Substance use disorders (SUD) frequently occur alongside bipolar disorder (BD), with some studies indicating a 29 % comorbidity rate in Western populations [1]. The relationship between BD and SUD is intricate and bidirectional - drug misuse can increase the risk of developing BD, and individuals with BD have a higher risk of developing SUD. This complex interplay often leads to earlier BD onset, more hospitalizations, and reduced effectiveness of pharmacological treatments, particularly mood stabilizers. This work aims to describe the impact of drugs in the risk of relapse in BD and to approach the differences in the evolution in substance users compared to non-users.

We conducted a prospective cohort study including the patients admitted to Hospital Clínic of Barcelona acute psychiatric unit with the diagnosis of manic or mixed episode during the period between 2015 and 2019. We established a follow-up of 3 years from the date of admission in which hospital readmissions are examined.

The study, which included 279 patients, concluded that only tobacco users showed significantly higher rates of emergency room (ER) visits and hospital readmissions in the period study, while cannabis was only associated with earlier onset of illness, current manic polarity, the presence of psychotic symptoms and a higher likelihood of discontinuing treatment. Alcohol, cocaine and stimulants did not appear to have an association with the variables studied.

Lack of follow-up information from people leaving the region or changing to private sector services, lack of detailed information around the pattern and history of consumption.

Tobacco seemed to have a clear negative association with the course of the illness. Cannabis, while its use was not associated with the relapse rate, was indirectly associated with variables suggesting a more severe symptomatology and a possible qualitatively different course of illness. More evidence is needed to define the mechanisms and patterns related to these effects.

There is growing evidence that tobacco smoking causes depression, but it is unclear which constituents of tobacco smoke (e.g. nicotine, carbon monoxide) may be responsible. We used Mendelian randomisation (MR) to measure the independent effect of nicotine on depression, by adjusting the effect of circulating nicotine exposure [via nicotine metabolite ratio (NMR)] for the overall effect of smoking heaviness [via cigarettes per day (CPD)] to account for the non-nicotine constituents of tobacco smoke.

Univariable MR and multivariable MR (MVMR) were used to measure the total and independent effects of genetic liability to NMR and CPD on major depressive disorder (MDD). Our primary method was inverse variance weighted (IVW) regression, with other methods as sensitivity analyses.

For the exposures, we used genome-wide association study (GWAS) summary statistics among European ancestry individuals for CPD (n = 143 210) and NMR (n = 5185). For the outcome, a GWAS of MDD stratified by smoking status was conducted using individual-level data from UK Biobank (n = 35 871-194 881).

Genetic variants associated with NMR (n = 6) and CPD (n = 53).

Univariable MR-IVW indicated a causal effect of CPD on MDD [odds ratio (OR) = 1.13, 95% confidence interval (CI) = 1.04-1.23, P = 0.003] but no clear evidence for an effect of NMR on MDD (OR = 0.98, 95% CI = 0.97-1.00, P = 0.134). MVMR indicated a causal effect of CPD on MDD when accounting for NMR (IVW: OR = 1.19, 95% CI = 1.03-1.37, P = 0.017; Egger: OR = 1.13, 95% CI = 0.89-1.43, P = 0.300) and weak evidence of a small effect of NMR on MDD when accounting for CPD (IVW: OR = 0.98, 95% CI = 0.96-1.00, P = 0.057; Egger: OR = 0.98, 95% CI = 0.96-1.00, P = 0.038).

The role of nicotine exposure in risk of depression cannot be entirely dismissed. However, the causal effect of tobacco smoking increasing depression risk appears to be largely independent of circulating nicotine exposure, which implies the role of alternative causal pathways.

The ideal cardiovascular health (CVH) construct has recently been updated to ¨ Life's Essential 8¨(LE8).

to determine LE8's prevalence and its association with sociodemographic and socioeconomic determinants in a Latino women cohort in Santiago de Chile.

Cross-sectional study on 619 women between 35 and 70 years old, representing 1.359.509 women (after expansion factors). LE8 was assessed through a survey on demographic and CV risk factors, as well as anthropometric, blood pressure, and biochemical measurements. The overall LE8 score was estimated for all participants, ranging from 0 to 100 (≥80 points, high CVH and < 50 points, low CVH). Besides, the score for each metric was determined. A descriptive analysis was performed with sample weights for the overall sample, and stratified by age, education, family income level and civil status. A regression analysis was performed adjusted by age group, family income and education level to determine the association of sociodemographic variables with LE8 score.

The mean overall LE8 score was 62.7 points. Only 11.5 % had a high LE8, while 18.2 % had a low score. The best-accomplished metrics were blood glucose and physical activity (PA); the worst were diet and nicotine exposure. The adjusted regression analysis showed significantly higher scores for younger age (+3.2 points for <45yo, p < 0.05) and higher education level (+5 points, p < 0.01 and +12 points, p = 0.000,1 for high school and tertiary education, respectively). Higher LE8 scores in women with high education level were significantly driven by improvements in 5 metrics (lipids, blood pressure, body mass index, diet and PA).

Nearly 1 out of 9 women from Santiago had an ideal LE8 score. Years of education are crucial determinants in the fight to get an ideal CVH.

Measuring sexual violence against children (SVAC) is vital to prevention and advocacy efforts, yet existing prevalence studies present estimates for few countries. Here we estimate the prevalence of SVAC for 204 countries by age and sex, from 1990 to 2023, and also report the age at which young survivors of lifetime sexual violence first experienced sexual violence.

We reviewed publicly available repositories for data on the prevalence of SVAC. To harmonise heterogeneity in the identified input data, we adjusted for alternative case definitions of SVAC and differential disclosure by survey mode. We then used a spatiotemporal Gaussian process regression to estimate a full time series of exposure to SVAC for each age-sex-country combination. We accounted for uncertainty in the underlying data and modelling processes. We also analysed the age at which adolescent and young adult survivors of lifetime sexual violence first experienced this type of violence by sex, data source, and world region.

We estimate that the global age-standardised prevalence of SVAC was 18·9% (95% uncertainty interval [UI] 16·0-25·2) for females and 14·8% (9·5-23·5) for males in 2023. At the super-region level, these estimates ranged from 12·2% (9·0-17·2) in southeast Asia, east Asia, and Oceania to 26·8% (21·9-32·7) in south Asia for females and from 12·3% (5·2-24·6) in central Europe, eastern Europe, and central Asia to 18·6% (9·7-32·3) in sub-Saharan Africa for males. At the country level, age-standardised estimates ranged from 6·9% (4·8-9·6) in Montenegro to 42·6% (34·4-52·1) in Solomon Islands among females and from 4·2% (1·7-9·2) in Mongolia to 28·3% (13·2-49·8) in Côte d'Ivoire among males. Globally, these estimates remained relatively stable since 1990, with slight variations at the country and regional levels. We also find that the first experience of sexual violence among adolescents and young people occurred before the age of 18 years for 67·3% of female and 71·9% of male survivors.

The prevalence of SVAC is extremely high for both females and males across the globe. Given data sparsity and ongoing measurement challenges, findings probably underestimate the true pervasiveness of SVAC. An overwhelmingly high proportion of survivors first experienced sexual violence during childhood, revealing a narrow yet sensitive window that should be targeted in future prevention efforts. It is a moral imperative to protect children from violence and mitigate its compounding impacts on health across the lifecourse.

The Gates Foundation.

Tobacco use is a major risk factor for cardiovascular disease (CVD), and its global disease burden trends require further clarification. This study aims to analyze trends in global CVD burden attributable to tobacco in 1990-2021 and project mortality rates and disease burden through 2045.

Using Global Burden of Disease Study (GBD) 2021 data, we analyzed temporal trends using age-period-cohort models, evaluated change points with Joinpoint regression, and conducted forecasting using Bayesian age-period-cohort (BAPC) models.

In 2021, tobacco-attributable CVD deaths reached 2.147 million globally (71.3% increase from 1990), although age-standardized mortality rates decreased to 25.36 per 100000 (83.3% reduction). Mortality rates were lowest in high SDI regions (326.71 per 100000) and highest in low-middle sociodemographic index (SDI) regions (788.05 per 100000). The proportion of deaths among those aged ≥80 years increased from 19.2% to 26.2%. Global mortality rates decreased by 1.8% annually, with a greater decline in females (-2.6%) than males (-1.6%). Projections suggest that by 2045, global CVD deaths may reach approximately 3.267 million (52.1% potential increase), although age-standardized mortality rates are expected to decrease to around 38.6 per 100000 (15.9% estimated reduction). Disability-adjusted life years (DALYs) are projected to potentially increase to 75.755 million (39.9% estimated increase), while age-standardized DALY rates could decline to approximately 1008.02 per 100000.

Between 1990 and 2021, global tobacco-attributable CVD mortality rates showed a declining trend, with notable regional, sex, and age disparities. Projections indicate that while age-standardized rates will continue to decrease, absolute numbers of deaths and disease burden will increase. The findings emphasize the need to strengthen tobacco control and CVD prevention in low-middle SDI regions.

Tobacco use during pregnancy is of significant concern as it is associated with adverse outcomes in expecting mothers and their fetuses. Smokeless tobacco use is widespread among women in India. However, there is a dearth of studies on smokeless tobacco use and its determinants during pregnancy in India. The study examines the prevalence and predictors of smokeless tobacco use, quit attempts, advice from healthcare providers to quit, and intentions to quit among pregnant women in India.

The study utilizes the Global Adult Tobacco Survey (GATS) 2 (2016-17) India data. GATS 2 was conducted in all 30 states and two union territories. GATS is a nationally representative household survey of individuals aged 15 years or above. A multistage sampling procedure was conducted separately for urban and rural areas.

The sample size for the study was 1403 currently pregnant women at the time of the survey. Bivariate analysis, multivariable regression, Chi-square test, and phi coefficient were utilized.

Smokeless tobacco use was reported by 7.4 % of pregnant women, highest among older age groups, Scheduled Tribes, poorer households, and North-Eastern and EAG states. About 64.4 % visited a healthcare provider, but only 23.7 % were asked about tobacco use, and 20.2 % were advised to quit. Quit attempts were made by 43.6 %, and only 20 % planned to quit within 12 months. Age, caste, education, occupation, and state of residence were statistically significant predictors of tobacco use, but not knowledge of the ill effects of smokeless tobacco use.

Addressing Smokeless tobacco use among pregnant women in India requires a multifaceted approach combining targeted interventions, strengthened healthcare provider support, health education campaigns, and evidence-based policies. Health education and awareness campaigns should disseminate accurate and comprehensive information about the risks of smokeless tobacco use during pregnancy on mother and child.

Population-level smoking (cigarette or tobacco or nicotine use) has reduced in high-income nations, but not proportionally compared to less developed regions. This study aimed to estimate smoking prevalence in Sub-Saharan Africa (SSA).

Databases searched included PubMed, EMBASE, PsycINFO, African Journal Online, the Global Health Data Exchange and Google Scholar. The search terms included 'cigarette', 'smoking', 'tobacco', 'nicotine', 'prevalence' and 'Sub-Saharan Africa'. Prevalence data on smoking was extracted separately for adolescents (10-17) and adults (18+). Prevalence of lifetime, past 12- and 6-month smoking was included. Weighted pooled prevalence was calculated using MetaXL, while meta-regression analysis was conducted with Stata version 17. For the estimation of pooled prevalence, we employed a DerSimonian-Laird estimation method. The risk of bias tool was utilised to assess the quality of the studies.

We included 195 papers. Overall, between 2018 and 2023, the weighted lifetime smoking prevalence was 8.8% (95% confidence interval [CI] 5.1, 13.4%), with a past-year prevalence of 10.8% (CI 4.0%, 19.9%), and daily smoking was 3.5% (CI 0.0%, 9.5%) in SSA. Among adolescents, the lifetime prevalence was 4.5% (CI 2.0%, 8.0%), with a past-year prevalence of 4.1% (CI 0.0%, 13.4%) and daily smoking was 4.7% (CI 1.0%, 10.6%). Among adults, the lifetime prevalence of smoking was 12.7% (CI 6.6%, 20.4%), 12.1% (CI 2.6%, 26.2%) in the past year and daily smoking was 3.3% (CI 0.0%, 9.8%).

These findings highlight the importance of maintaining consistent monitoring and ensuring timely follow-up in implementing smoking prevention measures and regulations in SSA countries.

Cigarette use, a leading cause of preventable disease and millions of deaths worldwide each year, is not often studied separately from other tobacco use, and global data and previous studies on cigarette smoking are based mostly on its prevalence rather than quantity. To address these oversights, we analyze the first wave of data from Global Flourishing Study, a study of over 200,000 adults nationally representative of 22 countries. We measured cigarette smoking by daily consumption per capita (mean) and per individual who smoked (intensity) as well as prevalence. The mean of daily smoking was positively correlated with the prevalence, whereas the intensity was not significantly related to the prevalence. Similarly, we found that random effects meta-analysis results of country-specific means of daily smoking in each category of demographic variables (age, gender, marital status, employment, religious service attendance, education, and immigration status) were more consistent with the results of prevalence than was the case with intensity, though there was variation across countries. Overall findings indicate the importance of studying the intensity as well as prevalence of smoking, as they are distinct and thus both required in order to assess tobacco-associated health risks and establish informed tobacco control policies.

Smoking is a major risk factor for esophageal squamous cell carcinoma (ESCC) and is linked to increased postoperative morbidity. However, its impact on long-term survival remains unclear. This study evaluated the influence of preoperative smoking status on postoperative complications and survival following esophagectomy for ESCC in a high-volume center.

Patients who underwent surgery for ESCC between 1996 and 2019 were retrospectively categorized as smokers (S-group) or non-smokers (NS-group). A subgroup analysis was performed to compare active and former smokers. Primary outcomes included major postoperative complications (Clavien-Dindo ≥ III), pulmonary complications, and postoperative mortality at 30 and 90 days. Long-term outcomes included overall survival (OS) and recurrence-free survival (RFS).

Among 694 patients, 97 (14%) were in the NS-group and 597 (86%) in the S-group. Smokers had significantly higher major morbidity rates (37% vs 23%, P = .002), including major pulmonary complications (29% vs 21%, P = .03). Active smoking was associated with increased 30-day mortality (P = .006) and higher rates of acute respiratory distress syndrome (P = .012) compared to former smokers. OS and RFS did not differ significantly between groups. The absence of post-operative smoking data limits long-term outcome interpretation.

Smoking was associated with increased perioperative morbidity, particularly pulmonary complications, but its effect on long-term survival remains uncertain. Structured smoking cessation programs should be integrated into perioperative care. Future studies should incorporate postoperative smoking status to better assess its impact on survival.

Parkinson's disease (PD) has become a public health concern with global ageing. With a focus on PD, this study sought to project its burden and trends at the national, regional and worldwide levels between 1990 and 2021.

Population-based study.

The Global Burden of Disease (GBD) 2021 provided the PD burden data. The GBD data are considered globally and regionally representative, as it integrates multiple data sources and employs standardised estimation methods. The age-standardised rate (ASR) and estimated annual percentage change (EAPC) were used to estimate trends in the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of PD from 1990 to 2021. ASR was used to calculate the EAPCs using a linear regression model. A Bayesian age-period-cohort model was used to predict future trends up to 2046.

Globally, the overall ASR of PD incidence, prevalence, DALYs and mortality increased from 1990 to 2021. The EAPCs were 1.09 (95% CI: 1.07 to 1.11) for incidence, 1.52 (95% CI: 1.49 to 1.54) for prevalence, 0.32 (95% CI: 0.28 to 0.36) for DALYs and 0.18 (95% CI: 0.13 to 0.23) for mortality. The incidence, prevalence, mortality and DALYs of PD in 2021 were higher in men than in women. The age-standardized incidence rate (ASIR) was 18.52 per 100 000 in men and 12.92 per 100 000 in women (EAPC: 1.11, 95% CI: 1.09 to 1.13 vs 1.07, 95% CI: 1.05 to 1.09). The age-standardized prevalence rate (ASPR) was 157.42 per 100 000 in men and 121.84 per 100 000 in women (EAPC: 1.70, 95% CI: 1.67 to 1.73 vs 1.25, 95% CI: 1.22 to 1.27). The ASMR was 6.57 per 100 000 in men and 3.59 per 100 000 in women (EAPC: 0.21, 95% CI: 0.14 to 0.28 vs -0.01, 95% CI: -0.04 to 0.03). The ASDR was 97.12 per 100 000 in men and 81.23 per 100 000 in women (EAPC: 0.37, 95% CI: 0.33 to 0.42 vs 0.14, 95% CI: 0.10 to 0.18). From 1990 to 2021, the burden of PD remained consistently higher in men than in women, with the gender difference widening with age. The prevalence, incidence, DALYs and mortality rates of PD increased with age before declining, peaking in the 80-84 age group for prevalence and incidence, while peaking in the 90-94 age group for mortality. DALY rates peaked in the 85-89 age group. The ASR of incidence and prevalence increased significantly in Norway (EAPC=3.39, 95% CI: 3.15 to 3.64; EAPC=5.04, 95% CI: 4.65 to 5.43). Lesotho was the nation with the highest rise in age-standardised DALYs for PD (EAPC=1.67, 95% CI: 1.41 to 1.93). The United Arab Emirates had the fastest increase in age-standardised mortality for PD (EAPC=1.98, 95% CI: 1.24 to 2.71). The global ASPR of PD is projected to show a continuous upward trend.

From 1990 to 2021, there were rising trends in the prevalence and burden of PD in most areas and nations worldwide. Our research indicates that the management and control of PD need significant improvement, particularly in light of the ageing population.

To determine the association of HP infection with COPD, assessing its prevalence and influence on symptoms, lung function, quality of life, exacerbations, hospitalizations, mortality, and healthcare costs.

We performed a systematic review and meta-analysis after conducting a systematic literature search in PubMed, Embase, Cochrane Library, Virtual Health Library, ScienceDirect, Scopus, Researchgate, and GoogleScholar, from database inception to 31/12/2022. We used the Der Simonian-Laird method to calculate pooled HP prevalence, the Mantel-Haenszel model to determine the association of HP with COPD, and the inverse variance method to compare the pulmonary function tests between infected and uninfected patients, always with a fixed-effect model.

Twenty-eight studies included a total of 8647 patients with COPD. The pooled prevalence of HP infection was 29.8% (95%CI 29.0-30.7%). The more severe stage of COPD lesser the prevalence of HP (p < 0.001). HP infection was associated with COPD, estimated odds ratio 1.90 (95%CI 1.71, 2.12), p < 0.001. The mean differences for p%FEV1, p%FVC and FEV1/FVC ratio between HP infected and uninfected patients with COPD were -13.06 (95%CI -14.54, -11.58), -3.72 (95%CI -5.64, -1.79) and -0.01 (95%CI -0.02, -0.00) respectively.

Our meta-analysis suggests an appreciable relationship between HP infection and COPD. Further longitudinal studies considerating confounders and investigating causality are required.

Lung cancer is the most common cancer worldwide, yet the current epidemiological profile of lung-cancer incidence by histological subtype is only partly understood. We aimed to assess geographical variation in incidence of lung cancer by subtype worldwide in 2022, geographical variation in adenocarcinoma incidence attributable to ambient particulate matter (PM) pollution worldwide in 2022, temporal trends in lung-cancer incidence by subtype from 1988 to 2017 in 19 countries, and generational changes.

For this population-based study, we used data from the Global Cancer Observatory (GLOBOCAN) 2022, Cancer Incidence in Five Continents Volumes VII-XII, and members of the African Cancer Registry Network. To obtain national estimates of lung cancer in 2022 for the four main histological subtypes (ie, adenocarcinoma, squamous cell carcinoma [SCC], small-cell carcinoma, and large-cell carcinoma) by year, sex, and age group, we combined national estimates with representative, subsite-specific incidence proportions of lung cancer on the basis of recorded incidence data compiled in Cancer Incidence in Five Continents Volume XII and from members of the African Cancer Registry Network. We calculated country-specific, sex-specific, and age-specific proportions of and sex-specific and age-specific incidence rates per 100 000 people for all four histological subtypes. To account for differences in age composition between populations by country, we calculated age-standardised incidence rates (ASRs) per 100 000 people for lung cancer by subtype and sex at national and regional levels. We also quantified the burden of adenocarcinoma incidence attributable to ambient PM pollution for 179 countries in 2022. We conducted joinpoint regression and age-period-cohort analysis to assess temporal trends in ASRs in 19 countries by sex.

In 2022, we estimated that there were 1 572 045 new cases of lung cancer worldwide among male individuals, of which 717 211 (45·6%) were adenocarcinoma, 461 171 (29·4%) were SCC, 180 063 (11·5%) were small-cell carcinoma, and 101 861 (6·5%) were large-cell carcinoma. In 2022, we estimated that there were 908 630 new cases of lung cancer worldwide among female individuals, of which 541 971 (59·7%) were adenocarcinoma, 155 598 (17·1%) were SCC, 87 902 (9·7%) were small-cell carcinoma, and 59 271 (6·5%) were large-cell carcinoma. Among male individuals, the highest ASRs were in east Asia for adenocarcinoma (27·12 [95% CI 27·04-27·21] per 100 000 people), east Europe for SCC (21·70 [21·51-21·89] per 100 000 people) and small-cell carcinoma (9·85 [9·72-9·98] per 100 000 people), and north Africa for large-cell carcinoma (4·33 [4·20-4·45] per 100 000 people). Among female individuals, the highest ASRs were in east Asia for adenocarcinoma (19·04 [18·97-19·11] per 100 000 people), north America for SCC (5·28 [5·21-5·35] per 100 000 people) and small-cell carcinoma (4·28 [4·21-4·35] per 100 000 people), and north Europe for large-cell carcinoma (2·87 [2·78-2·96] per 100 000 people). We estimated that 114 486 adenocarcinoma cases among male individuals and 80 378 adenocarcinoma cases among female individuals were attributable to ambient PM pollution worldwide in 2022, with ASRs of 2·35 (95% CI 2·33-2·36) per 100 000 male individuals and 1·46 (1·45-1·47) per 100 000 female individuals. Temporal trends in lung-cancer incidence by subtype and sex during 1988-2017 varied considerably across the 19 countries.

Estimated geographical and temporal distribution of lung-cancer incidence varied across the four main subtypes worldwide. Our study highlights the need for future studies that identify possible causal factors that contribute to the changing risk patterns of lung cancer.

Natural Science Foundation of China Young Scientist Fund, Medical Scientific Research Foundation of Guangdong Province in China, and Young Innovative Talents Project of General Universities in Guangdong Province in China.

Antimicrobial resistance (AMR) and smoking of tobacco products are two of the most important threats to global human health. Both are associated with millions of deaths every year. Surprisingly, the immediate interactions between these two threats remain poorly understood.

We aimed to elucidate the effect of toxic compounds from cigarette smoke, ashes, and filters on the spread of antibiotic resistance genes in human lung and environmental microbiomes.

Conjugation experiments using donor and recipient strain pairs of either Pseudomonas putida or Escherichia coli and AMR-encoding plasmids were conducted under exposure to different concentrations of cigarette smoke condensate in lung sputum medium, as well as cigarette ash and filter leachate in environmental media. We further measured reactive oxygen species (ROS) production of the donor strain under exposure to the cigarette-derived compounds to explore whether stress experienced by the bacteria could be one of the underlying mechanisms of change in plasmid transfer frequencies. Furthermore, used cigarette filters were submerged in a wastewater stream for several weeks, and the colonizing communities were analyzed using high-throughput sequencing and high-throughput quantitative polymerase chain reaction and compared with communities colonizing unused control filters.

Exposure to cigarette smoke condensate at relevant concentrations resulted in > 2 -fold higher transfer rates of a multidrug-resistance-encoding plasmid in artificial lung sputum medium. This was associated with higher ROS production as part of the bacterial stress response when exposed to cigarette-derived toxicants. Similar results were obtained for cigarette ash leachate in an environmental medium. Further, used cigarette filters were colonized by different microbial communities compared with unused filters. Those communities were significantly enriched with potential human pathogens and AMR.

The results of this study suggest that cigarette-derived compounds can indeed promote the spread of AMR within simulated human lung and environmental conditions. This study highlights that the consumption of cigarettes has not only direct but may also have indirect adverse effects on human health by promoting AMR. https://doi.org/10.1289/EHP14704.

Globally, the prevalence of prehypertension and hypertension among adults in low- and middle-income countries is on the rise. However, the data on young people remains scarce. In this context, we analyzed data from two national-level cross-sectional surveys-NFHS-4, which included 272,966 individuals, and NFHS-5, which included 250,213 individuals-to assess changes in the prevalence of prehypertension and hypertension among young Indians aged 15-24 years. Between 2015-2016 and 2019-2021, the prevalence of prehypertension increased significantly (p <  0.001), rising from 38.9% to 44.5% among men and from 21.1% to 26.9% among women. While hypertension prevalence among men increased from 5.2% to 6.2%, it remained stable at approximately 4.0% among women over the same period. Most states, with a few exceptions, exhibited an increase in prehypertension prevalence across both genders, and more than two-thirds of states also showed an increase in hypertension prevalence among men. High BMI was found to be strongly associated with both prehypertension and hypertension. The rising prevalence of prehypertension and hypertension among young Indians aged 15-24 years is concerning and underscores the urgent need to develop targeted preventive strategies for this age group.

The identification of COVID-19 first occurred in January 2020. The rapid transmission of this virus across human populations has led to the emergence of a global pandemic known as COVID-19. Dementia, anxiety and depression are neurological disorders that impact several higher cognitive functions, such as memory, cognition, orientation, understanding, computation, learning ability, language and decision-making.

This study aims to examine the impact of demographic factors on the occurrence of dementia, anxiety and depression in individuals who have recovered from a COVID-19 infection.

This study aims to investigate individuals who are at risk of developing dementia, anxiety and depression following exposure to COVID-19. Ethics Committee approval was obtained from hospital (Ethics Committee-Unique Hospital, Surat, India) and University Research Ethics Committee approval was obtained from Dehradun Institute of Technology University, Dehradun, India (DITU/UREC/2022/04/6). Patients willingly participated in the study and signed the ICF as per their preferred language. Patient data was obtained from the hospital with the assistance of medical staff. The study included patients who met the specific criteria for participation, as determined by the inclusion and exclusion criteria. Patients who satisfy the eligibility conditions were obligated to complete the questionnaire. The data was examined based on the subject's responses.

Exposure to COVID-19 has been linked to a heightened susceptibility to developing mental health issues, such as anxiety, depression and even dementia. Studies have demonstrated that persons who have acquired COVID-19 are more prone to developing various psychiatric disorders in comparison to those who have not been infected. Individuals with dementia encountered a decline in cognitive function and a rise in neuropsychiatric symptoms, including restlessness, confusion, irritability and lack of motivation, amidst the epidemic. Research has indicated that persons experiencing mild cognitive impairment or dementia exhibited elevated levels of despair and anxiety amongst the epidemic.

In this research study on the gender-specific effects of COVID-19 exposure on high-risk persons, development of dementia, anxiety and depression offers important new insights into the complex ways that the pandemic has affected mental health in different genders.

To evaluate the changing trend and cross-country inequality of bladder cancer (BC) burden over the past 30 years and further predict the trend until 2036. Based on the Global Burden of Disease (GBD) 2021 study, the global incidence, mortality, and disability-adjusted life years (DALYs) of bladder cancer from 1990 to 2021 were obtained. We described the distribution of BC at global, regional and national levels and overall/local trends. The age-period-cohort analysis, decomposition analysis and inequality analysis related to socio-demographic index (SDI) were conducted. Additionally, we predicted the future trend of BC burden using Bayesian age-period-cohort model. In the GBD 2021, the global incidence number of BC was 540,310, doubling compared to that in 1990. However, the age-standardized rate (ASR) drops from 6.90 to 6.35. The changes in bladder cancer mortality and DALYs are similar. The ratio of ASRs of burden between males and females is approximately 4:1. Interestingly, in regions with middle SDI, low-middle SDI, and low SDI, the ASR of incidence has shown an upward trend to varying degrees in recent 10 years. Central Europe has the highest ASR of DALYs. China bore the heaviest burden of bladder cancer and experienced the greatest increase in the burden of bladder cancer. Globally, population growth, aging, and epidemiological changes accounted for 89.83%, 83.91%, and - 73.74% of the changes in DALYs respectively. The absolute inequality related to the SDI increases significantly. The slope index of inequality for DALYs increases from 79.84 to 115.60, and the concentration index slightly decreases to 0.26 in 2021. The prediction showed that the ASRs of the three indicators of bladder cancer would continue to decline from 2022 to 2036. Despite a downward trend in ASRs from 1990 to 2021, the global bladder cancer burden has generally increased with regional and country variations. The burden growth pattern driven by population growth and aging may potentially increase the burden number in the future. Burden is concentrated in high-SDI countries and there are signs indicating a shift towards lower-SDI countries. These findings highlighted challenges in BC prevention and management.

As tobacco smoking decreases, the use of e-cigarettes is on the rise. There is a debate whether switching from smoking to the use of e-cigarettes might represent a harm reduction strategy for those who smoke tobacco heavily, a habit often observed in individuals with opioid dependence. The present study investigated the prevalence and patterns of tobacco smoking and e-cigarette use in patients in opioid maintenance treatment (OMT) and whether e-cigarette use contributed to the cessation of smoking tobacco.

In 2014 (n=84) and in 2021 (n=128), patients from two OMT clinics of a psychiatric university hospital were interviewed RESULTS: In both surveys, patients presented with a comparable average age (45.6 vs. 46.9 years of age), gender distribution (mainly male 71.4 vs. 75.8%), and length of OMT history (median: 66 vs. 55 months). The lifetime prevalence of e-cigarette use (45.2% in 2014 and 38.3% in 2021) was much higher than the current prevalence (4.9% and 7.8%, respectively). Few patients reported either a complete switch from smoking to the use of e-cigarettes (2014, n=1 vs. 2021, n=2) or the achievement of abstinence from smoking after a temporary use of e-cigarettes (2014, n=2 vs. 2021, n=1).

No increase in the use of e-cigarettes was observed in these groups of patients undergoing OMT. Presumably, harm reduction strategies relating to the use of e-cigarettes in this group need to be supported by motivational interventions. Given the high morbidity and mortality due to smoking, OMT clinics should offer professional help in reducing smoking.

Three beaches on the Eastern Black Sea coast of Türkiye, with different usage purposes and urbanization, were evaluated regarding marine litter densities and categories in four seasons. 3573 marine litter items were collected, classified, and recorded. In an area of 3,000 m2, the highest amount of litter was counted in summer with a total of 1473 pieces of litter (Average: 0.491 ± 0.131 items/m2), and the lowest was counted in the spring months with 577 pieces of litter (Average: 0.192 ± 0.026 items/m2). Plastics (79 ± 0.9%) were the most predominant, and litter items mainly consisted of metal (7.2 ± 0.5%) and paper/cardboard (5.6 ± 0.6%.). Beach litter was also associated with fishing activities and tourism. It was observed that litter relatively increased during the fishing season in the region where fishing activities were intense. SIMPER analysis revealed that Çamburnu, located near a fishing port, exhibited a significantly different litter composition, with fishing gear being the most dominant category.

Socioeconomic status and religion are associated with health indicators. This study compared the correlations between religious observance, socioeconomic status, and select health indicators among adults in neighboring cities in Israel based on data collected from the Maccabi Health Services database. One city is characterized by religious observance, while the other is primarily secular. Lower smoking rates and higher rates of low cholesterol, triglycerides and LDL levels were observed in the religious city. No significant differences were found for low HDL rates or diabetes. Unique characteristics of populations must be considered when planning health interventions.

Neuroimaging studies revealed that smoking is associated with abnormal white matter (WM) microstructure. However, results are controversial, and the impact of smoking on the WM integrity in young smokers is still unclear. In this study, we used diffusion tensor imaging to investigate the smoking-related WM alterations in young adult smokers. One hundred and twenty-six subjects (60 current smokers and 66 nonsmokers) aged 18-29 years participated in the study. The tract-based spatial statistics with multiple diffusion indices was applied to explore diffusivity patterns associated with smoking. Correlation analysis was performed to evaluate relationships between fractional anisotropy (FA) and smoking-related variables in young adult smokers. Compared with nonsmokers, young adult smokers showed higher FA dominantly in the anterior cerebral WM regions, while lower FA mainly in the posterior cerebral WM areas. The dominant diffusivity pattern for regions with larger FA was characterized by lower radial and axial diffusion (Dr and Da), while in areas with smaller FA, higher Dr without significant difference in Da was the main diffusivity pattern. Moreover, diffusion indices in the genu and body of the corpus callosum were related with smoking-related variables. Our findings indicate that smoking may have differential effects on the WM integrity in the anterior and posterior parts of the brain, and may also accelerate brain aging in young adult smokers.

The benefit of treatment with tyrosine kinase inhibitors targeting the epidermal growth factor receptor (EGFR-TKI) for lung adenocarcinoma (ADC), stratified by ethnicity, has not yet been fully elucidated.

We searched PubMed, Embase, and Cochrane databases for studies that investigated EGFR-TKI for lung ADC. We computed hazard ratios (HRs) or risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). We used DerSimonian and Laird random-effect models for all endpoints. Heterogeneity was assessed using I2 statistics. R, version 4.2.3, was used for statistical analyses.

A total of 18 studies, comprising 4,497 patients with lung ADC randomized to TKIs or chemotherapy alone. TKIs significantly improved OS (HR 0.91; 95% CI 0.88-0.95), PFS (HR 0.60; 95% CI 0.38-0.97), and ORR (HR 0.34; 95% CI 0.25-0.48) in Asian patients, compared with the chemotherapy alone. In Caucasian patients, TKIs significantly improved PFS compared with chemotherapy alone (HR 0.34; 95% CI 0.25-0.48) and ORR(RR 2.35; 95% CI: 1.05-5.28). TKIs significantly reduced any adverse events of any grade in patients with mixed ethnicity (RR 0.86; 95% CI 0.76-0.98) and any adverse events of grade ≥ 3 in Caucasian patients (RR 0.67; 95% CI 0.51-0.89).

This is the first meta-analysis to reveal the ethnic influence on the outcomes of oncologic treatments for patients with lung ADC. In collaboration with in-depth molecular characterization, these data will allow the creation of a clinical-pathological predictive model to increase the magnitude of the expected benefit for patients from different ethnic groups.

Amid shifting tobacco policies and escalating air pollution levels, Lung Cancer (LC) risk factors have changed notably. Continuous assessment of these risk factors is necessary. This study compares trends in tobacco, air pollution, and asbestos-associated Age-Standardized Mortality Rates (ASMR) from Trachea, Bronchus, and Lung (TBL) Cancer across the top ten most populated countries (2023 censuses) and globally.

We extracted overall and risk-factor-associated TBL cancer ASMR of the ten most populated countries for 1990-2019 from the Global Burden of Disease (GBD) database using the dedicated results tool (http://ghdx.healthdata.org/gbd-results-tool). GBD mapped the mortality data related to ICD codes (C33-C34, D02.1-D02.2, D38.1, 162-162.9, 231.1, 231.2, 231.8, 235.7 from ICD10 and B101 from ICD9). Tobacco, occupational exposure to asbestos and air pollution (ambient particulate matter and household air pollution) associated TBL cancer mortality data were extracted to evaluate the trends based on risk factors. We calculated relative changes in ASMRs between 1990 and 2019 for each sex in each country for each risk factor. Joinpoint regression analysis was performed to calculate the Estimated Annual Percentage Change (EAPC) and its corresponding 95% confidence interval (CI) for each line segment, allowing for trend assessment.

Globally, TBL Cancer mortality has decreased by 8%, with a decrease for males but an increase for females. Globally, both tobacco and air pollution-associated TBL cancer ASMR have decreased. While tobacco-associated ASMR has increased in China and Indonesia, air pollution-associated ASMR has also increased in China, India, Pakistan, and Nigeria. On stratification, while PM-associated mortality increased by 25% globally, household-associated TBL cancer ASMR decreased by 62%. China had the highest PM-associated TBL Cancer in 2019 (8.8/100,000), twice higher than the global average. Despite a decline in asbestos-associated TBL cancer ASMR from 8.91/100,000 to 6.0/100,000, the rate in the United States remained twice higher than the global average for the entire study period.

Tobacco-associated TBL cancer mortality is declining but still predominant. Ambient particulate matter-associated TBL cancer mortality is rising, requiring policy and awareness efforts. Expanding access to preventive services and addressing underlying risk factors are essential steps required toward reducing lung cancer mortality at the global level.

This study did not receive any funding support.

Lung cancer is a commonly diagnosed cancer and the leading cause of cancer-related mortality worldwide. Cancer delay pose significant challenges for health systems globally, with patient delay being a primary factor contributing to late diagnoses, ultimately resulting in adverse outcomes and reduced survival rates. However, the underlying reasons for patient delay are not well understood, and there is a scarcity of studies that specifically examine the experiences related to patient delay among lung cancer patients. Therefore, this study aims to explore the experiences of lung cancer patients and identify potential strategies to mitigate their delays in seeking care.

The interview framework was developed based on the Theory of Planned Behavior. Face-to-face semi-structured interviews were conducted with participants. Data analysis was performed using Colaizzi's phenomenological analysis method.

A total of 30 lung cancer patients participated in the interviews, which lasted between 26 and 42 min (with an average duration of 33 min). The duration of patient delay varied from 90 to 213 days. Four themes were identified: (1) reasons for patient delay, (2) health-seeking triggers, (3) perception of patient delay, and (4) potential solutions.

Lung cancer patients exhibited varying degrees of patient delay attributed to factors such as ignoring or dismissing symptoms, lack of family support, poor access to health services, and the COVID-19 pandemic. Promoting disease knowledge, optimizing resources and implementing technology-based solutions may serve as effective measures to address these issues.

In Saudi Arabia, colorectal cancer (CRC) is the most common cancer in men and the third in women, posing a significant health burden. A comprehensive report of CRC incidence rates and trends in Saudi Arabia is lacking. This study aims to examine trends in CRC incidence among the Saudi population.

We used data from the Saudi Cancer Registry to examine CRC age-specific incidence rates (ASIR) and age-standardized incidence rates (ASR) between 1997 and 2017. Joinpoint regression analysis was used to determine the magnitude and direction of observed trends stratified by age, sex, and CRC stage at diagnosis. Trends were measured using the annual percentage change (APC) and the average annual percentage change (AAPC) in CRC incidence rates.

In total, 19,463 new CRC cases were identified during the study period. Since 1997, ASR for CRC has steadily increased in men and women overall, irrespective of disease stages. The ASIR increased across all age groups and was more pronounced in older patients. Women aged 40-49 had a higher increase in incidence than men (AAPC= 5.3 % vs.4.7 %). Males aged 70-79 had an AAPC of 10.2 %, twice that of females (AAPC= 4.9 %). A consistent rise in ASIR was observed across all CRC stages and age groups in males and females. In recent years, males under 50 had a higher APC for distant CRC than females, while females aged 50-74 experienced a steeper increase in distant CRC than males.

We report a marked increase in the incidence of CRC over time in Saudi Arabia, affecting men and women across all age groups and disease stages at diagnosis. Our findings underscore the need to identify underlying risk factors and to develop and implement effective prevention policies and strategies, including screening programs to facilitate early detection and treatment.

To estimate the prevalence of lifetime e-cigarette use and explore the association between lifetime conventional and electronic cigarette use with suicidality among Chinese adolescents, focusing on sex and school-type differences.

A total of 22,509 students from 432 classes in 80 schools were recruited in Guangdong Province using a multistage, stratified cluster, random sampling method in 2021. Self-report questionnaires were used to collect information. Multivariable logistic regression models were performed and stratification analysis was conducted. All analyses were weighted and adjusted for the complex survey design.

The weighted prevalence of lifetime e-cigarette use among adolescents in Guangdong Province was 8.7 % (4.3 % were dual users and 4.4 % were e-cigarette-only users) and 2.6 % were conventional-cigarette-only users. Lifetime e-cigarette-only users (AOR [Adjusted OR] =1.46, 95 % CI = 1.21-1.76), conventional-cigarette-only users (AOR = 1.97, 95 % CI = 1.58-2.46) and dual users (AOR = 1.67, 95 % CI = 1.38-2.02) were at a higher risk of suicidal ideation than non-users. Lifetime e-cigarette-only users (AOR = 2.03, 95 % CI = 1.53-2.70), conventional-cigarette-only users (AOR = 1.97, 95 % CI = 1.42-2.73), and dual users (AOR = 2.76, 95 % CI = 2.10-3.61) had a significantly higher risk of suicide attempts than non-users. After further analysis stratified by sex and school type, the associations of lifetime cigarette use patterns with suicidality slightly varied.

The cross-sectional study design and self-report information.

The prevalence of e-cigarettes among Chinese adolescents is concerning. Lifetime conventional and e-cigarette use were associated with suicidality among Chinese adolescents, with sex and school type moderating these associations. Targeted measures to restrict cigarette use, including new tobacco product (e-cigarette) use, among adolescents are warranted.

The Neck Disability Index (NDI), a common Patient-Reported Outcome Measure (PROM) for neck pain, lacks sufficient study on its psychometric properties in preoperative patients with cervical spondylotic myelopathy (CSM).

This study aims to address these gaps by conducting an exploratory factor analysis of the Japanese NDI. The objectives are 2-fold: (1) to scrutinize the psychometric properties and internal consistency of the Japanese NDI, and (2) to explore the specific regions of pain and numbness influencing the NDI.

A single-center observational study.

A total of 100 preoperative patients with CSM.

The NDI and Numerical Rating Scale (NRS) were employed to assess preoperative neck disability and pain and numbness in various body regions.

Demographic and clinical characteristics were collected, encompassing age, sex, body mass index, American Society of Anesthesiologists classification, smoking status, comorbidities, pain and numbness at various sites using the NRS, and NDI. For evaluating the psychometric properties and internal consistency of the NDI, exploratory factor analysis (EFA) and Cronbach's α coefficient were utilized. Furthermore, the impact of pain and numbness on NDI factors was examined through multivariable regression analysis.

EFA identified 2 factors-Physical and Mental-highlighting the dual nature of neck-related disability. Physical factors (std.β=0.724, p<.001) exerted a stronger impact on NDI scores compared to Mental factors (std.β=0.409, p<.001). Cronbach's α coefficient was 0.831 for physical factors and 0.723 for mental factors, indicating a high level of internal consistency. Numbness in the hand (std.β=0.338, p<.001) and pain in the neck (std.β=0.202, p=.035) were significant variables influencing Physical factor, while numbness in the hand (std.β=0.485, p<.001) and pain in the head (std.β=0.374, p<.001) impacted mental factor.

This study contributes valuable insights into the psychometric properties of the NDI in preoperative patients with CSM. The identified factors emphasize the importance of addressing both physical and sensory symptoms in preoperative care.

The coronavirus disease 19 (COVID-19) pandemic has affected healthcare services, potentially leading to inequitable outcomes based on patients' socioeconomic status (SES). This study aimed to evaluate the impact of COVID-19 on out-of-hospital cardiac arrest (OHCA) outcomes by examining disparities across SES levels.

The study analyzed non-traumatic OHCA cases registered in the Korean Out-of-Hospital Cardiac Arrest Registry from 2010 to 2021, encompassing 238,668 patients aged 18 years and older. SES was assessed at both the individual (Medicaid vs non-Medicaid) and area levels using a deprivation index. Outcomes included any return of spontaneous circulation, survival to admission, survival to discharge, and favorable neurological recovery. Logistic regression and generalized additive models (GAMs) were used for analysis.

OHCA outcomes-including survival to admission, survival to discharge, and favorable neurological recovery-improved over the years, peaking in 2019 before subsequently declining. Logistic regression showed that the lowest SES area was associated with lower rates of ROSC (adjusted odds rations [aOR] 0.82, 95 % confidence interval [CI] 0.75-0.88) and survival to admission (aOR 0.56, 95%CI 0.49-0.64) and discharge (aOR 0.78, 95%CI 0.61-0.98) during the pandemic. GAM analysis revealed that lower SES groups (deprivation index levels 4 and 5) experienced higher-than-expected survival to admission and discharge rates, as well as favorable neurological recovery. Although outcomes in the deprivation index level 1 group (5.5 % in 2021) remained superior, indicating poor outcomes for the lowest SES area group (3.43 % in 2021), the disparity decreased following the pandemic.

Lower levels of SES are a significant risk factor for unfavorable neurological recovery in OHCA, independent of the COVID-19 pandemic. However, SES-related disparities in the outcomes decreased post-pandemic. Despite the overall negative impact of COVID-19, certain lower SES groups showed improved survival rates, likely due to differences in the EMS response and healthcare burden across regions.

Cigarette smoking causes serious complications and diseases in a person's life, such as Chronic Obstructive Pulmonary Disease (COPD) and some cancers, including lung cancer. On the other hand, studies have shown that smokers do not have a real understanding of the health hazards of smoking. This study was conducted to determine the perceived risk of lung cancer and COPD in current smokers. This cross-sectional study which was conducted between January-May 2023, recruited 380 current smokers by convenience sampling in community setting. The data were collected face to face using three questionnaires (1) the risk perception for lung cancer and COPD questionnaire, (2) the smoking stage of change questionnaire, and (3) the Fagerström test for nicotine dependence. We examined the relationship between the included variables and the smokers' perceived risk of lung cancer and COPD by using multiple linear regression. We found that lower education (coefficient = 3.60, 95%CI [1.00, 6.19], P < 0.0001) for elementary level and (coefficient = 2.81, 95% CI [0.36, 5.26], P < 0.05) for secondary level had greater lung cancer perceived risk. Besides, smoking age onset for 20 + years (coefficient=-1.36, 95%CI [-2.42, -3.17], P < 0.0001) lower than those who started before the age of 20 were associated with lower perceived risk for lung cancer. Regarding COPD, results indicated that lower education (coefficient = 4.54, 95% CI [1.87, 7.21], p < 0001) for elementary level (coefficient = 3.35, 95% CI [0.83, 5.87], p < 0.001) for secondary level and (coefficient = 3.03, 95% CI[-0.67, 4.25], P < 0.05) for high school dropout, and employment status (coefficient = 3.62, 95% CI[0.66, 6.59], p < 0.05) of employer and (coefficient = 3.23, 95% CI [0.14, 6.33], p < 0.05) for homemaker reported greater perceived risk. This study's results showed that participants' perceived risk was relatively low. It seems necessary to carry out interventions to inform about the harms of smoking and to enhance public awareness about the heightened risks of diseases such as lung cancer and COPD among cigarette smokers.

Although a substantial body of research has analyzed the effectiveness of cigarette package warning labels in tobacco control, the very general health warnings messages (HWMs) on cigarette packaging in China have shown limited effectiveness in deterring youth from smoking. Therefore, this study investigates the impact of specific and more detailed warning text messages on Chinese young people's risk perception of smoking and their intention to quit.

We employed a randomized survey experiment to examine the impact of specific text-based warning labels on Chinese young people's risk perception of smoking and intention to quit. The total effective sample size was 1064 participants. The subjects were divided into three groups: the first group served as the control group, which was shown the existing cigarette package warning labels; the second group was shown cigarette package warning labels related to cardiovascular, digestive, and respiratory diseases; and the third group was shown cigarette package warning labels related to sexual dysfunction.

The respiratory disease-related warnings significantly increased young people's awareness of smoking-related respiratory risks (p<0.01). The impact of warning labels for the three common diseases on enhancing young people's overall risk perception of smoking (p<0.05) and their intention to quit exhibited only weak statistical significance (p<0.05). In contrast, warning labels related to sexual dysfunction significantly increased young people's risk perception of smoking (p<0.001) and their intention to quit (p<0.001), with a much higher level of statistical significance compared to those related to the other three common diseases.

Detailed descriptions of the risks associated with all four diseases were positively correlated with awareness of smoking-related harm and the intention to quit. However, warnings related to sexual dysfunction had a greater level of statistical significance compared to those related to the other three common diseases. This stronger significance may be attributed to young people's heightened concern about sexual dysfunction.

To explore the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with risk of congenital heart disease (CHD) in offspring.

The parents of children with simple CHD aged 0 to 1 year (n=683) were recruited as the case group, while the parents of healthy children aged 0 to 1 year (n=740) served as the control group. A case-control study was conducted, and a questionnaire was used to collect information on perinatal exposures. After controlling for relevant confounding factors using multivariate logistic regression analysis and propensity score matching, the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with CHD were examined, as well as the cumulative effects of smoking and drinking on CHD risk.

Maternal active smoking (OR=2.91, 95%CI: 1.60-5.30), passive smoking (OR=1.94, 95%CI: 1.56-2.42), and alcohol consumption (OR=2.59, 95%CI: 1.89-3.54), as well as paternal smoking (OR=1.52; 95%CI: 1.22-1.90) and drinking (OR=1.48, 95%CI: 1.19-1.84), were associated with an increased risk of CHD in offspring. There was no interaction between parental smoking and drinking behaviors during the periconceptional period concerning the risk of CHD in offspring (P>0.05). The more parents' smoking and drinking behaviors during the perinatal pregnancy, the higher the risk of CHD in their offspring (OR=1.50, 95%CI: 1.36-1.65).

Parental smoking and alcohol consumption during the periconceptional period are associated with the occurrence of CHD in offspring, and there is a cumulative effect on CHD risk, suggesting that reducing tobacco and alcohol exposure during the periconceptional period may lower the incidence of CHD.

Lung cancer is one of the most common types of malignant cancer worldwide, causing a serious social and economic burden. It is classified into non-small cell lung cancer (NSCLC) and small cell lung cancer, with NSCLC accounting for 80-85% of cases. Eukaryotic translation initiation factor 4 gamma 1 (EIF4G1) is highly expressed in NSCLC, playing an important role in regulating tumor growth, angiogenesis, malignant transformation, and phagocytosis. Ubiquitin-specific protease 10 (USP10) functions as a deubiquitinating enzyme to regulate substrate protein deubiquitination and reverse the ubiquitin proteasome degradation pathway. Our previous study identified an interaction between EIF4G1 and USP10; however, their regulatory mechanism remains unclear. Herein, we found that USP10 positively regulates EIF4G1 in NSCLC cells. An in vivo ubiquitination assay demonstrated deubiquitination of EIF4G1 by USP10, which reversed the ubiquitin proteasomal degradation of EIF4G1, thereby increasing its stability. Upregulation of EIF4G1 promoted cell proliferation, migration, and invasion in NSCLC cells. The current study not only reveals a novel mechanism through which USP10 positively regulates EIF4G1 in NSCLC, but also demonstrates the potential of USP10 as a therapeutic target to treat NSCLC.

Delay in diagnosis and treatment of lung cancer is thought to be a major cause of its poor outcomes. We evaluated the delays within the presentation to the initiation of diagnostic and therapeutic interventions amongst lung cancer patients in Southern Iran.

This cross-sectional study was conducted from March 2019 to March 2021. The data collected through interview included socio-demographic, medical and clinical findings, and the time intervals needed to visit physician, refer to specialist, request diagnostic procedures, reach diagnosis of lung cancer, and hospitalization.

Eighty-nine patients (58 males and 31 females) with a mean age of 61.01 ± 12.25 years were included. The median time of symptom presentation and first physician visit interval was 25 days. Sixty-five days were spent for requesting, performing, and evaluating the diagnostic procedures. The median interval between diagnosis and initiation of treatment was 16 days. Totally, it took an average of 122 days from the presentation to the definite diagnosis of lung cancer. Patient-, diagnosis-, and treatment-related delays were not significantly correlated with any of the demographic, socioeconomic, and clinical (disease stage, symptom) variables, as well as the diagnosis tool and the first physician who visited the patient (p > 0.05).

There was a significant delay but relatively similar to other countries in the diagnosis and treatment of lung cancer patients in Southern Iran. The largest portion of delay could be attributed to the raising clinical suspicion in the physicians, referral for diagnostic assessments, and the diagnosis process.

Earlier studies suggested a potential association between tobacco smoking and nickel sensitization, but little is known about other contact allergens.

To investigate the association of smoking status and contact sensitizations as well as subtypes of dermatitis, and to analyse the sensitization profiles of tobacco smokers.

Within the Information Network of Departments of Dermatology (IVDK), we performed a cross-sectional multicentre pilot study comprising 1091 patch-tested patients from 9 departments, comparing 541 patients with a history of cigarette smoking (281 current and 260 former smokers) with 550 never-smokers.

We could not confirm the previously reported association between nickel sensitization and tobacco smoking. Moreover, sensitizations to other allergens, including colophony, fragrance mix I, Myroxylon pereirae and formaldehyde, were not increased in cigarette smokers compared with never smokers. Hand dermatitis (50.6% vs. 33.6%) and occupational cause (36.2% vs. 22.5%) were significantly more frequent among cigarette smokers compared with never-smokers as shown by non-overlapping 95% confidence intervals.

Although our study does not allow a firm conclusion on whether smoking status contributes to certain contact sensitizations, it confirms an association of smoking with hand dermatitis and occupational cause.

Objectives. Self-assessment of health is one of the most important factors determining manifestations in care for health, expressed in health-promoting behaviours. The way a person takes care of their health affects not only their health but also their well-being, quality of life and work ability. This study aimed to present results regarding self-assessment of health and care for health and the relationship with work ability in a group of working men aged 20-65 years. Methods. The sample of 600 men were assessed using a survey. The work ability index was used to measure work ability. An original survey was developed, which included questions about self-assessment of health and taking care of health, motives for taking care of health, physical activity, healthy eating and smoking. Results. Most men rated their health well and declared that they took care of it. Low health scores were obtained among overweight men, men without physical activity, men with unhealthy nutrition and smokers. High self-rated health was associated with good work ability. Conclusions. There is a constant need to make men of all ages aware of the role of individual health care in maintaining good health and high work ability.

Cardiovascular disease (CVD) is the leading cause of death in the United States, and rates of CVD incidence vary widely by race and ethnicity. Cigarette smoking is associated with increased risk of CVD. The purpose of the study was: 1) to examine smoking prevalence over time across Asian and Pacific Islander (API) and multi-race API subgroups; 2) to determine whether the CVD risk associated with smoking differed among these subgroups.

We identified patients belonging to 7 single race/ethnicity groups, 4 multi-race/ethnicity groups, and a non-Hispanic White (NHW) comparison group at two large health systems in Hawaii and California. We estimated annual smoking prevalence from 2011 through 2018 by group and gender. We examined incidence of CVD events by smoking status and race/ethnicity, and computed hazard ratios for CVD events by age, gender, race/ethnicity, census block median household income, census block college degree, and study site using Cox regression.

Of the 12 groups studied, the Asian Indian and Chinese American groups had the lowest smoking prevalence, and the Asian + Pacific Islander multiracial group had the highest smoking prevalence. The prevalence of smoking decreased from 2011 to 2018 for all groups. Multi-race/ethnicity groups had higher risk of CVD than the NHW group. There was no significant interaction between race/ethnicity and smoking in models predicting CVD, but the association between race/ethnicity and CVD incidence was attenuated after adjusting for smoking status.

There is considerable heterogeneity in smoking prevalence and the risk of CVD among API subgroups.

This cross-sectional study used data from Brazil's National Student Health Survey (PeNSE), from 2015 and 2019, to compare consumption of tobacco products among adolescent students in Brazil and identify associated factors. The study variables were current cigarette smoking, use of other tobacco products and use of any tobacco product. Pearson's Chi-square test was used to ascertain associations between the variables; bivariate and multivariate analyses were performed using logistic regression. Cigarette smoking remained stable between 2015 (6.6%) and 2019 (6.8%), but use of any tobacco product increased (from 10.6% in 2015 to 14.8% in 2019), involving particularly hookahs (7.8%) and e-cigarettes (2.8%). Cigarette smoking was greater among adolescents aged 16 and 17, whose skin colour was black or brown, who missed classes without permission, who reported having no friends, displayed other risk factors, such as drinking alcoholic beverages, or who were passive smokers. The prevalence of smoking has increased over the years and is associated with sociodemographic aspects and other health risk behaviour, highlighting the need for lifelong health promotion actions.

Despite significant changes in healthcare, work practices, and leisure activity, the proposed precipitating factors for abdominal wall hernias have remained largely unchanged for almost two centuries. We aimed to investigate if there have been shifts in these factors over time by examining patients' perception of precipitating factors for abdominal wall hernia development. This study was conducted in the Royal College of Surgeons In Ireland Department of Surgery, Connolly Hospital, Blanchardstown, Dublin, where patients with abdominal wall hernias completed a questionnaire  .

A total of 277 patients (mean age 55.7; 85.6% male) with abdominal wall hernia completed the questionnaire (66.1% inguinal; 10.8% umbilical; 6.9% paraumbilical; 10.5% epigastric; 3.2% incisional; 1.4% femoral, and 1.1% port-site). One hundred and twenty patients (43.3%) believed their hernia was due to lifting, 71 (25.6%) cited gym activity and 17 (6.1%) cited other sporting activities as the precipitating factor. Traditional factors - chronic cough and constipation - were cumulatively cited only by 11 patients (4.0%), while prostatic obstruction was not cited by any.

This study suggests that fitness pursuits may be an increasing contributor to the development of abdominal wall hernia. Greater attention should be paid to the proper use of gym equipment to minimise the risk of hernia development.

Socioeconomic mortality inequalities are persistent in Europe but have been changing over time. Smoking is a known contributor to inequality levels, but knowledge about its impact on time trends in inequalities is sparse.

We studied trends in educational inequalities in smoking-attributable mortality (SAM) and assessed their impact on general mortality inequality trends in England and Wales (E&W), Finland, and Italy (Turin) from 1972 to 2017. We used yearly individually linked all-cause and lung cancer mortality data by educational level and sex for individuals aged 30 and older. SAM was indirectly estimated using the Preston-Glei-Wilmoth method. We calculated the slope index of inequality (SII) and performed segmented regression on SIIs for all-cause, smoking and non-SAM to identify phases in inequality trends. The impact of SAM on all-cause mortality inequality trends was estimated by comparing changes in SII for all-cause with non-SAM.

Inequalities in SAM generally declined among males and increased among females, except in Italy. Among males in E&W and Finland, SAM contributed 93% and 76% to declining absolute all-cause mortality inequalities, but this contribution varied over time. Among males in Italy, SAM drove the 1976-1992 increase in all-cause mortality inequalities. Among females in Finland, increasing inequalities in SAM hampered larger declines in mortality inequalities.

Our findings demonstrate that differing education-specific SAM trends by country and sex result in different inequality trends, and consequent contributions of SAM on educational mortality inequalities. The following decades of the smoking epidemic could increase educational mortality inequalities among Finnish and Italian women.

Cardiovascular diseases (CVDs) are the leading cause of mortality globally while also contributing to excess health system costs. Significant advancements have been made in the understanding and prevention of deaths from CVD. In addition to risk factor modifications, one of the key developments in this area is the appropriate prescribing of antiplatelet medications for secondary prevention of CVD. With the advent of vascular devices, there has been an increased use of potent antiplatelet agents to mitigate thrombosis risk. A well-recognized, albeit rare complication of antiplatelet drugs is the heightened risk of bleeding. This adverse effect is particularly relevant when a patient receiving these medications may require an urgent surgery. In addition, for elective surgeries, although these drugs can be withheld, there may be some situations when interruption of antiplatelet agents, even for short duration, may lead to thrombotic events. There are no robust guidelines on how to manage these clinical scenarios, although there have been some important studies published recently in this area. In this review, we provide our approach to patients on antiplatelet drugs who may require urgent surgeries or surgical interventions.