Y) were retrospectively investigated in apparently healthy 615,077 normal-weight (body mass index (BMI) 21.0–24.9 kg/m2) participants aged 40–64 years who had regularly undergone health checkup. Machine learning and logistic regression analysis (nested case-control study) were used to predict 10 %IBW10Y. ResultsIn total, 6.8 % of men and 8.9 % of women had 10 %IBW10Y (P < 0.0001). The prevalence of obesity (BMI ≥25.0 kg/m2) after 10 years and weight gain were higher in participants with 10 %IBW10Y (72.3 %, 8.9 kg) (case-group) versus those without 10 %IBW10Y (11.5 %, −0.4 kg) (control-group), respectively. Machine learning showed positive contributing factors to 10 %IBW10Y were, in descending order, age early 40 s, current smoking, female sex, low serum triglyceride (≤59 mg/dL), and low glycated hemoglobin (HbA1c) (≤4.9 %). Age early 60 s, non-smoking, male sex, high triglyceride (≥200 mg/dL), and HbA1c 6.0 %−6.9 % were negative contributing factors. Logistic regression analysis showed similar results except for high HbA1c (≥7.5 %) as a positive contributing factor. ConclusionsIn middle-aged individuals with normal weight who undergo regular health check-ups, certain favorable features (female sex, low triglyceride, and low HbA1c), as well as smoking habits that are subject to change in the future, which could lead to weight gain, may be overlooked.250 ＜250 words

Analysis of the interlink between glucose-6-phosphate dehydrogenase (G6PD) and lung cancer through multi-omics databases

Glucose-6-Phosphate Dehydrogenase (G6PD) is a crucial enzyme that executes the pentose phosphate pathway. Due to its critical nodal position in the metabolic network, it is associated with different forms of cancer tumorigeneses and progression. Nonetheless, its functional role and molecular mechanism in lung cancer remain unknown. The present study provides intricate information associated with G6PD and Lung Cancer. Varieties of public datasets were retrieved by us, including UALCAN, TCGA, cBioPortal, and the UCSC Xena browser. The data obtained were used to assess the expression of G6PD, its clinical features, epigenetic regulation, relationship with tumour infiltration, tumour mutation burden, microsatellite instability, tumour microenvironment, immune checkpoint genes, genomic alteration, and patient's overall survival rate. The present study revealed that the G6PD expression was correlated with the clinical features of lung cancer including disease stage, race, sex, age, smoking habits, and lymph node metastasis. Moreover, the expression profile of G6PD also imparts epigenetic changes by modulating the DNA promoter methylation activity. Methylation of promoters changes the expression of various transcription factors, genes leading to an influence on the immune system. These events linked with G6PD-related mutational gene alterations (FAM3A, LAG3, p53, KRAS). The entire circumstance influences the patient's overall survival rate and poor prognosis. Functional investigation using STRING, GO, and KEGG found that G6PD primarily engages in hallmark functions (metabolism, immunological responses, proliferation, apoptosis, p53, HIF-1, FOXO, PI3K-AKT signaling). This work provides a wide knowledge of G6PD's function in lung cancer, as well as a theoretical foundation for possible prognostic therapeutic markers.

Food Insecurity and Cardiometabolic Risk among Turkish Adults: A Cross-Sectional Study

This study examined 175 volunteers aged 18‒64 to explore the connection between food insecurity and anthropometric measurements, diet quality scores and cardiometabolic risk factors. The design of the study is cross-sectional, and the data were obtained using a number of questionnaires applied to individuals who visited the diet clinic. Participants' diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015) and food security was evaluated using the Household Food Insecurity Access Scale. Cardiometabolic risk factors were determined based on HEI-2015 scores, Body Mass Index (BMI), waist circumference, waist/height ratio, physician-diagnosed diabetes, hypertension, dyslipidemia, regular physical activity status, and smoking habits. As a result of the study, 41.1% of the participants were found to be food-insecure, and 77.8% had diet quality that needed improvement. The average BMI value of food-insecure women was found to be higher than that of food-secure women (32.37±7.77 kg/m2 and 29.86±5.22 kg/m2, respectively) (p=0.003). Furthermore, food-insecure women had a higher average waist circumference (p=0.001). A significant negative relationship was determined between BMI value, waist circumference and waist/height ratio, which are among the cardiometabolic risk factors, and food insecurity.

A machine learning approach to determine the risk factors for fall in multiple sclerosis

BackgroundFalls in multiple sclerosis can result in numerous problems, including injuries and functional loss. Therefore, determining the factors contributing to falls in people with Multiple Sclerosis (PwMS) is crucial. This study aims to investigate the contributing factors to falls in multiple sclerosis using a machine learning approach.MethodsThis cross-sectional study was conducted with 253 PwMS admitted to the outpatient clinic of a university hospital between February and August 2023. A sociodemographic data collection form, Fall Efficacy Scale (FES-I), Berg Balance Scale (BBS), Fatigue Severity Scale (FSS), Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), and Timed 25 Foot Walk Test (T25-FW) were used for data collection. Gradient-boosting algorithms were employed to predict the important variables for falls in PwMS. The XGBoost algorithm emerged as the best performed model in this study.ResultsMost of the participants (70.0%) were female, with a mean age of 40.44 ± 10.88 years. Among the participants, 40.7% reported a fall history in the last year. The area under the curve value of the model was 0.713. Risk factors of falls in PwMS included MSIS-29 (0.424), EDSS (0.406), marital status (0.297), education level (0.240), disease duration (0.185), age (0.130), family type (0.119), smoking (0.031), income level (0.031), and regular exercise habit (0.026).ConclusionsIn this study, smoking and regular exercise were the modifiable factors contributing to falls in PwMS. We recommend that clinicians facilitate the modification of these factors in PwMS. Age and disease duration were non-modifiable factors. These should be considered as risk increasing factors and used to identify PwMS at risk. Interventions aimed at reducing MSIS-29 and EDSS scores will help to prevent falls in PwMS. Education of individuals to increase knowledge and awareness is recommended. Financial support policies for those with low income will help to reduce the risk of falls.

Modifiable lifestyle factors and the risk of post-COVID-19 multisystem sequelae, hospitalization, and death

Effective prevention strategies for post-COVID complications are crucial for patients, clinicians, and policy makers to mitigate their cumulative burden. This study evaluated the association of modifiable lifestyle factors (smoking, alcohol intake, BMI, physical activity, sedentary time, sleep duration, and dietary habits) with COVID-19 multisystem sequelae, death, and hospitalization in the UK Biobank cohort (n = 68,896). A favorable lifestyle (6-10 healthy factors; 46.4%) was associated with a 36% lower risk of multisystem sequelae (HR, 0.64; 95% CI, 0.58-0.69; ARR at 210 days, 7.08%; 95% CI, 5.98-8.09) compared to an unfavorable lifestyle (0-4 factors; 12.3%). Risk reductions spanned all 10 organ systems, including cardiovascular, coagulation, metabolic, gastrointestinal, kidney, mental health, musculoskeletal, respiratory disorders, and fatigue. This beneficial effect was largely attributable to direct lifestyle impacts independent of corresponding pre-infection comorbidities (71% for any sequelae). A favorable lifestyle was also related to the risk of post-COVID death (HR 0.59, 0.52-0.66) and hospitalization (HR 0.78, 0.73-0.84). These associations persisted across acute and post-acute infection phases, irrespective of hospitalization status, vaccination, or SARS-CoV-2 variant. These findings underscore the clinical and public health importance of adhering to a healthy lifestyle in mitigating long-term COVID-19 adverse impacts and enhancing future pandemic preparedness.

Cancer and immune response: The role of PD-1/PD-L1 checkpoint in laryngeal carcinoma. Preliminary results.

The overall survival of laryngeal squamous cell carcinoma (LSCC) hasn't changed significantly in the last decades, leading to a negative prognosis in advanced stages. So, the immunotherapy takes space with the inhibition of PD-1/PD-L1 checkpoint, involved in suppression of immune response. A prospective study was conducted on LSCC patients, selected according to strict criteria. The study was approved by the ethics committee of our Hospital. Parameters were: sex, age, smoking and alcohol habits, C-reactive protein (CRP) level in the serum, laryngeal subsite involved, differentiation-based histopathologic grading of tumor, neck node involvement, tumor stage, expression levels of PD-L1 (as Combined Positive Score - CPS). P-value < 0.05 was statistically significant. 58 patients were included: 31.03% were females, mean age 63.55±10.09. A statistically significant correlation between CPS and smoking habits and N stage was found. CRP resulted increased in 44.83% of patients with a statistically significant correlation with CPS. The most cases were glottic cancers (46.55%). 75.86% of tumors were moderately-differentiated, without correlation with CPS. PD-L1 expression levels are variables independent of sex, age, alcohol consumption, differentiation degree of LSCC. A statistically significant correlation between PD-L1 expression levels and smoking habits, neck node status and CRP was found. This last finding demonstrates the involvement of PD-1/PD-L1 checkpoint in immune response in case of cancer. However, these results need further studies to detect the best patients tailored for treatment with anti-PD-1/PD-L1 blocking antibodies.