Smoking Levels Research Articles

Causal relationships between modifiable risk factors and polycystic ovary syndrome: a comprehensive Mendelian randomization study.

Polycystic Ovary Syndrome (PCOS) is a heritable condition with an as yet unclear etiology. Various factors, such as genetics, lifestyle, environment, inflammation, insulin resistance, hyperandrogenism, iron metabolism, and gut microbiota, have been proposed as potential contributors to PCOS. Nevertheless, a systematic assessment of modifiable risk factors and their causal effects on PCOS is lacking. This study aims to establish a comprehensive profile of modifiable risk factors for PCOS by utilizing a two-sample Mendelian Randomization (MR) framework. After identifying over 400 modifiable risk factors, we employed a two-sample MR approach, including the Inverse Variance Weighted (IVW) method, Weighted Median method, and MR-Egger, to investigate their causal associations with PCOS. The reliability of our estimates underwent rigorous examination through sensitivity analyses, encompassing Cochran's Q test, MR-Egger intercept analysis, leave-one-out analysis, and funnel plots. We discovered that factors such as smoking per day, smoking initiation, body mass index, basal metabolic rate, waist-to-hip ratio, whole body fat mass, trunk fat mass, overall health rating, docosahexaenoic acid (DHA) (22:6n-3) in blood, monounsaturated fatty acids, other polyunsaturated fatty acids apart from 18:2 in blood, omega-3 fatty acids, ratio of bisallylic groups to double bonds, omega-9 and saturated fatty acids, total lipids in medium VLDL, phospholipids in medium VLDL, phospholipids in very large HDL, triglycerides in very large HDL, the genus Oscillibacter, the genus Alistipes, the genus Ruminiclostridium 9, the class Mollicutes, and the phylum Tenericutes, showed a significant effect on heightening genetic susceptibility of PCOS. In contrast, factors including fasting insulin interaction with body mass index, sex hormone-binding globulin, iron, ferritin, SDF1a, college or university degree, years of schooling, household income, the genus Enterorhabdus, the family Bifidobacteriaceae, the order Bifidobacteriales, the class Actinobacteria, and the phylum Actinobacteria were determined to reduce risk of PCOS. This study innovatively employs the MR method to assess causal relationships between 400 modifiable risk factors and the susceptibility of PCOS risk. It supports causal links between factors like smoking, BMI, and various blood lipid levels and PCOS. These findings offer novel insights into potential strategies for the management and treatment of PCOS.

The Effect of Benzene Exposure on Liver and Kidney Function in Human

Background: Exposure to benzene in the workplace causes health issues for the workers, it has negative impacts on the blood, liver, and kidney. Also, it is classified as carcinogenic. Methods: This study is cross-sectional; it involved 32 participants; 16 exposed to benzene and 16 non-exposed. The sample was collected by filling out a questionnaire and taking blood samples to test liver and kidney functions. Results: This study found that the means of AST and ALT levels of exposed workers were lower than the control group, while the mean level of ALP was higher. Moreover, it did not find a relationship between qualification, years of experience, age, and level of liver enzymes of exposed participants, however, it reported a positive correlation between smoking and bilirubin level. On the other hand, there are no statistical differences between the two groups in the levels of urea and creatinine, but the mean of urea level was quite higher in the exposed group than non-exposed. Besides, there are no associations between urea and creatinine levels and age, qualification, smoking, and years of experience. Conclusion: This study demonstrated a clear association between exposure to benzene and its effect on the liver. Therefore, suitable precautions should be taken to protect the workers in the gas station.

Controlling the nutritional status score: a new tool for predicting postoperative mortality in patients with infrarenal abdominal aortic aneurysm treated with endovascular aneurysm repair.

AAA is a fatal condition that commonly occurs during vascular surgery. Nutritional status exerts a significant influence on the prognosis of various pathological conditions Scores from the CONUT screening tool have been shown to predict outcomes of certain malignancies and chronic diseases. However, the ramifications of nutritional status on AAA patients undergoing EVAR have not been elucidated in prior studies. In this study, we aimed to elucidate the correlation between CONUT scores and postoperative prognostic outcomes in patients with AAA undergoing EVAR. This was a retrospective review of 177 AAA patients treated with EVAR from June 2018 to November 2019 in a single center. Patient characteristics, CONUT scores, and postoperative status were collected. These patients were stratified into groups A and B according to CONUT scores. Subsequently, a comparative analysis of the baseline characteristics between the two cohorts was conducted. Cox proportional hazards and logistic regression analyses were employed to identify the autonomous predictors of mid-term mortality and complications, respectively. Compared with group A, patients in group B had higher midterm mortality (p < 0.001). Univariate analysis showed that CONUT scores; respiratory diseases; stent types; preoperative Hb, CRP, PT, and Fb levels were risk factors for death. Multivariate analysis confirmed that CONUT score [HR, 1.276; 95% CI, 1.029-1.584; p = 0.027] was an independent risk factor for mortality. Logistic regression analysis showed that prior arterial disease, smoking, and D-dimer levels were risk factors, although multivariate analysis showed smoking (OR, 3.492; 95% CI, 1.426-8.553; p = 0.006) was an independent risk factor. Kaplan-Meier curves showed that patients in group B had shorter mid-term survival than those in group A (log-rank p < 0.001). Malnutrition was strongly associated with mid-term mortality in patients with infrarenal AAA treated with EVAR.

The Risk of and Associated Demographic and Laboratory Variables for Amputations for Inpatients with Diabetic Foot Ulcers

ObjectiveDiabetic foot ulcers (DFUs) are a leading cause of morbidity and mortality, which disproportionately impacts underserved populations. This study aimed to provide data regarding the rates and outcomes of amputation in patients admitted with DFU in our health system, which cares for an ethnically diverse and underserved population. MethodsThis retrospective study examined the electronic medical records of adult patients hospitalized with DFU at 3 hospitals in our health system between June 1, 2016, and May 31, 2021. ResultsAmong 650 patients admitted with DFU, 88% self-identified as non-White race. Male sex (odds ratio [OR], 0.62), low body mass index (OR, 0.98), and history of smoking (OR, 1.45) were significantly associated with amputation during the study period. A higher erythrocyte sedimentation rate (OR, 1.01), C-reactive protein level (OR, 1.05), and white blood cell count (OR, 1.11) and low albumin level (OR, 0.41) were found to be significantly associated with amputation versus no amputation during admission. The amputation risk during the index admission for DFU was 44%. ConclusionOur study identified a high DFU-related amputation risk (44%) among adult patients who were mostly Black and/or Hispanic. The significant risk factors associated with DFU amputation included male sex, low body mass index, smoking, and high levels inflammation or low levels of albumin during admission. Many of these patients required multidisciplinary care and intravenous antibiotic therapy, necessitating a longer length of stay and high readmission rate.

Non-communicable disease risk factors and Covid-19 antibody levels after vaccination

Background: Non-communicable diseases (NCDs) have been identified as predictors of the severity of Coronavirus Disease 2019 (Covid-19). Some factors like smoking, alcohol consumption, and physical inactivity, which are associated with NCDs, may potentially hinder the efficacy of vaccines, reducing their ability to prevent the severity and complications of infectious diseases such as the Covid-19. Objective: This study investigated the NCD, risk factors associated with the levels of quantitative antibodies after the second Covid-19 vaccination.Methods: A cross-sectional study was conducted at a Covid-19 vaccination centre in Jakarta. Ninety subjects, aged ≥18, completed demographic and NCDs risk factor questionnaires. Blood samples were collected and analysed by using the electro chemiluminescence immunoassay analyser (ECLIA) method to measure quantitative antibody levels 30 days after 2nd Covid-19 vaccination. The bivariate analysis was performed to explore associations among the variables. The logistic regression was subsequently performed to identify the factors that remained independent in influencing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody status. Results: The mean value of antibody level in this study was 191 U/ml. The results indicated that 35.5% (n=32) of respondents had SARS-CoV-2 antibody levels below average. The regression results suggested that the odds of having higher antibody levels were reduced for individuals with hypertension (Adjusted Odd Ratio [AOR] = 0.74, p value = 0.022), diabetes (AOR = 0.82, p value = 0.038) comorbidities accompanied with smoking (AOR = 0.55, p value = 0.044), drinking alcohol (AOR = 0.92, p value = 0.030), and low physical activity levels (AOR = 0.67, p value = 0.043). Conclusion: The study found that 35.5% of participants had SARS-CoV-2 antibody levels below the average. Factors such as hypertension, diabetes, comorbidities with smoking, alcohol consumption, and low physical activity were associated with reduced odds of higher antibody levels.

The effects of alcohol use on smoking cessation treatment with nicotine replacement therapy: An observational study

IntroductionConcurrent users of tobacco and alcohol are at greater risk of harm than use of either substance alone. It remains unclear how concurrent tobacco and alcohol use affects smoking cessation across levels of alcohol use and related problems. This study assessed the relationship between smoking cessation and levels of alcohol use problems. Methods59,018 participants received nicotine replacement therapy through a smoking cessation program. Alcohol use and related symptoms were assessed using the Alcohol Use Disorders Identification Test (AUDIT-10) and the AUDIT-Concise (AUDIT-C). The primary outcome was 7-day point prevalence cigarette abstinence (PPA) at 6-month follow-up. We evaluated the association between alcohol use (and related problems) and smoking cessation using descriptive methods and mixed-effects logistic regression. Results7-day PPA at 6-months was lower in groups meeting hazardous alcohol consumption criteria, with the lowest probability of smoking abstinence observed in the highest risk group. The probability of successful tobacco cessation fell with increasing levels of alcohol use and related problems. Adjusted predicted probabilities were 30.3 (95 % CI = 29.4, 31.1) for non-users, 30.2 (95 % CI = 29.4, 31.0) for low-risk users, 29.0 (95 % CI = 28.1, 29.9) for those scoring below 8 on the AUDIT-10, 27.3 (95 % CI = 26.0, 28.6) for those scoring 8–14, and 24.4 (95 % CI = 22.3, 26.5) for those scoring 15 or higher. ConclusionHeavy, hazardous alcohol use is associated with lower odds of successfully quitting smoking compared to low or non-use of alcohol. Targeting alcohol treatment to this group may improve tobacco cessation outcomes.

Investigations on the effects of injection parameters and EGR in a glow plug assisted methanol fueled Hot Surface Ignition (HSI) Engine

Methanol can be produced from renewable sources and is also clean burning. Hence it is an ideal alternative fuel for transportation applications. However, its low cetane number prevents its direct application in compression ignition (CI) engines. One of the promising but not widely explored methods is to use a hot surface for its ignition in CI engines at normal compression ratios. In this work a turbocharged automotive common rail diesel engine was modified to operate in the hot surface ignition (HSI) mode with methanol as the sole fuel with 3% by mass of lubricity and corrosion inhibiting additive. Initially, a single pulse injection (SPI) strategy was employed at different injection timings at a BMEP of 8 bar. Subsequently a double pulse injection (DPI) strategy was employed and the effects of gap between the injection pulses, injection timing and injection pulse width share among the two pulses were studied. The HSI mode of neat methanol performed with comparable brake thermal efficiency (BTE), reduced combustion rates and hence low NOx emission levels with respect to diesel operation when the DPI mode was employed with almost equal pulse width share. Engine performance was better at rail pressures of around 800 bar. Hot EGR of up to 8% was beneficial as it reduced the engine-out NOx without affecting the BTE. The engine was operated at different BMEPs in the range of 4–10 bar and compared with the baseline diesel operation. The BTE was similar to the baseline diesel engine at all loads. Engine-out NOx was lower than diesel operation by 23.6%–61.5% while near zero smoke levels and similar CO and THC emissions (after the DOC) were observed. Though slipped methanol and formaldehyde were the significant unregulated emissions, they were reduced to very low levels after the DOC.

Circulatory Metabolite Ratios as Indicators of Lifestyle Risk Factors Based on a Greek NAFLD Case-Control Study.

An ensemble of confounding factors, such as an unhealthy diet, obesity, physical inactivity, and smoking, have been linked to a lifestyle that increases one's susceptibility to chronic diseases and early mortality. The circulatory metabolome may provide a rational means of pinpointing the advent of metabolite variations that reflect an adherence to a lifestyle and are associated with the occurrence of chronic diseases. Data related to four major modifiable lifestyle factors, including adherence to the Mediterranean diet (estimated on MedDietScore), body mass index (BMI), smoking, and physical activity level (PAL), were used to create the lifestyle risk score (LS). The LS was further categorized into four groups, where a higher score group indicates a less healthy lifestyle. Drawing on this, we analyzed 223 NMR serum spectra, 89 MASLD patients and 134 controls; these were coupled to chemometrics to identify "key" features and understand the biological processes involved in specific lifestyles. The unsupervised analysis verified that lifestyle was the factor influencing the samples' differentiation, while the supervised analysis highlighted metabolic signatures. Τhe metabolic ratios of alanine/formic acid and leucine/formic acid, with AUROC > 0.8, may constitute discriminant indexes of lifestyle. On these grounds, this research contributed to understanding the impact of lifestyle on the circulatory metabolome and highlighted "prudent lifestyle" biomarkers.

Characterising smoking and nicotine use behaviours among women of reproductive age: a 10-year population study in England

BackgroundTobacco smoking affects women’s fertility and is associated with substantial risks of adverse pregnancy outcomes. This study explored trends by socioeconomic position in patterns of smoking, use of non-combustible nicotine products, and quitting activity among women of reproductive age in England.MethodsData come from a nationally representative monthly cross-sectional survey. Between October 2013 and October 2023, 197,266 adults (≥ 18 years) were surveyed, of whom 44,052 were women of reproductive age (18–45 years). Main outcome measures were current smoking, vaping, and use of nicotine replacement therapy (NRT), heated tobacco products (HTPs), and nicotine pouches; mainly/exclusively smoking hand-rolled cigarettes and level of dependence among current smokers; past-year quit attempts among past-year smokers; and success of quit attempts among those who tried to quit. We modelled time trends in these outcomes, overall and by occupational social grade (ABC1 = more advantaged/C2DE = less advantaged).ResultsSmoking prevalence among women of reproductive age fell from 28.7% [95%CI = 26.3–31.2%] to 22.4% [19.6–25.5%] in social grades C2DE but there was an uncertain increase from 11.7% [10.2–13.5%] to 14.9% [13.4–16.6%] in ABC1. By contrast, among all adults and among men of the same age, smoking prevalence remained relatively stable in ABC1. Vaping prevalence among women of reproductive age more than tripled, from 5.1% [4.3–6.0%] to 19.7% [18.0–21.5%], with the absolute increase more pronounced among those in social grades C2DE (reaching 26.7%; 23.3–30.3%); these changes were larger than those observed among all adults but similar to those among men of the same age. The proportion of smokers mainly/exclusively smoking hand-rolled cigarettes increased from 40.5% [36.3–44.9%] to 61.4% [56.5–66.1%] among women of reproductive age; smaller increases were observed among all adults and among men of the same age. Patterns on other outcomes were largely similar between groups.ConclusionsAmong women of reproductive age, there appears to have been a rise in smoking prevalence in the more advantaged social grades over the past decade. Across social grades, there have been substantial increases in the proportion of women of reproductive age who vape and shifts from use of manufactured to hand-rolled cigarettes among those who smoke. These changes have been more pronounced than those observed in the general adult population over the same period.

Polymorphisms in ERBB4 and TACR1 associated with dry mouth in clozapine-treated patients.

Sialorrhea is a common and uncomfortable adverse effect of clozapine, and its severity varies between patients. The aim of the study was to select broadly genes related to the regulation of salivation and study associations between sialorrhea and dry mouth and polymorphisms in the selected genes. The study population consists of 237 clozapine-treated patients, of which 172 were genotyped. Associations between sialorrhea and dry mouth with age, sex, BMI, smoking, clozapine dose, clozapine and norclozapine serum levels, and other comedication were studied. Genetic associations were analyzed with linear and logistic regression models explaining sialorrhea and dry mouth with each SNP added separately to the model as coefficients. Clozapine dose, clozapine or norclozapine concentration and their ratio were not associated with sialorrhea or dryness of mouth. Valproate use (p = 0.013) and use of other antipsychotics (p = 0.015) combined with clozapine were associated with excessive salivation. No associations were found between studied polymorphisms and sialorrhea. In analyses explaining dry mouth with logistic regression with age and sex as coefficients, two proxy-SNPs were associated with dry mouth: epidermal growth factor receptor 4 (ERBB4) rs3942465 (adjusted p = 0.025) and tachykinin receptor 1 (TACR1) rs58933792 (adjusted p = 0.029). Use of valproate or antipsychotic polypharmacy may increase the risk of sialorrhea. Genetic variations in ERBB4 and TACR1 might contribute to experienced dryness of mouth among patients treated with clozapine.

Systematic review of tobacco smoking prevalence among young people in treatment for first-episode psychosis.

To determine whether smoking prevalence in first-episode psychosis (FEP) is different than in people with established psychosis in long-term treatment. A systematic review of cross-sectional, case-control and cohort studies identified from searches of PubMed, Embase, CINAHL and PsycINFO up to 12 August 2023. 20 studies out of 2773 screened titles were included. There was no clear pattern of smoking by diagnosis as smoking rates in people with FEP ranged from 43% to 78%, while in those with established psychosis, it ranged from 19% to 76%. The wide range of smoking levels in both populations precluded conclusions as to whether smoking rates are different between people with FEP and established psychosis suggesting that factors other than the time course of the illness influence smoking levels.

Analysis and prevention strategies of risk factors for postoperative stroke complications in cardiac surgery

Objective To analyze the risk factors associated with postoperative stroke complications in cardiac surgery. Methods A retrospective analysis was conducted on the clinical data of 549 patients who underwent cardiac surgery. Among these patients, 501 did not experience a stroke postoperatively (non-stroke group), while 48 developed a postoperative stroke (stroke group). Patients who experienced a stroke postoperatively were divided into two groups based on the type of surgery: those who underwent surgery with cardiopulmonary bypass (18 patients) and those without cardiopulmonary bypass (30 patients). The clinical characteristics of the two groups of patients with postoperative strokes were compared, and the risk factors influencing the occurrence of postoperative stroke complications in cardiac surgery were analyzed. Results ① Clinical findings: Cardiopulmonary bypass group had lower cortical infarction rates but higher large-area and bilateral infarction rates compared to the non-cardiopulmonary bypass group (p < 0.05). No significant gender, age, or infarction type differences were observed (p > 0.05). ② Univariate analysis: No significant differences were found in gender, smoking, alcohol, lipids, or glucose levels (p > 0.05). However, age, education, hypertension, diabetes, hypotension, and atrial fibrillation showed significant differences (p < 0.05). ③ Multivariate Logistic regression: Age, education, hypertension, diabetes, hypotension, and atrial fibrillation were independent risk factors for postoperative stroke complications (p < 0.05). Conclusion Cardiopulmonary bypass increases risk of large-area and bilateral strokes; non-bypass surgery associates with cortical strokes. Age, educational level, hypertension, diabetes, postoperative hypotension, and atrial fibrillation are all factors independently associated with the occurrence of postoperative cerebral infarctions in cardiac surgery. Early interventions may reduce postoperative strokes.

Factors Influencing Drug Prescribing for Patients with Hospitalization History in Circulatory Disease: Patient Severity, Composite Adherence, and Physician-Patient Relationship - A Retrospective Cohort Study.

With countries promoting generic drug prescribing, their growth may plateau, warranting further investigation into the factors influencing this trend, including physician and patient perspectives. Additional strategies may be needed to maximize the switch to generic drugs while ensuring healthcare system sustainability, focusing on factors beyond mere low cost. Emphasizing affordability and clarifying other prescription considerations are essential. This study aimed to provide initial insights into how patient severity, composite adherence, and physician-patient relationships impact generic switching. This study utilized a long-term retrospective cohort design by analyzing data from a national healthcare database. The population included patients of all ages, primarily older adults, who required primary-to-tertiary preventive actions with a history of hospitalization for cardiovascular diseases (CVDs) (International Classification of Diseases, Tenth Revision) during April 2014 to March 2018 (4 years). We focused on switching to generic drugs, with temporal variations in clinical parameters as independent variables. Lifestyle factors (smoking and drinking) were also considered. Adherence was measured as a composite score comprising 11 elements. The physician-patient relationship was established based on the interval between physician change and prescription. Logistic regression analysis and propensity score matching (PSM) were employed, along with complementary analysis of physician-patient relationships, proportion of days covered (PDC), and adherence for a subset of the population. The study included 48,456 patients with an average follow-up of 36.1±8.8 months. The mean age was 68.3 ± 9.9 years, body mass index was 23.4 ± 3.4 kg/m2, systolic blood pressure was 131.2 ± 15.0 mmHg, low-density lipoprotein cholesterol (LDL-C) was 116.6 ± 29.3 mg/dL, hemoglobin A1c (HbA1c) was 5.9% ± 0.8%, and serum creatinine was 0.9 ± 0.8 mg/dL. Logistic regression analysis revealed significant associations between generic switching and systolic blood pressure (odds ratio [OR], 0.996, 95% confidence interval [CI]: 0.993-0.999), serum creatinine levels (OR, 0.837, 95% CI: 0.729-0.962), glutamic oxaloacetic transaminase levels (OR, 0.994, 95% CI: 0.990-0.997), PDC score (OR, 0.959, 95% CI: 0.948-0.970), and adherence score (OR, 0.910, 95% CI: 0.875-0.947). Additionally, generic drug rates increased with improvements in the HbA1c level band and smoking level (P<.01, P<.001). The group with a superior physician-patient relationship after PSM had a significantly higher rate of generic drug prescribing (51.6±15.2%) than the inferior relationship group (47.7±17.7%) (P<.001). Although physicians' understanding influences the choice of generic drugs, patient condition (severity) and adherence also impact this decision. For example, improved creatinine levels are associated with generic drug choice, while stronger physician-patient relationships correlate with higher rates of generic drug utilization. These findings may contribute to the appropriate prescription of pharmaceuticals if the policy diffusion of generic drugs begins to slow down. Thus, preventing serious illness while building trust may result in clinical benefits and positive socio-economic outcomes.

Selecting a birth weight standard for an indigenous population in a LMIC: A prospective comparative study.

The aim of the present study was to compare birth weight (BW) distribution and proportion of BWs below or above specified percentiles in low-risk singleton pregnancies in healthy South African (SA) women of mixed ancestry with expected values according to four BW references and to determine the physiological factors affecting BW. This was an ancillary study of a prospective multinational cohort study, involving 7060 women recruited between August 2007 and January 2015 in two townships of Cape Town, characterized by low socioeconomic status, and high levels of drinking and smoking. Detailed information about maternal and pregnancy characteristics, including harmful exposures, was gathered prospectively, allowing us to select healthy women with uncomplicated pregnancies without any known harmful exposures. In this cohort we compared the median BW and the proportion of BWs <P3, 5 and 10 or >P90, 95 and 97 according to four reference standards (INTERGROWTH-21st, customized according to the method described by Mickolajczyk, Fetal Medicine Foundation and revised Fenton reference) with expected values. Appropriate parametric and nonparametric tests were used, and sensitivity analysis was performed for infant sex, first trimester bookings and women of normal body mass index (BMI). Multiple regression was used to explore effects of confounders. Written consent and ethics approval was obtained. The cohort included 739 infants. The INTERGROWTH-21st standard was closest for the actual BW-distribution and categories. Below-expected BW was associated with boys, younger, shorter, leaner women, lower parity and gravidity. Actual BW was significantly influenced by maternal weight, BMI, parity and gestational age. Of the four references assessed in this study, the INTERGROWTH-21st standard was closest for the actual BW distribution. Maternal variables significantly influence BW.

Work-, lifestyle-, and health-related factors among women and men working in the emergency medical services

Objectives. This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods. The cross-sectional study (N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work. A low level of smoking and alcohol use, and a high level of leisure-time physical activity were reported. The ambulance personnel had, on average, good self-rated health, high work ability and high physical capacity. However, the results also showed high proportions with risk factors for cardiovascular disease (CVD), e.g., high blood pressure, and high levels of blood lipids. More women than men reported high work demands. Furthermore, women performed better in tests of physical capacity and had a lower level of CVD risk factors. Conclusions. Exposure to work-related factors that might affect health was common among ambulance personnel. Lifestyle- and health-related factors were somewhat contradictory, with a low proportion reporting lifestyle-related risk factors, but a high proportion having risk factors for CVD.

Culturally relevant acceptance-based telehealth wellness program for Latine adults who smoke and experience psychological distress: Findings from a feasibility study

Latine adults who smoke have a low probability of receiving evidence-based smoking cessation interventions. Acceptance and Commitment Therapy (ACT) has shown to be efficacious for treating tobacco dependence, but its usefulness for Latine populations is just emerging and has not been studied in the context of a culturally tailored treatment. This single-arm study evaluated the feasibility of recruitment and retention, and treatment acceptability of the PRESENT Wellness Program: a culturally relevant ACT-based smoking cessation treatment for Latine adults who also experience psychological distress. Secondary objectives were the examination of smoking rates and levels of depression, anxiety, and psychological inflexibility (ACT core target) among Latine adults. Taking place during the COVID-19 pandemic, the treatment entailed 8 sessions delivered via telehealth (1 in-person/video and 7 by phone), and nicotine patches. Participants (N = 23) completed baseline assessments and follow-ups 1-week post-end of treatment (EOT) and 2-months post EOT. Most participants were women (70%), ranging from young adult to middle-aged, born in the US (57%), working full time (52.2%), and reporting financial strain (70%). Average number of sessions completed was 5.5. Follow-up rates were 61% at both follow-ups. The program was acceptable as indicated by quantitative and qualitative measures. Point-prevalence smoking abstinence was 35% at both follow-ups. Participants reported an average decline across time [% or M(SD)] in all secondary measures, as follows: everyday smoking [Baseline = 87%; 1-wk post EOT = 13%; 2 mo post EOT = 8.7%]; depression [Baseline = 13.7(6.3); 1-wk post EOT = 9.9 (6.6); 2 mo post EOT = 7.4 (5.8)]; anxiety [Baseline = 12.7 (5.4); 1-wk post EOT = 9.7 (6.4); 2 mo post EOT = 8.1 (5.2)]; and psychological inflexibility [Baseline = 50.6 (7.2); 1-wk post EOT = 33.0 (10.7); 2 mo post EOT = 32.6 (12.4)]. ConclusionThe current study observed that implementation of an acceptance-based smoking cessation treatment delivered in a hybrid mode is feasible and acceptable for English-speaking Latine persons. The PRESENT Wellness Program shows promise to address smoking and behavioral health challenges in the Latine community. Replication and expansion of the study is warranted, including the linguistic adaptation and evaluation of the program among Spanish-preferring Latine persons who smoke.

Greater physical activity levels are associated with lower prevalence of tumors and risk of cancer in Spanish population: A cross-sectional study

Cancer is a leading cause of death worldwide and insufficient physical activity is a significant risk factor. This study analyzed the tumor prevalence based on sex, age, smoking, BMI, and physical activity level (PAL) in the Spanish people. Data from the Spanish National Health Survey (ENSE) was used, comprising a sample of 17,704 people diagnosed with malignant tumors. The findings revealed compelling associations (P < 0.001) between all variables examined and the prevalence of malignant tumors. Notably, women exhibited a higher prevalence than men (P < 0.05). Furthermore, individuals classified as obese displayed a greater prevalence of tumors than those within the normal weight range (P < 0.05). The analysis also showed that the inactive group had a higher prevalence of malignant tumors than the active group (P < 0.05). This study identified significant dependency relationships (P < 0.001) between PAL and the various population groups examined. Additionally, the general population analyzed in the ENSE2017 study demonstrated a reduced risk of developing malignant tumors among the active (P < 0.05) and very active groups (P < 0.05) compared to the inactive group. This risk reduction was consistently observed across different subgroups, including men, women, specific age groups, smoking, and BMI categories (P < 0.05). This study highlighted the importance of regular physical activity in reducing the risk and prevalence of malignant tumors in the Spanish population. These findings underscore the critical role of engaging in physical activity as a protective measure against cancer. Encouraging individuals to adopt an active lifestyle could significantly contribute to cancer prevention efforts and promote overall well-being.

Prevalence of sexual disorders in relapsing-remitting multiple sclerosis patients depending on various risk factors

Objective. Multiple sclerosis is a perilous, disabling, physically as well as mentally, demyelinating disease of the central nervous system. This work aims to evaluate prevalence of sexual dysfunctions and their correspondence with non- and disease related risk factors, as well as with MRI findings in patients with relapsing-remitting multiple sclerosis. Results. Based on conducted multifactorial analysis, the most prominent risk factor associated with presence of sexual dysfunctions in in patients with relapsing-remitting multiple sclerosis was depression. Sexual dysfunctions are tied to cognitive deficit, in general and in separate domains, particularly in memory, executive functions and language. Considering disease-related agents, sensory and motor deficits are linked to the development of sexual dysfunctions in case of relapsing-remitting multiple sclerosis. Among non-disease-related factors, unemployment, marital status, level of education and tobacco smoking are affecting sexual dysfunctions’ severity. According to the MRI, frontal lobe and corpus callosum and periventricular area were affected more often comparing to other brain regions in case of sexual dysfunctions. Conclusions. Patients suffering from relapsing-remitting multiple sclerosis encounter secondary and tertiary sexual dysfunctions. Knowing all struggles of MS, patients should be offered more nuanced management options that will improve their quality of life on a deeper level.

Differential abundance in upper respiratory microbiome between smoking and non-smoking COVID-19 patients

The COVID-19 pandemic caused by SARS-CoV-2 has resulted in significant respiratory morbidity and mortality. Smoking is a well-established risk factor for adverse respiratory outcomes, and it may exacerbate COVID-19 outcomes by altering the upper respiratory tract (URT) microbiome. However, the association between smoking, the URT microbiome, and COVID-19 severity remains controversial. In this study, we investigated the microbial community in the UTR of smoking and non-smoking COVID-19 patients using 16S ribosomal RNA metagenomic datasets. By characterizing the microbial profiles of the URT of 88 COVID-19 patients with and without a smoking history, we examined the differences in the URT microbiome between smokers and non-smokers and identified bacteria that could serve as smoking signatures. Our study found that Prevotella was the most abundant genus in the URT microbiome of both smoking and non-smoking COVID-19 patients, followed by five other dominant genera. Notably, Fusobacterium was significantly higher in smokers than non-smokers, suggesting that smoking may affect the URT microbial composition. However, the alpha and beta diversity indices showed no significant differences within and across communities, regardless of smoking status or levels of severity. Differential abundance analysis suggested that the impact of smoking on the URT microbiome may lead to an increase in the abundance of Streptobacillus in smoking patients. Overall, this study highlights the potential impact of smoking on the URT microbiome and its relevance to COVID-19 outcomes. Thus, it provides insights into the underlying mechanisms that may lead to worsened COVID-19 outcomes due to smoking-induced alterations in the URT microbiome.

Non-medical Use of Prescription Psychostimulants and Academic Performance in Medical Students

Objective: It is well-known that healthy medical students use psychostimulants to improve their cognitive functions and reduce their need for sleep. The main motivation behind this cognitive enhancement is to increase academic performance. However, the literature is not clear enough to support this situation.&#x0D; Methods: This cross-sectional study was conducted with an online survey and 585 students participated. The grade point average number was used to assess the student' academic performance. Additionally, the scale based on self-evaluations was used to assess levels of pharmaceutical knowledge, study performance, academic success, academic anxiety, and study performance.&#x0D; Results: Out of 585 healthy students, 40 (7.3%) admitted to using psychostimulants to enhance their academic performance. However, there was no significant difference in grade point average scores and perceived academic success levels between users and non-users. Nonetheless, most of the users reported that they benefited from taking psychostimulant drugs. Risk factors for non-medical use of prescription psychostimulants included high levels of pharmacology knowledge, smoking, and poor academic performance.&#x0D; Conclusion: Although non-medical use of prescription psychostimulants did not appear to affect academic performance significantly, most students reported positive subjective experiences, which could have a motivational effect. Therefore, it is crucial to investigate the benefits and side effects of psychostimulants in healthy young individuals in more detail and to provide them with up-to-date information on this issue.