Smoking Levels Research Articles

Evaluation of the Relationship between Sublingual Varices and Hypertension.

Objectives: Sublingual varices are characterized by abnormally dilated veins. Some systemic conditions such as cardiovascular disease have been suggested to be associated with sublingual varices. Due to the convenience in examining the sublingual area, the present study aimed to assess the relationship between sublingual varices and hypertension. Materials and Methods: In this descriptive-analytic study, 500 patients were categorized into two groups: those with sublingual varices and those without. Two oral medicine specialists assessed the lesions, and the blood pressure of all patients was measured while they were in a relaxed sitting position. Age and gender data were recorded for all participants. Statistical analysis included t-test, chi-square, and logistic regression, with significance set at P<0.05. Results: The frequency of sublingual varices was 21.8%. Mean systolic blood pressure was 139.68±19.01mmHg in patients with sublingual varices and 118.09±13.78mmHg in patients without the lesions (P=0.561). Mean diastolic blood pressure was 100.45±17.81mmHg and 80.31±12.08mmHg in patients with and without sublingual varices, respectively (P<0.001). Smoking was significantly more prevalent among patients who had the lesions (P<0.05). Gender (P=0.686) and age (P=0.875) showed no significant relationship with sublingual varices, while smoking and blood pressure levels were significantly associated with these varices (P<0.001). Conclusion: It is advisable to monitor and manage blood pressure in patients with sublingual varices who may not be aware of their blood pressure status. Our results showed that smoking could be one of the predictive factors for sublingual varices.

Tobacco Smoke Exposure in Early Childhood and Later Risk of Inflammatory Bowel Disease: A Scandinavian Birth Cohort Study.

To examine the association between early-life smoking exposure and later risk of inflammatory bowel disease [IBD]. We followed 115663 participants from the Norwegian Mother, Father and Child [MoBa] and All Babies in Southeast Sweden [ABIS] cohorts from birth [1997-2009] through 2021. IBD was identified through national patient registers. Validated questionnaire data defined maternal smoking during pregnancy, maternal environmental tobacco smoke [ETS] exposure during pregnancy, and child ETS exposure by ages 12 and 36 months. Cox regression was used to estimate adjusted hazard ratios [aHRs] for sex, maternal age, education level, parental IBD, and origin. Cohort-specific estimates were pooled using a random-effects model. During 1 987 430 person-years of follow-up, 444 participants developed IBD [ABIS, 112; MoBa, 332]. Any vs no maternal smoking during pregnancy yielded a pooled aHR of 1.30 [95% CI = 0.97-1.74] for offspring IBD. Higher level of maternal smoking during pregnancy (compared with no smoking, average ≥6 cigarettes/day: pooled aHR = 1.60 [95% CI = 1.08-2.38]) was associated with offspring IBD, whereas a lower smoking level was not (average 1-5 cigarettes/day: pooled aHR = 1.09 [95% CI = 0.73-1.64]). Child ETS exposure in the first year of life was associated with later IBD (any vs no ETS, pooled aHR = 1.32 [95% CI = 1.03-1.69]). Estimates observed for child ETS exposure by 36 months were similar but not statistically significant. In this prospective Scandinavian cohort study, children exposed to higher levels of maternal smoking during pregnancy or ETS during the first year of life were at increased risk of later IBD.

Analysis of the effect of changes in serum osteopontin levels on patients with acute cerebral infarction.

To investigate the correlation of serum osteopontin levels with disease severity and prognosis in patients with acute cerebral infarction. This retrospective analysis included forty patients with acute cerebral infarction (ACI) admitted to the Department of Neurology of Baoding Children's Hospital from May, 2019 to May, 2022 within 24 hours of onset were selected as the observation group, while 40 healthy subjects in our hospital during the same period were selected as the control group. The correlation between serum Osteopontin (OPN) levels and risk factors on one day, seven days and 14 days was analyzed. Patients in the observation group were subdivided into the good prognosis group and the poor prognosis group according to mRS score, and the serum OPN levels of the two groups were compared. The correlation between serum OPN and disease severity and prognosis of patients with ACI was analyzed. The serum OPN levels in the observation group were significantly higher than those in control group (P< 0.05), and its level was positively correlated with NIHSS score and infarct size. The proportion of patients with hyperlipidemia, smoking, drinking, hypertension and OPN level on seven day in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The OPN level > 8.720 ng/ml on seven days was an independent risk factor for poor prognosis of cerebral infarction. OPN is involved in the entire pathophysiological process of ACI, and its level can predict the severity of the disease in patients with ACI, and can be used as an important indicator for evaluating their clinical prognosis.

Full Arch Implant-Prosthetic Rehabilitation in Patients with Cardiovascular Diseases: A 7-Year Follow-Up Prospective Single Cohort Study.

Aim: The rising average age increases edentulous cases, demanding more implant-prosthetic rehabilitation, with cardiovascular diseases being significant factors. This study compared healthy patients (CG = Control Group) and those with cardiovascular disease (TG = Test Group) for implant survival, Marginal Bone Loss (MBL), peri-implant tissue level parameters as Periodontal Screening and Recording (PSR), Plaque Index (PI), Bleeding on Probing (BoP) Peri-implant Probing Depth (PPD), and surgical complications. Smoking impact on both groups and medication influence in the TG were secondary outcomes. Patients underwent full-arch implant prosthetic rehabilitation. Methods: Implant survival rate, MBL, and surgical complications were recorded during the monitoring period (7 years), while peri-implant parameters were assessed at the end of the observational time. A total of 26 and 28 CG and TG patients were recruited, respectively. Results: A total of 128 implants were placed in CG, while 142 in the TG. Implant survival and MBL showed no significant differences (p > 0.05). Nevertheless, peri-implant parameters were more unfavorable in TG. The only significant surgical complication was higher bleeding rates in the TG (p < 0.05). Conclusions: Cardiovascular patients showed similar implant survival and MBL but had adverse peri-implant parameters and increased bleeding rates. Higher smoking levels may relate to unfavorable implant outcomes. Further investigation is needed on drug impact with larger samples.

(078) The Effect of Smoking Cessation on Semen Quality

Abstract Introduction Extensive research efforts have always focused on the deleterious effects of smoking on male reproduction by comparing fertility in smokers versus nonsmokers. Nevertheless, studies on the effect of smoking cessation on male fertility remain scarce. Objective Our primary aim was to investigate the reversibility of the negative impact of smoking on male fertility. Secondarily, we studied the effect of both time after smoking cessation as well as the smoking index on semen quality improvement. Methods Our study included 60 participants who applied to a smoking cessation program. The volunteers started by completing a fertility background questionnaire. Two semen specimens, provided 2 weeks apart, were analyzed according to the WHO guidelines for each candidate on three different occasions. The first was right before smoking cessation followed by the 2nd and 3rd at 3 and 6 months after stopping smoking, respectively. Semen quality was compared between the 3 occasions. The degree of change was correlated with the level of smoking. The nicotine level in urine was used for smoking cessation compliance monitoring during the study. Results Comparing semen quality on the 3 different occasions respectively, we detected a significant improvement in semen volume (3.33 ml ± 1.07 vs. 3.88 ml ± 0.80 vs. 4.34 ml ± 0.67, P &amp;lt; 0.001), sperm concentration (14.77 million /ml ± 6.49 vs. 17.71 million /ml ± 6.41 vs. 19.27 million/ml ± 6.46, P &amp;lt; 0.001), total sperm count (49.33 million ± 25.31 vs. 70.16 million ± 30.85 vs. 84.01 million ± 31.00, P &amp;lt; 0.001), progressive motility (20.7% vs. 35.3% vs. 42.28%, P &amp;lt; 0.001), total motility (41.48% vs. 60.33% vs. 67.67%, P &amp;lt; 0.001) and abnormal morphology (69.32% Vs. 50.88% vs. 40.82%, P &amp;lt; 0.001). Improvement in all parameters was positively correlated to time after cessation. Higher smoking indices were related to higher levels of improvement in semen volume, sperm concentration, and total count (areas under the curve of 0.867, 0.852, and 0.863 respectively, P &amp;lt; 0.001 for each). Conclusions The negative effect of smoking on semen quality is reversible. Smoking cessation has a time-dependent positive effect on main semen parameters, hence, positive potential for fecundity improvement in men. Disclosure No.

Clearing the air: evaluating institutions' social media health messaging on wildfire and smoke risks in the US Pacific Northwest.

Wildfire smoke contributes substantially to the global disease burden and is a major cause of air pollution in the US states of Oregon and Washington. Climate change is expected to bring more wildfires to this region. Social media is a popular platform for health promotion and a need exists for effective communication about smoke risks and mitigation measures to educate citizens and safeguard public health. Using a sample of 1,287 Tweets from 2022, we aimed to analyze temporal Tweeting patterns in relation to potential smoke exposure and evaluate and compare institutions' use of social media communication best practices which include (i) encouraging adoption of smoke-protective actions; (ii) leveraging numeric, verbal, and Air Quality Index risk information; and (iii) promoting community-building. Tweets were characterized using keyword searches and the Linguistic Inquiry and Word Count (LIWC) software. Descriptive and inferential statistics were carried out. 44% of Tweets in our sample were authored between January-August 2022, prior to peak wildfire smoke levels, whereas 54% of Tweets were authored during the two-month peak in smoke (September-October). Institutional accounts used Twitter (or X) to encourage the adoption of smoke-related protective actions (82% of Tweets), more than they used it to disseminate wildfire smoke risk information (25%) or promote community-building (47%). Only 10% of Tweets discussed populations vulnerable to wildfire smoke health effects, and 14% mentioned smoke mitigation measures. Tweets from Washington-based accounts used significantly more verbal and numeric risk information to discuss wildfire smoke than Oregon-based accounts (p = 0.042 and p = 0.003, respectively); however, Tweets from Oregon-based accounts on average contained a higher percentage of words associated with community-building language (p < 0.001). This research provides practical recommendations for public health practitioners and researchers communicating wildfire smoke risks on social media. As exposures to wildfire smoke rise due to climate change, reducing the environmental disease burden requires health officials to leverage popular communication platforms, distribute necessary health-related messaging rapidly, and get the message right. Timely, evidence-based, and theory-driven messaging is critical for educating and empowering individuals to make informed decisions about protecting themselves from harmful exposures. Thus, proactive and sustained communications about wildfire smoke should be prioritized even during wildfire "off-seasons."

Comparison Between Smoked Tobacco and Medical Cannabis Cigarettes Concerning Particulate Matter.

Introduction: Cannabis is a widely used drug like tobacco and alcohol. In the meantime, it is also prescribed for medical treatment in some countries. Tobacco smoke contains chemical carcinogens and particulate matter (PM) that are both harmful to health. Method: In this study, we investigated PM levels in second-hand smoke (SHS) of hand-tamped cannabis cigarettes compared to cigarettes with tubing tobacco and the 3R4F reference cigarette. Results: It could be demonstrated that the largest proportion of the particle mass is attributable to particles with a diameter of less than 1μm and that every tested cigarette emitted more PM than the 3R4F reference cigarette. In addition, our data clearly revealed that cannabis smoke contains higher PM levels in SHS than tobacco cigarettes. Compared to the reference cigarette, the PM1 emissions of cannabis were 105% higher. Also, the cannabis mixed cigarettes had higher PM levels than the 3R4F cigarettes. For instance, the PM10 emissions were 93% higher. Also, the Gauloises Mélange tubing tobacco also reached higher PM concentrations than the 3R4F cigarette. Discussion: Regardless of negative health effects, cannabis is seen as a harmless drug in the public eye. We found strong indications for potential health risks by PM from cannabis products and, therefore, the public should be educated about a potential harm.

A prospective study of the effect of COVID-19 on psychiatric symptoms and sleep problems from infection to 9-month follow-up.

Diverse psychological consequences of the COVID-19 pandemic have been reported for 6months after infection. We conducted a prospective study to evaluate the psychological impact of COVID-19 infection in newly diagnosed cases that were followed up at 1, 6, and 9months after infection. 137 people were recruited and divided into four groups based on the COVID-19 Treatment Guidelines. They were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Post-traumatic stress disorder Checklist for DSM-5 (PCL-5), and Symptom Checklist 90 (SCL-90). We found that 9months after infection, patients continued to report poor sleep (74.5%), PTSD (78.3%), somatization (17%), anxiety (17%), aggression (5.7%), phobic anxiety (4.7%), psychoticism (1.9%), paranoid (3.8%), and obsessive-compulsive (9.4%) symptoms, as well as depression and interpersonal sensitivity. The most significant risk factors for psychiatric complications were older age, level of education, smoking, hospitalization duration, hypertension, and critical severity. The negative mental health effects of COVID-19 persist after hospital discharge, and many patients continue to experience moderate-to-severe issues that may endure for 9months. Notably, there was a progressive improvement in these symptoms over that time.

Prevalence, associated factors, and gene polymorphisms of obesity in Tibetan adults in Qinghai, China

ObjectivesTo explore the prevalence and associated factors of obesity in Tibetan adults in Qinghai, China, and to determine the association between the FTO (rs1121980 and rs17817449) and MC4R gene (rs17782313 and rs12970134) polymorphisms with obesity.MethodsA cross-sectional survey was conducted in 2015 in Qinghai to selected Tibetan adults aged 20 to 80 years. Prevalence of obesity (BMI ≥ 28 kg/m2) and overweight (BMI 24 ~ 27.9 kg/m2) were evaluated. Multivariable logistic models were used to determine the associated factors. Pair-matched subjects of obesity cases and normal-weight controls were selected for the gene polymorphism analyses. Conditional logistic models were used to assess the association between gene polymorphisms with obesity. Additive and multiplicative gene-environment interactions were tested.ResultsA total of 1741 Tibetan adults were enrolled. The age- and sex- standardized prevalence of obesity and overweight was 18.09% and 31.71%, respectively. Male sex, older age, heavy level of leisure-time exercise, current smoke, and heavy level of occupational physical activity were associated with both obesity and overweight. MC4R gene polymorphisms were associated with obesity in Tibetan adults. No significant gene-environment interaction was detected.ConclusionThe prevalence of obesity and overweight in Tibetan adults was high. Both environmental and genetic factors contributed to the obesity prevalent.

Long-term exposure to high perceived temperature and risk of mortality among patients with chronic kidney disease

Health risks due to climate change are emerging, particularly from high-temperature exposure. The perceived temperature is an equivalent temperature based on the complete heat budget model of the human body. Therefore, we aimed to analyze the effect of perceived temperature on overall mortality among patients with chronic kidney disease. In total, 32,870 patients with chronic kidney disease in Seoul participated in this retrospective study (2001–2018) at three medical centers. The perceived temperature during the summer season was calculated using meteorological factors, including the air temperature near the automated weather station, dew point temperature, wind velocity, and total cloud amount. We assessed the association between perceived temperature using Kriging spatial interpolation and mortality in patients with CKD in the time-varying Cox proportional hazards model that was adjusted for sex, age, body mass index, hypertension, diabetes mellitus, estimated glomerular filtration rate, smoking, alcohol consumption, and educational level. During the 6.14 ± 3.96 years of follow-up, 3863 deaths were recorded. In multivariable analysis, the average level of perceived temperature and maximum level of perceived temperature demonstrated an increased risk of overall mortality among patients with chronic kidney disease. The concordance index for mortality of perceived temperature was higher than temperature, discomfort index, and heat index. When stratified by age, diabetes mellitus, and estimated glomerular filtration rate, patients with chronic kidney disease with young age (age <65 years) showed higher hazard ratio for mortality (interaction P = 0.049). Moreover, the risk of death in the winter and spring seasons was more significant compared to that of the summer and autumn seasons. Therefore, long-term exposure to high perceived temperature during summer increases the risk of mortality among patients with chronic kidney disease.

Correlates of Smoking, Work Stress, and Mindful Awareness among Private Hospital Workers in Istanbul

Background: The recent increase in workload and stress experienced by healthcare workers (HCW) is a significant global concern. Mindfulness enables one to be aware of emotions, thoughts, and present moment experiences. Objectives: The primary objective of this research is to investigate the correlates between smoking, occupational stress, and mindful awareness levels, among HCWs within the private healthcare sector. This study was conducted at a tertiary-level university-affiliated hospital in Istanbul between January – February 2023. 208 HCW participated, yielding a response rate of 20%. The participants were requested to complete a 61-item questionnaire consisting of demographics, General Work Stress Scale(GWS), Mindful Attention Awareness Scale (MAAS) and Test to Assess the Psychological Dependence on Smoking (TAPDS). Results: Smokers had significantly higher levels of mean GWS scores than nonsmokers. The mean MAAS scores of smokers were the lowest in the group with the highest scores of psychological dependence; it was highest in the group with the lowest scores. A negative correlation was found between general work stress and mindful awareness levels and between psychological dependence on smoking and mindfulness levels. HCWs aged 45 and older had significantly lower general stress than others. Conclusion: This study showed that the general work stress levels of smoker HCWs were higher than those of nonsmokers. Mindful awareness level was the lowest in the group, with the highest scores in psychological dependence on smoking. There was a negative correlation between psychological dependence on smoking and both work stress and mindful awareness levels. This study demonstrated that high work stress and low mindful awareness levels are not only related to each other but also to high psychological dependence on smoking.

Smoking Behavior Change and the Risk of Heart Failure in Patients With Type 2 Diabetes: Nationwide Retrospective Cohort Study.

Heart failure (HF) is one of the most common initial manifestations of cardiovascular disease in patients with type 2 diabetes. Although smoking is an independent risk factor for HF, there is a lack of data for the incidence of HF according to changes in smoking behaviors in patients with type 2 diabetes. We aimed to examine the association between interval changes in smoking behavior and the risk of HF among patients with type 2 diabetes. We conducted a retrospective cohort study using the National Health Insurance Service database. We identified 365,352 current smokers with type 2 diabetes who had 2 consecutive health screenings (2009-2012) and followed them until December 31, 2018, for the incident HF. Based on smoking behavior changes between 2 consecutive health screenings, participants were categorized into quitter, reducer I (≥50% reduction) and II (<50% reduction), sustainer (reference group), and increaser groups. During a median follow-up of 5.1 (IQR 4.0-6.1) years, there were 13,879 HF cases (7.8 per 1000 person-years). Compared to sustainers, smoking cessation was associated with lower risks of HF (adjusted hazard ratio [aHR] 0.90, 95% CI0.86-0.95), whereas increasers showed higher risks of HF than sustainers; heavy smokers who increased their level of smoking had a higher risk of HF (aHR 1.13, 95% CI 1.04-1.24). In the case of reducers, the risk of HF was not reduced but rather increased slightly (reducer I: aHR 1.14, 95% CI 1.08-1.21; reducer II: aHR 1.03, 95% CI 0.98-1.09). Consistent results were noted for subgroup analyses including type 2 diabetes severity, age, and sex. Smoking cessation was associated with a lower risk of HF among patients with type 2 diabetes, while increasing smoking amount was associated with a higher risk for HF than in those sustaining their smoking amount. There was no benefit from reduction in smoking amount.

The combined effect of split fueling strategy and EGR on the combustion, performance, and emission characteristics of a CRDI biofuel engine

AbstractThe current research investigates the impact of a split fueling strategy combined with several flow rates of exhaust gas recirculation (EGR) on the combustion and emission characteristics of a diesel engine running on B20 waste cooking oil (WCO) biodiesel. A four‐stroke single‐cylinder common rail direct injection engine was employed for experiments. It operates with a B20 blend of WCO biodiesel at 600 bar pressure for varying pilot fueling conditions of 10%, 20%, and 30%. The B20 blend with 30% pilot fuel injection (B20P30) showed excellent performance and emission characteristics compared with B20 blend with 10% pilot fuel injection (B20P10) and B20 with 20% pilot fuel injection (B20P20). However, B20P30 had greater levels of nitrogen oxide (NOx) emissions than those by diesel. EGR discharge levels in 5% increments, ranging from 0% to 15% were introduced to address this issue. The experimental findings revealed that both cylinder peak pressure and heat release rate showed a reduction when the EGR flow rate was enhanced. The recirculation of exhaust gas into the combustion chamber led to a slight increase in the emission levels of hydrocarbon (HC), carbon monoxide (CO), and smoke, as well as a decrease in carbon dioxide (CO2). Nevertheless, the introduction of EGR significantly decreased NOx emissions by 22.94%, 35.05%, and 47.96% for EGR flow rates of 5%, 10%, and 15%, respectively, when compared with the engine operating without EGR. Overall, the two‐stage fueling strategy, B20P30 blended with 10% EGR corroborated to be beneficial in reducing NOx emissions with minimal performance penalties. Although there was a slight uptick in certain emissions, the overall trade‐off between emission reduction and performance was favorable. The culmination of this study is targeting the objectives of sustainable development goal 7 (clean energy) and goal 13 (climate action) to be achieved by 2030.

Effect of smoking on Brain-Derived Neurotrophic Factor (BDNF) blood levels: A systematic review and meta-analysis

BackgroundBrain-Derived Neurotrophic Factor (BDNF) is a neurotrophin that plays a crucial role in neuronal survival and plasticity. Previous studies have suggested that smoking may influence BDNF levels, but the findings have been inconsistent. MethodsA comprehensive search of electronic databases was conducted to identify relevant studies. Inclusion criteria were applied to select studies that investigated the relationship between smoking and blood levels of BDNF. A random-effects model was used to estimate the overall effect size. ResultsA total of 23 studies were included. The meta-analysis revealed a significant association between smoking and increased blood levels of BDNF (standardized mean difference [SMD] = −0.38, 95 % confidence interval [CI] 0.15 to 0.62, p = 0.002). Subgroup analyses based on BDNF source showed a significant increase in plasma-derived BDNF levels (SMD = 1.02, 95 % CI 0.50 to 1.53, p = 0.0001), while no significant difference was observed in serum-derived BDNF levels (SMD = 0.02, 95 % CI -0.19 to 0.22, p = 0.87). The pooled analysis revealed a non-significant difference in blood levels of BDNF between former smokers and non-smokers (random-effects model, SMD = 0.21, 95 % CI -0.04 to 0.46, p = 0.1). ConclusionSmokers exhibited significantly higher plasma levels of BDNF compared to non-smokers. Further research is needed to elucidate the underlying mechanisms and explore the potential therapeutic implications of targeting BDNF in smoking.

Anterior-wall and non-anterior-wall STEMIs do not differ in long-term mortality: results from the augsburg myocardial infarction registry.

Different ST-segment elevation myocardial infarction (STEMI) localizations go along with dissimilarities in the size of the affected myocardium, the causing coronary vessel occlusion, and the right ventricular participation. Therefore, this study aims to clarify if there is any difference in long-term survival between anterior- and non-anterior-wall STEMI. This study included 2,195 incident STEMI cases that occurred between 2009 and 2017, recorded by the population-based Augsburg Myocardial Infarction Registry, Germany. The study population comprised 1.570 men and 625 women aged 25-84 years at acute myocardial infarction. The patients were observed from the day of their first acute event with an average follow-up period of 4.3 years, (standard deviation: 3.0). Survival analyses and multivariable Cox regression analyses were performed to examine the association between infarction localizations and long-term all-cause mortality. Of the 2,195 patients, 1,118 had an anterior (AWS)- and 1,077 a non-anterior-wall-STEMI (NAWS). No significant associations of the STEMI localization with long-term mortality were found. When comparing AWS with NAWS, a hazard ratio of 0.91 [95% confidence interval: 0.75-1.10] could be calculated after multivariable adjustment. In contrast to NAWS, AWS was associated with a greater <28 day mortality, less current or former smoking and higher creatine kinase-myocardial band levels (CK-MB) and went along with a higher frequency of impaired left ventricular ejection fraction (<30%). Despite pathophysiological differences between AWS and NAWS, and identified differences in multiple clinical characteristics, no significant differences in long-term mortality between both groups were observed.

Reflection of prenatal exposure to wildfire smoke on reduced birth weight in 2015-2019

Wildfire smoke contains many different types of air pollutants which are cause for concern. Studies on epidemiology have identified correlations between PM2.5 exposure to wildfire smoke and mortality, respiratory and cardiovascular morbidities, and may result in a reduction in birth weight. However, evidence from Indonesia is limited. For this study, a retrospective cohort epidemiological study was undertaken to quantify the Indonesian population’s exposure to wildfire-PM2.5. We present 9652 (88%) records of newborns to identify an association between fire-sourced PM2.5 and birth weight in Palangka Raya, Indonesia from 2015 to 2019. On an annual basis, geospatial, and season variations in wildfire-PM2.5 concentrations were observed using a satellite-based dataset from CAMS and used for gestational exposure to wildfire smoke. Applying a general linear model with birth weight (yi) as a continuous outcome, the relationship between PM2.5 exposure and low birth weight was examined. In addition, the binary outcome of low birth weight was analysed. A statistically significant difference in the birth weight reduction between infants delivered to mothers exposed to high levels of wildfire smoke and those exposed to low levels of wildfire smoke was observed over the entire time frame (2015-2019) (ρ-value &lt; 0.001). In comparison to infants born to mothers exposed to lower concentrations, the birth weight of infants delivered to mothers exposed to high concentrations of PM2.5 in the third trimester decreased by 19.96%. A 1.9% reduction in birth weight could be caused by exposure during the fire-prevalent in the first trimester of pregnancy (ρ-value &lt; 0.001). Since an estimation model predicted a 10 g/m3 increase in PM2.5 exposure between the first and last trimesters of pregnancy, variations in the second trimester did not significantly affect the association (ρ-value = 0.761). This emphasizes the significance of foetal development during these two trimesters. Exposure to pollution from wildfires contributes significantly to the global burden of newborns’ birth weight.

Relationship between Cigarette Smoking and Anxiety Level among Nurses

Background: This study aims to determine whether cigarette smoking and anxiety degrees are related among nurses. Methods: A correlation design study was conducted at Baquba Teaching Hospital in Diyala Governorate, and the study period extended from September 10th, 2023, to January 28th, 2024. A nonprobability purposive sample was used to include 200 nurses working at Baquba Teaching Hospital, Iraq. Data were collected using a self-administered questionnaire from January 10th to February 7th, 2024. There were two components to the study instruments. Initially, the demographic sheet contained the individuals' sociodemographic data. The Taylor manifest anxiety scale is included in the second section. The collected data were analyzed using SPSS version 26. Results: Findings of the current study showed that 47.5% of nurses had a moderate level of anxiety, while 35.5% experienced a small level of anxiety, and 17.0% suffered from a severe level of anxiety regarding smoking cigarettes. The nonparametric correlation analysis (Spearman's rho) carried out to examine the relationship between cigarette smoking and anxiety levels among nurses yielded a significant correlation coefficient of 0.01 (p &gt; 0.05). The findings revealed a strong and positive correlation between all aspects related to cigarette smoking and anxiety levels. Conclusion: According to the results of the present study, it concluded that nurses reported moderate levels of anxiety, and it was displayed that there was a relationship between nurses' anxiety levels and cigarette smoking depending on their age groups and length of hospital employment. Recommendation: It is recommended that training and educational programs be implemented to cultivate a suitable health promotion culture among nurses, thereby enabling them to offer more effective support to patients who smoke.

Physical Activity among Older People with Chronic Illnesses: A Cross-sectional Study

BSTRACT Article History: Received: November 21, 2023 Accepted: January 31, 2024 Background: The significance of physical activity in preventing and treating chronic illnesses has long been established. However, there are limited studies focusing on the physical activity among old people with chronic illnesses in Jordan. Purpose: This study aimed to explore the association between physical-activity level, chronic illnesses, and multimorbidity among people 60 years old and above in Jordan. Methods: A crosssectional design was used in the northern region of Jordan. A survey was conducted among 200 old people aged 60 years and above. The survey included sociodemographic data and the International Physical Activity Questionnaire (IPAQ). The statistical analyses included descriptive statistics, correlation coefficient, and logistic-regression analysis. Results: Approximately 41% of old people had a sufficient level of physical activity. Gender, level of schooling, smoking, heart conditions, diabetes, and multimorbidity were significantly associated with physical activity. In the logistic-regression analysis, gender (OR 0.221, 95% CI 0.096-0.507), heart condition (OR 0.093, 95% CI 0.011-0.760), and diabetes (OR 0.312, 95% CI 0.120-0.810) were found to be significantly associated with physical activity among old people. Conclusion: This study revealed a low physical activity among old people. It is important to develop policies that support regular physical activity for old people with chronic illnesses. Implications for Nursing: Community-based healthpromotion programs should be developed to encourage regular physical activity among older people with chronic illnesses. Keywords: Physical activity, Older people, Chronic illnesses, Cross-sectional study.

Marginal bone loss in dental implants: A literature review of risk factors and treatment strategies for prevention.

Marginal bone loss (MBL) occurs in the periapical cervical bone after dental implant placement and abutment connection. MBL may not result in peri-implantitis; however, it is always accompanied by MBL. Recent studies have demonstrated that early MBL is a predictor of peri-implantitis. In this narrative review, we aimed to provide an evidence base for recommended treatment strategies for clinicians to prevent MBL. We reviewed the recent literature and performed a narrative synthesis of the evidence, focusing on available systematic reviews and meta-analyses of implant marginal bone resorption. The available evidence indicates that certain biological, material, and technical factors can influence MBL and consequently dictate the risk of developing peri-implant disease in later years. The order of the impact of the strength of each factor is unknown. Current recommendations to prevent MBL include controlling patients' smoking and hemoglobin A1c levels to sufficiently low levels before surgery and throughout their lifetime. Regarding the material, a platform-switching, conical-connecting implant system, and an abutment with a height of at least 2 mm should be selected. Placement should be performed using techniques that ensure sufficient soft tissue (keratinized gingival width > 2 mm, supracrestal tissue height > 3 mm), and non-undersized preparations in the cortical bone should be made with connected concave abutments during primary or secondary surgery. Patients should receive supportive peri-implant therapy during maintenance. MBL development is multifactorial and can be reduced by considering the biological, material, and technical factors.

Full title: Does the level of vitamin D influence pain intensity, functional ability, and quality of life in individuals with chronic low back pain Running title: The relationship between chronic low back pain and vitamin D levels

Objective: This study aimed to determine the association connection vitamin D level and demographics, duration of pain, pain intensities, neuropathic pain intensities, functional abilities, and quality of life in patients with chronic mechanical low back pain. Materials and Methods: After blood samples were taken to analyze serum 25 hydroxyvitamin-D, the participants were organized into two groups: those with vitamin D level &gt;20 ng/mL, which was considered sufficient or insufficient, and those with level ≤20 ng/mL, which was considered deficient. The participants’ resting, activity, and night pain levels were recorded with the visual analog scale (VAS), neuropathic pain using Douleur Neuropathic 4 (DN4), functional abilities using the Oswestry Disability Index, and quality of life using the 36-item Short-Form Health Survey. Results: This study included 157 participants. The patients in the vitamin D level &gt;20 ng/mL group were considerably older than those in the vitamin D level ≤20 ng/mL group. Furthermore, the vitamin D level &gt;20 ng/mL group had higher educational level than the other group. While the vitamin D level &gt;20 ng/mL group had lower VAS-resting and VAS-activity scores than the vitamin D level ≤20 ng/mL group, no meaningful disparity was detected between them in terms of night pain VAS score, DN4, pain duration, disability, and quality of life. Conclusion: The results indicated that differences exist between vitamin D deficiency and chronic low back pain in terms of age, educational level, smoking, and pain level. According to the results, vitamin D level in patients with chronic low back pain was correlated with young age, smoking habit, low educational level, and high pain level.