Assessing the association between e-cigarette use and cardiovascular disease: A meta-analysis of exclusive and dual use with combustible cigarettes.

BACKGROUND: Growing evidence highlights the impact of e-cigarette use on cardiovascular health, prompting a crucial examination of its association with cardiovascular disease (CVD) in both exclusive e-cigarette and dual use scenarios with combustible cigarettes. This meta-analysis assessed the association between e-cigarette use and CVD by synthesizing the existing literature. METHODS: Pertinent observational studies were identified using multiple electronic databases, from August 22nd, 2006, to April 10th, 2024. A meta-analysis was conducted using random-effect models. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. FINDINGS: A total of 20 observational studies involving 8,499,444 participants were included in the meta-analysis. Dual use (e-cigarettes and combustible cigarette) increased the odds of CVD by 2.56 times (95 % CI: 2.11, 3.11) compared to never use of both. Current e-cigarette use combined with former combustible cigarette increased the odds of CVD by 2.02 times (95 % CI: 1.58, 2.58) compared to never use of either. Exclusive current e-cigarette use did not show a statistically significant association with CVD odds compared to never use of either (OR = 1.24, 95 % CI: 0.93, 1.67). CONCLUSIONS: Dual use of e-cigarettes and combustible cigarettes was significantly associated with CVD, but results failed to show a significant association between exclusive e-cigarette use and CVD. Robust and longitudinal studies are needed to understand the long-term implications of e-cigarette use and CVD. Public health efforts should focus on awareness, smoking cessation, and regulating both e-cigarettes and combustible cigarettes.

The association between exercise and prescription opioid misuse: A scoping review.

Exercise prevents chronic diseases and modulates pain. People experiencing pain often use opioids for relief, increasing the risk of prescription opioid misuse. Nonetheless, exercise may influence prescription opioid misuse through the release of endorphins or induced injury-related pain. We aimed to summarize the existing literature on the association between exercise and prescription opioid misuse. We identified studies published through December 2021 in Cochrane, Embase, Medline, and Pubmed, using search terms like "opioid-related disorders," "opioid misuse," "exercise," and "sports." Observational and experimental studies with adult samples published in English were included. Exclusion criteria included participants < 18 years old, studies including heroin use as the outcome, and studies conducted among pregnant or institutionalized individuals. The risk of bias and quality assessment were conducted independently by two authors using the National Institutes of Health Study Quality Assessment Tools, and decisions were cross-checked with a third author. Our search yielded 10,796 records, of which eight studies were included. These studies were heterogeneous clinically and methodologically. Three were intervention trials, three were cross-sectional, and two were cohort studies. Three studies evaluated yoga, two evaluated exercise, and three evaluated sports. Significant findings showed lower prescription opioid misuse among people who exercise, except for one study that showed greater odds of prescription opioid misuse among college athletes. We conclude that the findings on the association between exercise and prescription opioid misuse vary, even within similar study types and samples. Future researchers should consider large samples, standardized questions, and common outcome measures in research on exercise and prescription opioid misuse. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Concerns on healthcare access, utilization, and safety due to COVID-19 among American adults with vision loss.

BACKGROUND: Limited studies have indicated that Americans with vision loss are differentially impacted by COVID-19. OBJECTIVE: We examined concerns with healthcare and safety among Americans with vision loss during the early phase of the pandemic (April 2020). METHODS: The Flatten Inaccessibility Survey assessed the impact of COVID-19 on healthcare (pharmacy access, maintenance of eyecare regimen, caregiver access, and resource denial) and safety (social distancing, clean surfaces, and touching public signage) concerns among Americans with low vision or who were blind. Multivariable logistic regression was used to determine associations between respondent characteristics and each concern. RESULTS: A total of 1921 adults responded to the survey, of whom 65% were blind and 35% had low vision. Most respondents were female (63%) and white (74%). Respondents with additional disabilities/comorbidities were more likely to report healthcare access concerns (pharmacy access, eyecare regimen, caregiver access, and ventilator access) and safety concerns (social distance, clean surfaces, and touching signage) than those with vision loss alone. In addition, females, those identifying as "other" gender, older individuals, and people with adult onset of vision impairment were more likely to experience COVID-19-related concerns and challenges related to healthcare and overall safety. CONCLUSION: These results suggest that while Americans with vision loss have been differentially impacted by COVID-19, adults with vision loss and additional disabilities/comorbidities are more likely to have concerns with healthcare and safety than those with vision loss alone.

Hospitalised versus outpatient COVID-19 patients' background characteristics and comorbidities: A systematic review and meta-analysis.

This study aimed to systematically assess COVID-19 patient background characteristics and pre-existing comorbidities associated with hospitalisation status. The meta-analysis included cross-sectional, cohort, and case-series studies with information on hospitalisation versus outpatient status for COVID-19 patients, with background characteristics and pre-existing comorbidities. A total of 1,002,006 patients from 40 studies were identified. Significantly higher odds of hospitalisation were observed in Black individuals (OR = 1.33, 95% CI: 1.04-1.70), males (OR = 1.59, 95% CI: 1.43-1.76), and persons with current/past smoking (OR = 1.59, 95% CI: 1.34-1.88). Additionally, individuals with pre-existing comorbidities were more likely to be hospitalised [asthma (OR = 1.22, 95% CI: 1.02-1.45), COPD (OR = 3.68, 95% CI: 2.97-4.55), congestive heart failure (OR = 6.80, 95% CI: 4.97-9.31), coronary heart disease (OR = 4.40, 95% CI: 3.15-6.16), diabetes (OR = 3.90, 95% CI: 3.29-4.63), hypertension (OR = 3.89, 95% CI: 3.34-4.54), obesity (OR = 1.98, 95% CI: 1.59-2.46) and renal chronic disease (OR = 5.84, 95% CI: 4.51-7.56)]. High heterogeneity and low publication bias among all factors were found. Age was not included due to the large variability in the estimates reported. In this systematic review/meta-analysis for patients with COVID-19, Black patients, males, persons who smoke, and those with pre-existing comorbidities were more likely to be hospitalised than their counterparts. Findings provide evidence of populations with higher odds of hospitalisation for COVID-19.

Avulsión de la tuberosidad posterior del calcáneo en pico de pato. Reporte de un caso / Avulsion of the posterior calcaneal tuberosity (Beak fracture): A Case report

Las fracturas del calcáneo representan el 2-3,1% de las fracturas en general y las avulsiones del tendón de Aquiles son las menos frecuentes de este grupo. Fueron descritas por Bohler como "fracturas en pico de pato". Los casos publicados son muy escasos, Sang-Myung y cols. publicaron la revisión más grande con 764 casos de fracturas de calcáneo, 20 de ellos con avulsión de la tuberosidad del calcáneo. Los mecanismos de acción más frecuentes son tropiezo, caída o golpe directo. Se presenta a un paciente de 48 años que concurre al Servicio de Urgencias de un hospital de segundo nivel, tras caerse de un árbol y quedar suspendido sobre la pierna derecha. Ingresó para estudio con evidencia radiográfica de fractura por avulsión del calcáneo y fue sometido a una osteosíntesis, con una excelente evolución clínica. Consideramos importante comunicar este caso, dada la escasa frecuencia de este tipo de fracturas. Nivel de Evidencia: IV

Calcaneal fractures account for 2-3.1% of all fractures; among these the least common are avulsions of the Achilles tendon, described by Dr Bohler as "Beak fractures". Descriptions in the literature are very scarce, the largest report being that of Sang-Myung et al in 2012, where a summary of 764 cases of calcaneal fractures contained 20 avulsion fractures. The most common mechanisms of trauma are tripping, falling, or a direct knock. This report presents the clinical case of a 48 year-old patient, who attended the Emergency Service of a second-level hospital after falling from a tree which resulted in being suspended by the lower right limb. Radiographs revealed signs of a calcaneal avulsion fracture, which was surgically managed via osteosynthesis with excellent clinical outcomes in follow-up. Given the infrequency of this type of fracture, we considered it important to present this article. Level of Evidence; IV

Sleep Disturbances, Obesity, and Cognitive Function in Childhood: A Mediation Analysis.

BACKGROUND: Childhood cognitive development is influenced by biological and environmental factors. One such factor, obesity, impairs cognitive development and is associated with sleep disturbances. OBJECTIVES: We aimed to examine the mediating role of sleep disturbances on the relation between BMI and cognitive function in children. METHODS: A total of 9951 children aged 9-10 y were included in this cross-sectional study. Children were recruited from the longitudinal ABCD (Adolescent Brain Cognitive Development) Study. Cognitive development was assessed using metrics for fluid, crystallized, and total cognitive function. Mediation analyses were conducted via linear regression modeling, with adjustment for potential confounders (sex, age, ethnicity, household income, parental education, and self-reported physical activity) for each of the 3 outcomes. Mediation significance was determined by bootstrapping. RESULTS: A statistically significant inverse association was found between BMI and total (ß = -0.41, P < 0.001) and fluid (ß = -0.49, P < 0.001) cognition, but not for crystallized cognition. Total sleep disturbances partially mediated the association between BMI and fluid cognition (indirect effect: -0.02, P = 0.002; proportion of the total effect: 0.05, P = 0.002), but no mediation was found in the association between BMI and total cognition. CONCLUSIONS: Sleep disturbances partially mediate the effect of childhood obesity on cognitive function, particularly in fluid cognitions. Future work is necessary to understand the effects of sleep disturbances and obesity on reduced childhood cognition throughout time, predominantly across the life course.

Knowledge, Attitudes, and Behaviors Related to Hepatitis C Screening and Treatment among Health Care Providers in Washington, DC.

Elimination of chronic hepatitis C (HCV) will require scaling up treatment, including possible HCV treatment by primary care providers. The District of Columbia (DC) has a substantial population living with untreated hepatitis C, and treatment expansion would benefit the resident population. The aim of this study was to assess the knowledge, attitudes, and behaviors of primary care providers and specialists related to hepatitis C screening and treatment. We conducted a prospective, online survey of physicians and nurse practitioners (n = 153) in DC on their knowledge, attitudes, and behaviors related to hepatitis C screening and treatment, as well as referral patterns, interest in learning, and preferred learning modalities. We compared responses by provider type. Key findings indicated that HCV screening and treatment knowledge was higher among specialty physicians as compared to primary care providers. The most common reported facilitators of HCV screening included a prompt in the electronic medical record (63%), patient education (57%), and support staff (41%). While 71% reported that HCV treatment was important in the community they serve, only 26% indicated that access to HCV specialist expertise and consultation was a major area of need. Additionally, 59% reported that they refer all HCV patients to specialists for treatment. Primary care providers in DC had moderate interest in learning how to treat chronic hepatitis C, but they need additional training. Patients are typically referred to gastroenterology, infectious diseases, and hepatology specialists who may have limited capacity to expand treatment.

"Such Behaviors Are Not in My Home Village, I Got Them Here": A Qualitative Study of the Influence of Contextual Factors on Alcohol and HIV Risk Behaviors in a Fishing Community on Lake Victoria, Uganda.

In Uganda, elevated HIV prevalence in fishing communities along Lake Victoria have been attributed in part to heavy alcohol use, but qualitative research is needed to understand the contextual factors influencing alcohol and sexual risk. Eight focus group discussions were conducted (n = 50; 23 male, 27 female) in Gerenge, Uganda with five occupational groups: fishermen, fishmongers, alcohol-sellers, commercial sex workers, and restaurant owners. Data was analyzed using content analysis. Alcohol use was prevalent and said to influence risky sex. Sex-related alcohol expectancies and occupational factors influenced individuals to drink during sex and structural factors related to the built environment, economy, and policy were identified as key contributors to both alcohol use and sexual risk in general. The findings highlight alcohol reduction as an important component of HIV/AIDS prevention and suggest structural interventions should be prioritized in this context.

Purification and applications of a lectin from the mushroom Gymnopilus spectabilis.

A lectin was isolated from fruiting bodies of the mushroom Gymnopilus spectabilis (GSL) by ionic exchange chromatography. The lectin agglutinates mouse red cells exhibiting broad specificity towards several monosaccharides including the N-acetylneuraminic acid. Agglutination was also inhibited by the glycoproteins: fetuin, lactoferrin, and recombinant erythropoietin. GSL is a glycoprotein possessing 16 % of carbohydrates; the SDS-PAGE showed two bands with molecular mass of 52.1 and 64.4 kDa. Isoelectric focusing displayed microheterogeneity, with two bands at pIs 5.1 and 5.3. The lectin was stable between pH 2 and pH 8 while at pH 10, the agglutination decayed to 50 % of initial activity. Incubation at 40 and 80 °C led to 50 and 100 % loss in activity of the lectin, respectively. Synthesized GSL-Sepharose interacts with serum pregnant mare gonadotropin, and at least two subpopulations of this glycoprotein were separated. There was no interaction between transferrin and soluble GSL while a partial recognition was achieved with GSL-Sepharose. The terminal sialic acid seems to play an active role in modifying the interaction with GSL, depending if the lectin is in a soluble or immobilized form. The purified lectin inhibited in vitro the growth of Staphylococcus aureus and Aspergillus niger.

Screening for lectins from basidiomycetes and isolation of Punctularia atropurpurascens lectin.

Aqueous extracts of basidiomycete fungi were screened for the presence of lectins by hemagglutination (HA) assays with mouse, rabbit, and sheep red blood cells. From mycelia and/or fruiting bodies, 23 extracts were prepared; 15 extracts exhibited HA activity towards mouse erythrocytes, with specific activities ranging from 12 to 440 lectin units (LU) mg(-1) protein. In HA inhibition assays, 43 carbohydrates including mono-, di-, tri-, tetrasaccharides, glycoproteins, and polysaccharides were tested as haptens, to determine the saccharide-binding specificities of the lectins. A novel lectin with specificity towards N-acetyl-glucosamine was purified from mycelia of Punctularia atropurpurascens using affinity chromatography on chitosan-Sepharose. The lectin has a subunit molecular mass of 67 kDa determined by SDS-PAGE and a pI of 5.0.

Azospirillum brasilense Sp7 produces an outer-membrane lectin that specifically binds to surface-exposed extracellular polysaccharide produced by the bacterium.

Azospirillum sp promotes the growth of many important crop plants. We demonstrated lectin binding activity in outer-membrane protein extracts of A. brasilense Sp7 by hemagglutination assays. The lectin specifically recognised the exopolysaccharide (EPS) produced by aggregated cells. Affinity chromatography using EPS-Sepharose was used to identify a 67 kDa outer-membrane lectin (OML) that recognised a binding region in the extracellular polysaccharide. Results show the specific recognition and binding between EPS and OML. The potential relationship between cell-to-cell aggregation and the OML-EPS interaction is discussed.