Smoking Control Research Articles

Pressurization System under Various Operating Conditions for Smoke Control

The importance of smoke control systems has been emphasized for a safe evacuation and efficient firefighting activities during fire situations. To protect stairwells from smoke hazards, ‘Design Guide for Smoke Control System of Special Evacuation Stairwell and Lobby (NFPC501A)’ has been presented. In domestic area, pressurization systems utilize an air supply system consisting of fans, ducts, and dampers for supplying the outdoor air to the lobbies . For a 10-story model building, the design of the pressurization system must consider the leakage/supply flow rate, pressure loss, and fan performance. In this study, the flow field of the pressurization system under various operating conditions was analyzed using CONTAM network model.

Assessing the Need for Additional Evacuation Measures in Deep Underground Stations

Underground railroad stations face evacuation challenges owing to the rapid spread of smoke and extended escape routes during fires. Evacuation in deeply underground domestic railroad stations relies solely on stairways, with no legal standards for additional evacuation methods. In contrast, international standards such as NFPA 130 and Japan’s Fire Protection Engineering Association (JAFPE) recommend using evacuation elevators as a supplementary means of evacuation. This study analyzed smoke behavior in deep underground railroad stations through fire simulations at the Soongsil University and Guryong station. It also examined additional evacuation measures to enhance evacuation safety through evacuation simulations. The results show that during a fire, smoke spread follows the same path as the passenger evacuation routes because of the chimney effect. Even with smoke control and ventilation systems in operation, smoke follows the same evacuation routes, such as stairways or escalators. Therefore, the study concluded that evacuation elevators should be installed as an additional means to improve evacuation efficiency, and placed in smoke-protected evacuation routes. The study also found that combining evacuation stairways and elevators significantly enhances the evacuation efficiency.

Journey towards a smoke-free nation

“A journey of a thousand miles begins with a single step.” Singapore’s journey towards a smoke-free society started early in the 1970s when legislations were introduced to restrict smoking in certain public spaces and ban tobacco advertising.1 The National Smoking Control Programme was launched in 1986 with important objectives set to prevent youths from picking up the smoking habit, help current smokers quit, protect non-smokers from second-hand smoke, and tighten regulations against smoking. Public health campaigns and outreach programmes to schools, youth organisations, army camps and workplaces were conducted. There was widespread dissemination of information on the hazards of smoking through mass media coverage and printed materials. Singapore was among the first 40 countries to ratify the World Health Organization (WHO) Framework Convention on Tobacco Control, with its 6 recommendations supporting tobacco cessation—including monitoring tobacco use, protecting people from tobacco smoke, offering smoking cessation assistance, warning dangers of tobacco, enforcing bans on tobacco advertising, and raising taxes on tobacco.2

Income level is associated with differences in primary and secondary stroke prevention in China

IntroductionThe aim of this study was to assess differences in the effects of income level on the primary and secondary prevention of stroke in the Chinese population.Material and methodsThis was a population-based study using data from a China Kadoorie Biobank survey that began in 2004 in 10 geographical regions. Community residents (n = 512,715) aged 30–79 years were recruited. Stroke was determined by the self-reporting of a doctor’s diagnosis, and participants with a high risk of stroke were identified using the model developed in the Prediction for ASCVD Risk in China study.ResultsThe final numbers of people included in this study were 8,884 with stroke and 218,972 with a high risk of stroke. The participants’ income level was positively associated with high levels of physical activity and the consumption of a healthy diet, but negatively associated with the control of alcohol consumption (all p < 0.05). In addition, positive associations were observed between the control of smoking and the use of antiplatelet and antihypertensive medication for primary prevention (all p < 0.05), but there was a negative association with the control of blood pressure (p < 0.001).ConclusionsLow-income individuals were less likely to control smoking and their diet and use preventive medications, while high-income individuals were less likely to control their alcohol consumption and blood pressure. Moreover, medication use was low for both primary and secondary prevention in high-income individuals.

An Overview of Tobacco Control Policies in China

The tobacco epidemic is a global public health concern as the toxic substances in tobacco pose a severe threat to human health. In response to this issue, countries around the world have adopted various strategies to control tobacco use. The Chinese government began to pay attention to the health hazards of smoking in the 1970s and joined the international community in tobacco control endeavors by becoming a signatory of the World Health Organization Framework Convention on Tobacco Control in the early 21st century. It has further intensified its tobacco control measures in recent years with its “Healthy China” strategy. This article gives an overview of tobacco control policies released by the Chinese government over the years, with a separate analysis of the provisions on smoking control stipulated in the Health China Action Plan (2019-2030). Also discussed are the outcomes of those policies and the challenges China faces in tobacco control, as well as the lessons China can learn from international experiences in this regard.

Tertiary lymphoid structures and B-cell infiltration are IPF features with functional consequences.

Recent literature has shown the presence of B cells and autoantibodies in idiopathic pulmonary fibrosis (IPF) which would imply the presence of tertiary lymphoid structures (TLS, sites where the immune response is triggered), yet TLS are not considered features of the histological characteristics of IPF. This study aims to quantify the presence, size, and degree of activation of TLS in biopsied and explanted lungs from patients with early- and late-IPF, never treated with antifibrotics, and relate their presence and activity to the clinical course, disease progression, and lung inflammation. Immunohistochestry for B cells and CD4, CD8, and CD45 cells was performed in lung tissue from IPF patients: 18 at diagnosis (early), 39 explanted (end-stage), and 12 smoking controls. TLS activation was assessed by CD40 expression. Spirometry along 31 (12-72) months of follow-up was used to characterize end-stage IPF as slow progressors or rapid progressors. B cells, along with other inflammatory cells, were higher in early- and end-stage IPF than in controls (p < 0.001). In rapid progressors, all inflammatory cells were higher than in slow progressors (p < 0.05). TLS were present in 100% of early- and end-stage IPF and in 50% of controls. In end-stage IPF, the TLS area and activation score were higher than in early IPF (p < 0.0001; p = 0.005) and controls (p < 0.04; p < 0.002). TLS activation score correlated with FVC decline during follow-up in rapid progressors (r = 0.73; p = 0.007) but not in slow progressors. A prominent B-cell infiltration, along with the presence of TLS, the activity of which correlates with FVC decline, is an important component of IPF from the beginning of the disease, likely playing an important role on its mechanism and progression.

Numerical Study on the Influence of the Slope Composition of the Asymmetric V-Shaped Tunnel on Smoke Spread in Tunnel Fire

Asymmetrical V-shaped tunnels often appear in tunnels crossing the river or urban underground road tunnels. The smoke flow inside is affected by a lot of factors. A full understanding of the smoke flow in this kind of tunnel is the basis of the smoke control. In this study, the effects of slope composition and fire heat release rate (HRR) on the longitudinal induced airflow velocity, the smoke back-layering length at the small slope side, and the maximum ceiling temperature were studied by the numerical method. The results show that when the fire occurs at the slope change point of the V-shaped tunnel, the maximum ceiling temperature decreases with the increase in the slope of the large-slope side tunnel. The longitudinally induced velocity is primarily related to the slope of the large-slope side tunnel and the fire HRR. When the slope difference between the side tunnels or the slope of the large-slope side tunnel is large, the smoke in the small-slope side tunnel flows back toward the fire source after reaching its maximum dispersion distance and then reaches a quasi-steady state. The smoke back-layering length is mainly affected by the slope and length of the large-slope side tunnel. When the slope of the large-slope side tunnel is 9%, the induced airflow velocity from the small-slope side can prevent the spread of smoke. The empirical models of the smoke back-layering length and the longitudinal induced airflow velocity in the small-slope side tunnel are drawn, respectively, by the theoretical analysis and the numerical results. This study can provide technical support for the design and operation of smoke control systems in V-shaped tunnels.

Smoke control and temperature distribution of tunnel fires under longitudinal ventilation combined with shaft exhaust

Longitudinal segmental smoke exhaust is often used for fire tunnels longer than 5 km. With the combined effect of longitudinal ventilation in the main tunnel and fan suction in the exhaust shaft, the smoke exhaust path is different from that of a traditional single-tube tunnel. Findings reported in the literature is insufficient to support the rapid development of extra-long road tunnels. In this paper, a numerical model was established by FDS (Fire Dynamics Simulator), and a 1:15 model test platform was built for verification. The effects of different longitudinal velocities, exhaust velocities, bifurcation angles, and exhaust shaft slopes on tunnel fires were analyzed for the longitudinal ventilation combined with shaft exhaust smoke evacuation mode (LVSE). The results show that when the exhaust velocity is greater than 4.5m/s, increasing the exhaust velocity has a limited effect on reducing the smoke length downstream of the exhaust shaft. The bifurcation angle has a significant effect on the velocity distribution in the ventilation shaft and the main tunnel. When the bifurcation angle is less than 45°, the airflow in the main tunnel is more likely to enter the exhaust shaft, and the velocity in the exhaust shaft is more than 5m/s. It is more favorable to reduce the smoke length when the slope of the exhaust shaft is not less than 7%. The high-temperature flue gas collects and forms a vortex near the vent under the LVSE mode, which makes the temperature decay rate slower than that when only longitudinal ventilation is used. The temperature decay model for the LVSE mode is obtained. This study is intended to provide a reference basis for the fire safety design of extra-long road tunnels under the LVSE mode.

Study on the elimination characteristics of smoke particles with different materials using electric agglomeration technology

ABSTRACT Fire smoke, consisting of solid particles and liquid droplets, poses risks of asphyxiation, poisoning, making it a significant contributor to fire-related fatalities and environmental pollution. The exploration of effective smoke control methods represents a vital approach to reducing the threat of fire smoke to public health and safety. This study aims to determine the characteristics of elimination for the fire smoke generated from burning four typical materials, thereby validating the universality of electric agglomeration smoke elimination technology. The results indicate that the elimination efficiency of electric agglomeration varies with the material type of the smoke. The rate of change in smoke transmittance from fast to slow is: polyvinyl chloride (PVC), polystyrene (PS), wood, and styrene butadiene rubber (SBR), respectively. With an external potential of 4 kV, PVC smoke reaches the safe threshold after 12.1 s, while SBR smoke achieves it in just 4.9 s. Analysis of the microscopic morphology of agglomerates with scanning electron microscopy (SEM) reveals that particle size distribution is an important factor affecting electric agglomeration elimination. This is because larger initial particles carry a greater charge, enabling the formation of larger agglomerates for more efficient removal. This study provides theoretical guidance for the practical application of electric agglomeration in eliminating smoke particles.

Association between Multi-Domain Lifestyle and Objective Cognitive Impairment in Elderly People with SCD and MCI in Chinese Communities.

Controlling the lifestyle associated with dementia risk can delay the process of cognitive decline. Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early states in the development of dementia and are also the window period for early intervention in dementia. The purpose of this study was to explore the association between multi-domain lifestyle and objective cognitive impairment in elderly people with SCD and MCI in Chinese communities and to provide reference for effective implementation of precise health management measures to reduce the risk of dementia. A total of 265 middle-aged and elderly volunteers recruited from the community were divided into SCD group (107 cases), MCI group (80 cases), and healthy control (HC) group (78 cases). All participants received clinical interview, examination, and cognitive assessments. The total Dementia Risk Reduction Lifestyle Scale (DRRLS) scores in the HC, SCD, and MCI groups [110.00 (11.25) vs. 101.00 (10.00) vs. 79.50 (20.75)] exhibited statistically significant differences among them. The total score of the DRRLS showed a significant negative correlation with the Trail-Making Test (TMT), and significant positive correlations with both the Verbal Fluency Test (VFT) and Auditory Verbal Learning Test (AVLT) scores (p < 0.05). After adjusting for confounding factors, such as age and years of education, multiple linear regression analysis revealed several points. In the SCD group, brain-strengthening exercise and interpersonal relationship scores were negatively correlated with TMT scores (β = -11.257, -15.077; all p < 0.05), while health responsibility, smoking control behavior, and interpersonal relationship scores were positively correlated with AVLT scores (β = 0.485, 0.344, and 0.406; all p < 0.05). In the MCI Group, brain-strengthening exercise, brain-healthy diet, and interpersonal relationship were negatively correlated with TMT (β = -22.011, -16.206, -11.696; all p < 0.01), whereas health responsibility, mental activity, smoking control behavior, interpersonal relationship, and stress management were positively correlated with AVLT (β = 0.450, 0.435, 0.308, 0.256, 0.607; all p < 0.05). In Chinese communities, the unhealthy lifestyle of elderly individuals with SCD and MCI is significantly associated with cognitive function impairment. The greater their unhealthy lifestyle habits, the more pronounced the scope and severity of cognitive function impairment becomes. Furthermore, different dimensions of lifestyle have varying impacts on cognitive domains.

An effective and efficient approach for smoke control in underground parking garages

Underground parking garages are enclosed spaces not directly exposed to the exterior. A smoke control system is typically required to facilitate occupants’ safe evacuation/relocation and assist in firefighting/rescue. Currently, there is a lack of guidelines for designing such systems in primary codes/standards. Only a limited number of local authorities have developed amendments to address this issue. These amendments either rely on outdated approaches, such as air change method, or simply repurpose carbon monoxide ventilation systems for smoke control without conducting additional engineering analysis and providing justification. The intent of this study is to examine the adopted approaches and explore an effective and efficient approach for garage smoke control. According to the study’s findings, it is discovered that garage floor height significantly impacts the performance of smoke control system. Additionally, structural components (beams) also influence the performance of smoke control system. Moreover, this study derives a linear equation to ascertain available safe egress time (ASET) when utilizing the carbon monoxide ventilation system or typical air change methods. Taking cost into consideration, the study concludes that for effective and cost-efficient smoke control in large underground garages, employing a carbon monoxide ventilation system is preferable to the traditional or equivalent air change method.

Application Attempt of Virtual Simulation in "Smoke Control and Exhaust Engineering"

Application Attempt of Virtual Simulation in "Smoke Control and Exhaust Engineering"

WP1.8 - No, we can’t repair your hernia: An audit to assess pre-operative optimisation for umbilical hernia repair

Abstract Aims The European Hernia Association recently published guidelines which clearly outline the importance of pre-operative optimisation for those undergoing elective umbilical/epigastric hernias. The main factors of importance are: smoking cessation and BMI &amp;lt;35. This audit aimed to identify if we are adequately optimising our patients. Methods We retrospectively evaluated all elective umbilical hernia repairs from 1st January 2022- 31st December 2022 within a district general hospital setting. Clinic letters and pre-operative records were used to ascertain smoking status, BMI and diabetic control (HbA1c). Results 60 umbilical hernias were performed in our district general hospital setting from 1st January 2022- 31st December 2022. Of these patients, 12% (N=7) were known smokers and 13% (N=8) had a BMI of over 35 documented. Additionally, only in 15 cases, was there clear documentation of the patient smoking status. Out of these patients, 9 were subsequently found to be non-smokers and 6 remained smokers despite being given smoking cessation advice. Furthermore, in 10% (N=6) of these cases, there was poor diabetic control (HbA1c &amp;gt; 48), which was not addressed in clinic pre-operatively. Conclusion Patient factors such as smoking, obesity and diabetic control have been shown to significantly increase the rate of post-operative wound infections and complications. Patients are not being adequately optimised for elective procedures which puts them at increased risk of complications and increases the burden on limited NHS resources.

Global, regional, and national burden of intracerebral hemorrhage and its attributable risk factors from 1990 to 2021: results from the 2021 Global Burden of Disease Study

BackgroundIntracerebral hemorrhage (ICH) results from the rupture of blood vessels causing bleeding within the brain and is one of the major causes of death and long-term disability globally, particularly in low- and middle-income countries. Despite having a lower incidence than ischemic stroke, ICH imposes a greater social and economic burden. To our knowledge, since the release of the 2021 Global Burden of Disease (GBD) report, there has been no comprehensive update on the epidemiology and trends of ICH. This study aims to analyze the impact of gender, age, and the Sociodemographic Index (SDI) on the burden of ICH at global, regional, and national levels.MethodsData on the incidence, deaths, and disability-adjusted life years (DALYs) of ICH and its related risk factors from 1990 to 2021 were extracted from the GBD 2021 project, encompassing 203 countries and regions. Furthermore, temporal trends of the global intracerebral hemorrhage burden were assessed through Joinpoint analysis.ResultsIn 2021, there were 3.444 million new cases of ICH worldwide, with an age-standardized prevalence rate of 40.8 per 100,000 people, representing a 31.4% decrease compared to 1990. In 2021, ICH caused 3.308 million deaths, with an age-standardized mortality rate of 39.1 per 100,000 people, a reduction of 36.6% since 1990. Globally, ICH accounted for 79.457 million DALYs, with an age-standardized DALY rate of 92.4 per 100,000 people, representing a 39.1% decrease since 1990. Regionally, Central Asia, Oceania, and Southeast Asia had the highest age-standardized prevalence rates of ICH, whereas Australasia, high-income North America, and Western Europe had the lowest rates. Nationally, the Solomon Islands, Mongolia, and Kiribati had the highest age-standardized prevalence rates, whereas Switzerland, New Zealand, and Australia had the lowest. Hypertension, smoking, and environmental pollution were identified as the primary risk factors for ICH. This study also validated the significant association between SDI and the burden of ICH, with the age-standardized DALY rate of ICH decreasing significantly as SDI increased.ConclusionDespite the decreasing burden of intracerebral hemorrhage, it remains a significant public health issue in countries with a lower SDI. Prevention strategies should prioritize hypertension management, air quality improvement, and smoking control to further mitigate the impact of intracerebral hemorrhage.

The Association Between Vitamin B12 Deficiency and Diabetic Foot Ulcer in Type 2 Diabetic Patients in Qassim Province, Saudi Arabia: A Case-Control Study.

Background Diabetic foot ulcer (DFU) is a major complication of diabetes with many identified risk factors. These include poor control of diabetes, cardiovascular disease, smoking, and end-stage kidney disease. This study aims to shed light on the micronutrient status of diabetic patients and its effect on DFU, particularly, the association between vitamin B12 deficiency and DFU. Methodology This retrospective case-control study included adults in Buraydah who were at least 18 years old and had type 2 diabetes mellitus. Data were obtained from the electronic files of the patients who visited the diabetes center from January 2018 to August 2023 and were analyzed using SPSS version 27.0.1 (IBM Corp., Armonk, NY, USA). Results The research involved 221 participants, with 114 controls (individuals with diabetes but no DFU), and 107 cases (individuals with diabetes affected by DFU). Vitamin B12 levels varied, with 79.2% falling within the normal range of 187-883 pg/mL. The average age of cases (58.5 years, SD = 11.3) was notably higher than that of controls (54.1 years, SD = 14.1).Glycated hemoglobin levels were significantly higher in cases (8.7, SD = 2.0) compared to controls (7.6, SD = 2.2) (p < 0.001). Regarding physical activity, cases showed a significantly higher percentage of inactivity (62.1%) compared to controls (39.1%) (p = 0.046). Neuropathy exhibited a significant association with ulcer development, with 59.1% of cases having neuropathy compared to 23.5% of controls (p < 0.001). Furthermore, complications such as dry foot and fissures (60.0% vs. 6.3%), Charcot joint (36.8% vs. 12.2%), and foot trauma (40.9% vs. 3.9%) were significantly more prevalent in cases compared to controls (p < 0.001 for all). Conclusions The significant associations observed with advanced age, uncontrolled diabetes, longer diabetes duration, neuropathy, and specific foot complications underscore the multifactorial nature of ulcer development. The normal levels of vitamin B12 in most patients reflect no positive impact of normalized vitamin B12 levels on DFU. However, further observational studies with multiple vitamin B12 readings over a longer period are needed to establish its association with DFU development.

Prevalence of latent tuberculosis infection (LTBI) in healthcare workers in Latin America and the Caribbean: systematic review and meta-analysis.

Tuberculosis remains a significant global health concern, and healthcare workers (HCWs) face a high risk of acquiring latent tuberculosis infection (LTBI) through occupational exposure. In the Latin American and Caribbean (LAC) region, where the burden of tuberculosis is substantial, understanding the prevalence of LTBI among HCWs is crucial for effective infection control measures. Therefore, we conducted a systematic review and meta-analysis to estimate the prevalence of LTBI among HCWs in LAC countries. Our search included MEDLINE, Scopus, EMBASE, Web of Science, and Google Scholar databases, focusing on relevant English-language records. We looked for observational studies from inception until December 2023. Our analysis included 38 studies representing 15,236 HCWs and 6,728 LTBI cases. These studies spanned the period from 1994 to 2023 and were conducted in Brazil, Peru, Cuba, Colombia, Trinidad and Tobago, Mexico, and Chile. The mean prevalence of LTBI among HCWs was 35.32% (range 17.86-56.00%) for interferon-gamma release assay (IGRA) and 43.67% (range 6.68-70.29%) for tuberculin skin test (TST). The pooled prevalence of LTBI among HCWs was 34.5% (95% CI 25.4-44.1%) for IGRA and 43.0% (95% CI 35.5-50.7%) for TST. When considering both IGRA and TST tests, the overall prevalence of LTBI among HCWs was 40.98% (95% CI 34.77-47.33%). LTBI was associated with longer lengths of employment and exposure to patients, family members, or any person with TB. Additionally, older HCWs faced a higher risk of LTBI. Specific professional roles (such as nurses, nurse technicians, or physicians), smoking, and deficient TB infection control measures increased the likelihood of LTBI. However, information regarding gender and BCG vaccination status showed discordance among studies. Our findings underscore a substantial burden of LTBI among HCWs in LAC countries. Implementing adequate infection control measures is essential to prevent and control transmission within healthcare settings.

Numerical studies on the synergistic effects of smoke extraction and control performance by mechanical ventilation shafts during tunnel fires

High smoke extraction efficiency and a relatively stable smoke layer stratification are both expected in tunnel ventilation systems. The purpose of this paper is to explore the overall performance of mechanical board-coupled shaft (MBCS) under different ventilation strategies. A total of 57 simulations were conducted, and the effects of the distance between the shaft and board (hD) and ventilation velocity on the overall performance were investigated. The results indicate that the performance of smoke extraction and control will be improved by the application of mechanical ventilation and board. Smoke movement patterns under different working conditions were different, for cases of hD≤0.40m the smoke could propagate through the whole tunnel without backflow, while for cases of hD>0.40m, the backflow exists and the smoke movement can be separated into three periods (propagation, stagnation, and retraction). The critical criterion of backflow was investigated and a simple model was deduced to estimate the maximum propagation length. Moreover, the dimensionless time for the smoke flow to reach its maximum propagation length was established. Finally, a comprehensive index φ was proposed to evaluate the synergistic effects of smoke extraction and control performance. These studies may provide positive significance for the ventilation design.

Study on the variation law of smoke layer thickness with ceiling structure height in long-narrow space with one end opening

The ceiling structure in a long-narrow space has a significant impact on the thickness of the fire smoke layer. This paper mainly studies the influence of the height of the ceiling structure on the thickness of the smoke layer before the ceiling structure. Firstly, a theoretical analysis is conducted on the relationship between the critical thickness that affects the smoke flow state and the smoke layer thickness directly below the ceiling structure, and a formula for calculating the smoke layer thickness under gradient flow conditions is derived. Then a small-scale experimental platform was built to study the deviation of actual fire smoke relative to theoretical calculations. Experimental results show that due to the smoke cannot maintain gradient flow when crossing the ceiling structure, there is difference with theoretical calculations in the smoke layer thickness directly below the ceiling structure and some distance before the ceiling structure (which may be of greater concern for personnel evacuation). The gradient flow coefficient and thickness coefficient are defined to represent the above differences. After analysis, it was found that the gradient flow coefficient and thickness coefficient showed different linear variation patterns when the height of the ceiling structure was longer than 35 cm or shorter than 30 cm. Through numerical analysis, this study suggests that the main reason for the change in this linear pattern is whether the potential energy conversed from kinetic energy of the thin layer close to the ceiling structure can directly make the smoke to cross the ceiling structure. The research conclusions of this paper can assist in the engineering design of building smoke control and personnel evacuation.

The effect of healthy eating on the development of stomach and colorectal cancer by the smoking and drinking status: Results from the Korean National Cancer Center (KNCC) community cohort study.

Determining the effect of dietary factors on cancer is a crucial issue when accounting for the effect of other major risks, such as smoking and drinking. A total of 15,563 adults from the Korean National Cancer Center Community Cohort were analyzed to determine and to compare the effect of dietary factors on stomach and colorectal cancer in overall and in the subgroup of non-smokers (or urinary cotinine concentrations <5 ng/mg) and non-drinkers with Cox proportional-hazard models. During the mean follow-up (13.7 years), 469 and 299 cases of stomach and colorectal cancer were identified, respectively. The preventive effect of vegetable, fish, and soybean/tofu intake on colorectal cancer was found in women after adjustment for smoking, drinking, BMI, and sociodemographic factors. In the subgroup analysis of non-smokers and non-drinkers, the effect on colorectal cancer was increased in women (≥1 time/week vs. almost never, vegetables: hazard ratio (HR) 0.30, 95% confidence interval (CI) 0.13-0.69; fish: HR 0.46, 95% CI 0.26-0.83), and the fresh fish intake effect on stomach cancer was newly identified in men (HR 0.36, 95% CI 0.15-0.86). These effects were more pronounced and additionally shown in other dietary factors such as soybean or tofu in women and vegetables and fish in men, when subjects with <5 ng/mg urinary cotinine concentrations applied. The protective effect of healthy eating on the risk of stomach and colorectal cancer were different by smoking and drinking status. Rigorous control of smoking and drinking effects is necessary when measuring the effect of dietary factors on cancer, properly.

Role of ATG4 Autophagy-Related Protein Family in the Lower Airways of Patients with Stable COPD.

Autophagy is a complex physiological pathway mediating homeostasis and survival of cells degrading damaged organelles and regulating their recycling. Physiologic autophagy can maintain normal lung function, decrease lung cellular senescence, and inhibit myofibroblast differentiation. It is well known that autophagy is activated in several chronic inflammatory diseases; however, its role in the pathogenesis of chronic obstructive pulmonary disease (COPD) and the expression of autophagy-related genes (ATGs) in lower airways of COPD patients is still controversial. The expression and localization of all ATG proteins that represented key components of the autophagic machinery modulating elongation, closure, and maturation of autophagosome membranes were retrospectively measured in peripheral lungs of patients with stable COPD (n = 10), control smokers with normal lung function (n = 10), and control nonsmoking subjects (n = 8) using immunohistochemical analysis. These results show an increased expression of ATG4 protein in alveolar septa and bronchiolar epithelium of stable COPD patients compared to smokers with normal lung function and non-smoker subjects. In particular, the genes in the ATG4 protein family (including ATG4A, ATG4B, ATG4C, and ATG4D) that have a key role in the modulation of the physiological autophagic machinery are the most important ATGs increased in the compartment of lower airways of stable COPD patients, suggesting that the alteration shown in COPD patients can be also correlated to impaired modulation of autophagic machinery modulating elongation, closure, and maturation of autophagosomes membranes. Statistical analysis was performed by the Kruskal-Wallis test and the Mann-Whitney U test for comparison between groups. A statistically significant increased expression of ATG4A (p = 0.0047), ATG4D (p = 0.018), and ATG5 (p = 0.019) was documented in the bronchiolar epithelium as well in alveolar lining for ATG4A (p = 0.0036), ATG4B (p = 0.0054), ATG4C (p = 0.0064), ATG4D (p = 0.0084), ATG5 (p = 0.0088), and ATG7 (p = 0.018) in patients with stable COPD compared to control groups. The ATG4 isoforms may be considered as additional potential targets for the development of new drugs in COPD.