Ectopic and visceral fat deposition in aging, obesity, and idiopathic pulmonary fibrosis: an interconnected role.

Idiopathic pulmonary fibrosis (IPF) is considered an age-related disease. Age-related changes, along with other factors such as obesity, hormonal imbalances, and various metabolic disorders, lead to ectopic fat deposition (EFD). This accumulation of fat outside of its normal storage sites is associated with detrimental effects such as lipotoxicity, oxidative stress, inflammation, and insulin resistance. This narrative review provides an overview of the connection between ectopic and visceral fat deposition in aging, obesity, and IPF. It also elucidates the mechanism by which ectopic fat deposition in the airways and lungs, pericardium, skeletal muscles, and pancreas contributes to lung injury and fibrosis in patients with IPF, directly or indirectly. Moreover, the review discusses the impact of EFD on the severity of the disease, quality of life, presence of comorbidities, and overall prognosis in IPF patients. The review provides detailed information on recent research regarding representative lipid-lowering drugs, hypoglycemic drugs, and lipid-targeting drugs in animal experiments and clinical studies. This may offer new therapeutic directions for patients with IPF.

Cotton swabs decorated with Ag@BPQD for the fluorescence determination of 3-aminosalicylic and 5-aminosalicylic acid.

Novel and portable cotton swab-based fluorometry was constructed for the first time for 3-aminosalicylic acid (3-ASA) and 5-aminosalicylic acid (5-ASA) detection. It was carried out by fluorescence enhancement on silver (Ag)-doped black phosphorus quantum dots (Ag@BPQD). Ag@BPQD were prepared from AgNO3 and bulk black phosphorus in N, N-dimethylformamide (DMF) solution by solvothermal decomposition after mechanical exfoliation. Ag@BPQD show blue fluorescence with a quantum yield (QY) of 2.43%. In the presence of Ag@BPQD, 3-ASA exhibited bright blue fluorescence (λex = 328 nm, λem = 448 nm). The fluorescence of 5-ASA was also enhanced significantly and exhibited bright green emission (λex = 328 nm, λem = 484 nm). The linear range of 3-ASA is 0-90 µM with a detection limit (LOD) of 0.10 µM, relative standard deviation (RSD) ≤ 2.04%, and a recovery range of 98.0-104.3%. The linear range of 5-ASA is 0-120 µM with a LOD of 0.12 µM, RSD ≤ 1.34%, and a recovery range of 98.0-101.3%. When 3-ASA and 5-ASA were mixed in different ratios, the fluorescence showed different colors. The possible mechanism of the interaction between 3-ASA (or 5-ASA) and Ag@BPQD may be ascribed to the generation of excited-state intramolecular proton transfer. To realize convenient detection of 3-ASA and 5-ASA, a Ag@BPQD portable sensing method using cotton swabs were built. The proposed approach provides the detection of 3-ASA and 5-ASA in environmental and biological samples with high efficiency, accuracy and portability.

Preeclampsia and syncytiotrophoblast membrane extracellular vesicles (STB-EVs).

Preeclampsia (PE) is a hypertensive complication of pregnancy that affects 2-8% of women worldwide and is one of the leading causes of maternal deaths and premature birth. PE can occur early in pregnancy (<34 weeks gestation) or late in pregnancy (>34 weeks gestation). Whilst the placenta is clearly implicated in early onset PE (EOPE), late onset PE (LOPE) is less clear with some believing the disease is entirely maternal whilst others believe that there is an interplay between maternal systems and the placenta. In both types of PE, the syncytiotrophoblast (STB), the layer of the placenta in direct contact with maternal blood, is stressed. In EOPE, the STB is oxidatively stressed in early pregnancy (leading to PE later in gestation- the two-stage model) whilst in LOPE the STB is stressed because of villous overcrowding and senescence later in pregnancy. It is this stress that perturbs maternal systems leading to the clinical manifestations of PE. Whilst some of the molecular species driving this stress have been identified, none completely explain the multisystem nature of PE. Syncytiotrophoblast membrane vesicles (STB-EVs) are a potential contributor to this multisystem disorder. STB-EVs are released into the maternal circulation in increasing amounts with advancing gestational age, and this release is further exacerbated with stress. There are good in vitro evidence that STB-EVs are taken up by macrophages and liver cells with additional evidence supporting endothelial cell uptake. STB-EV targeting remains in the early stages of discovery. In this review, we highlight the role of STB-EVs in PE. In relation to current research, we discuss different protocols for ex vivo isolation of STB-EVs, as well as specific issues involving tissue preparation, isolation (some of which may be unique to STB-EVs), and methods for their analysis. We suggest potential solutions for these challenges.

Real-world unassisted quit success and related contextual factors: a population-based study of Chinese male smokers.

OBJECTIVES: To examine the association of exposure to secondhand smoke (SHS) and tobacco advertising with unassisted smoking cessation among Chinese male smokers. METHODS: A questionnaire was administered to 6500 male adult smokers from six cities in China selected in a cross-sectional multistage sampling design. The survey collected self-reported demographic characteristics, smoking and cessation status, SHS exposure and tobacco advertising exposure, with 5782 valid questionnaires included in this study. Multiple logistic regression analysis was used to assess the association of unassisted smoking cessation with exposure to SHS and tobacco advertising. RESULTS: 42.1% of smokers who made unassisted quit attempts achieved abstinence (95% CI 32.5% to 51.7%). SHS (adjusted OR (aOR) 0.36; 95% CI 0.18 to 0.71; p=0.033) and tobacco advertising exposure (aOR 0.63; 95% CI 0.37 to 0.95; p=0.039) were negatively associated with unassisted smoking cessation. CONCLUSION: The vast majority of Chinese male smokers rely on unassisted methods to quit smoking. Success prevalence is high, which is very beneficial to health. This study suggests that exposure to secondhand smoking and tobacco advertising hinders the success of unassisted cessation. These findings speak to the need for environmental tobacco control measures to promote unassisted smoking cessation among Chinese adult male smokers.

Generalized Hardy's Paradox.

Here, we present the most general framework for n-particle Hardy's paradoxes, which include Hardy's original one and Cereceda's extension as special cases. Remarkably, for any n≥3, we demonstrate that there always exist generalized paradoxes (with the success probability as high as 1/2^{n-1}) that are stronger than the previous ones in showing the conflict of quantum mechanics with local realism. An experimental proposal to observe the stronger paradox is also presented for the case of three qubits. Furthermore, from these paradoxes we can construct the most general Hardy's inequalities, which enable us to detect Bell's nonlocality for more quantum states.

Individual and regional association between socioeconomic status and uncertainty stress, and life stress: a representative nationwide study of China.

BACKGROUND: Many studies have examined the association between socioeconomic status (SES) and mental stress. Uncertainty stress is a prominent aspect of mental stress. Yet no research has ever empirically analyzed the impact of SES on uncertainty stress. METHODS: Students were identified through a multistage survey sampling process including 50 universities. Each student participant completed the Global Health Professions Student Survey (GHPSS) on Tobacco Control in China. Regional variables were retrieved from the National Bureau of Statistics database. Both unadjusted and adjusted methods were considered in the analyses. RESULTS: Among the 11,942 participants, severe uncertainty stress prevalence was 19.6%, while severe life stress prevalence was 8.6%. Multilevel logistic regression showed that most SES variables were associated with uncertainty stress. Students with "operation and commercial work" as mother's occupation and "rural or township" as family location exhibited a higher prevalence of severe uncertainty stress. Lower family income and original region gross domestic products (GDP) were also associated with higher severe uncertainty stress prevalence. However, only father's occupation was correlated with life stress. CONCLUSIONS: Based on the literature review, this is the first empirical study examining the impact of SES on uncertainty stress in China and elsewhere in the world. Our research underscores the importance of decreasing socioeconomic inequalities in controlling excessive uncertainty stress.

Contextual influences affecting patterns of overweight and obesity among university students: a 50 universities population-based study in China.

BACKGROUND: Many studies have examined childhood and adolescent obesity, but few have examined young adults and the effect of their home and current living environments on prevalence rates. The present study explores contextual factors affecting overweight and obesity among university students in China and, in particular, focuses on how the SES-obesity relationship varies across different geographical contexts. METHODS: Participants were 11,673 students, who were identified through a multistage survey sampling process conducted in 50 universities. Individual data was obtained through a self-administered questionnaire, and contextual variables were retrieved from a national database. Multilevel logistic regression models were used to examine urban and regional variations in overweight and obesity. RESULTS: Overall the prevalence of overweight and obesity in the study sample was 9.5% (95% CI 7.7, 11.3%). After controlling for individual factors, both attributes of the home location (regional GDP per capita and rurality) and the current university location (city population) were found to be important, thus suggesting that the different origins of students affect current levels of obesity. At the individual level, while students with more financial resources were more likely to be obese, the extent of this relationship was highly dependent upon area income and city size. CONCLUSION: The results of this study add important insights about the role of contextual factors affecting overweight and obesity among young adults and indicate a need to take into account both past as well as present environmental influences when considering the role of contextual factors in models of the nutrition transition.

Regional contextual determinants of internet addiction among college students: a representative nationwide study of China.

Background: Many studies have reported factors associated with internet addiction (IA) but little attention has been paid to contextual influences. The present study examined the association between regional contextual determinants of IA among college students in China. Methods: Participants comprised 6929 college students, who were identified through a multistage survey sampling process conducted in 28 university/colleges in China. Individual data was obtained through a self-administered questionnaire, and regional variables were retrieved from a national database. Multilevel logistic regression models were used to examine individual and regional influences on IA. Results: The overall IA prevalence was 13.6%. The final multiple level logistic models showed that higher frequent air pollution and PM2.5 level had 4.34 and 1.56 times the likelihood of suffering from IA, respectively; but higher regional per capita area of paved roads had lower likelihood of IA, ORs were from 0.66 to 0.39. Conclusions: The results of this study add important insights about the role of contextual regional factors, especially air pollution, affecting IA among college students in China, and demonstrates the need to account for environmental influences in addressing IA.

Violent injuries and regional correlates among women in China: results from 21 cities study in China.

BACKGROUND: Ecological models depict violent injuries against women being influenced by both individual and environmental characteristics. However, only few studies examined the association between regional variables and the likelihood of violent injuries. Our study is a preliminary assessment of the impact of regional variables on the likelihood that a woman has experienced violent injuries. METHODS: Participants were 16 866 urban residents, who were identified through a multi-stage sampling process conducted in 21 Chinese cities. Out of the sampled population, 8071 respondents were female. Subsequent analyses focused solely on the female sample. Multilevel logistic regression analyses were performed to examine regional variation in violent injuries. RESULTS: Prevalence of violent injuries against women is 10.7% (95% CI: 7.8%, 15.5%). After controlling for individual-level characteristics, higher regional male-female ratio (OR: 1.97, P < 0.05), population growth rate (OR: 4.12, P < 0.01) and unemployment rate (OR: 2.45, P < 0.01) were all associated with an elevated risk of violent injuries among Chinese women caused by physical attack. CONCLUSIONS: The results suggest violent injuries among Chinese women caused by physical attack have become an important social and public health problem. The findings point to the importance of developing effective health policies, laws and interventions that focuses on the unequal economic development between different regions.

Who smokes in smoke-free public places in China? Findings from a 21 city survey.

Efforts toward controlling secondhand smoke in public places have been made throughout China. However, in contrast to the western world, significant challenges remain for effectively implementing smoke-free regulations. This study explores individual and regional factors which influence smoking in smoke-free public places. Participants included 16 866 urban residents, who were identified through multi-stage sampling conducted in 21 Chinese cities. The reported smoking prevalence in smoke-free public places was 41.2%. Of those who smoked in smoke-free public places, 45.9% had been advised to stop smoking. Participants stated that no-smoking warnings/signs with 'please' in the statement had a better likelihood of gaining compliance and preventing smoking in public spaces. Multilevel logistic regression analysis showed that ethnicity, education, occupation, type of smoking, age of smoking initiation, smoking situation, stress, household smoking restrictions and city population were all associated with smoking in smoke-free public places. Interestingly local smoke-free regulations were not associated with smoking in public places. The findings underscore that efforts to restrict smoking in public places in China should emphasize strong enforcement, while simultaneously raising public awareness of the perils of second hand smoke.

Socioeconomic inequalities and mental stress in individual and regional level: a twenty one cities study in China.

OBJECTIVES: This study will examine explanatory variables including socioeconomic inequalities related to mental stress at both the individual and regional level. METHODOLOGY: A cross-sectional multistage sampling process was used to obtain participants. Data on mental stress and individual socioeconomic status were gathered via face to face interview. Regional variables were retrieved from a national database. Multilevel logistic regression analysis was used to assess socioeconomic variances in mental stress. RESULTS: Among the 16,866 participants, 27.2% reported severe levels of mental stress (95% CI: 19.4%-35.1%). Multilevel regression analysis indicated that lower individual educational attainment and income, and lower regional Per Capita GDP was associated with mental stress. The results also indicated that managers, clerks, and professional workers manifested higher stress levels than those in other occupations. CONCLUSIONS: Based on the results of this study individual and regional socioeconomic inequalities in China are associated with mental stress.

Environmental Smoking Restrictions and Light Cigarette Adoption Among Chinese Urban Smokers.

Light cigarette adoption involves complex psychological and behavioral processes with many underlying factors. While numerous studies have shown that environmental restrictions on smoking are associated with higher probability of smoking cessation, it is also possible that some smokers may switch from regular to light cigarettes due to environmental pressures. The current study evaluates whether smoking restrictions in households, workplaces, and public places were respectively associated with light cigarette adoption. A cross-sectional multistage sampling process was used to recruit participants and collect data about demographics and smoking characteristics and environmental restriction variables. Multiple logistic models were employed to examine the association between environmental smoking restrictions and light cigarette adoption. Of 4735 respondents, 1592 (30.3 %) were current smokers, and 69.7 % (N = 1141) of the smokers were identified as light cigarette adopters. In a multivariate model, smoking restrictions in households, workplaces, and public places were significantly associated with higher light cigarette adoption. Under environmental smoking restrictions, which pose unique challenges to tobacco control efforts, light cigarette adoption may increase. The study findings are essential for health policy makers in designing and implementing targeted smoking cessation interventions and health education programs.

MicroRNA analysis of medium/large placenta extracellular vesicles in normal and preeclampsia pregnancies.

Background: Preeclampsia (PE) is a hypertensive disorder of pregnancy, affecting 2%-8% of pregnancies worldwide, and is the leading cause of adverse maternal and fetal outcomes. The disease is characterized by oxidative and cellular stress and widespread endothelial dysfunction. While the precise mechanisms are not entirely understood, the pathogenesis of PE is closely linked to placental dysfunction and, to some extent, syncytiotrophoblast extracellular vesicle release (STB-EVs). These vesicles can be divided into the less well-studied medium/large EVs (220-1,000 nm) released in response to stress and small EVs (<220 nm) released as a component of intercellular communication. The previously described production of m/lSTB-EVs in response to cellular stress combined with the overwhelming occurrence of cellular and oxidative stress in PE prompted us to evaluate the microRNAome of PE m/lSTB-EVs. We hypothesized that the microRNAome profile of m/lSTB-EVs is different in PE compared to normal pregnancy (NP), which might permit the identification of potential circulating biomarkers not previously described in PE. Methods/study design: We performed small RNA sequencing on medium/large STB-EVs isolated from PE and NP placentae using dual-lobe ex vivo perfusion. The sequencing data was bioinformatically analyzed to identify differentially regulated microRNAs. Identified microRNAs were validated with quantitative PCR analysis. We completed our analysis by performing an in-silico prediction of STB-EV mechanistic pathways. Results: We identified significant differences between PE and NP in the STB-EVs micro ribonucleic acid (microRNA) profiles. We verified the differential expression of hsa-miR-193b-5p, hsa-miR-324-5p, hsa-miR-652-3p, hsa-miR-3196, hsa-miR-9-5p, hsa-miR-421, and hsa-miR-210-3p in the medium/large STB-EVs. We also confirmed the differential abundance of hsa-miR-9-5p in maternal serum extracellular vesicles (S EVs). In addition, we integrated the results of these microRNAs into the previously published messenger RNA (mRNA) data to better understand the relationship between these biomolecules. Conclusions: We identified a differentially regulated micro-RNA, hsa-miR-9-5p, that may have biomarker potential and uncovered mechanistic pathways that may be important in the pathophysiology of PE.

Identification of F-box gene family in Brassica oleracea and expression analysis in response to low-temperature stress.

Unfavorable climatic conditions, such as low temperatures, often hinder the growth and production of crops worldwide. The F-box protein-encoding gene family performs an essential role in plant stress resistance. However, a comprehensive analysis of the F-box gene family in cabbage (Brassica oleracea var capitata L.) has not been reported yet. In this study, genome-wide characterization of F-box proteins in cabbage yielded 303 BoFBX genes and 224 BoFBX genes unevenly distributed on 9 chromosomes of cabbage. Phylogenetic analysis of 303 BoFBX genes was classified into nine distinct subfamily groups (GI-GIX). Analysis of the gene structure of BoFBX genes indicated that most genes within the same clade are highly conserved. In addition, tissue-specific expression analysis revealed that six F-box genes in cabbage showed the highest expression in rosette leaves, followed by roots and stems and the lowest expression was observed in the BoFBX156 gene. In contrast, the expression of the other five genes, BoFBX100, BoFBX117, BoFBX136, BoFBX137 and BoFBX213 was observed to be upregulated in response to low-temperature stress. Moreover, we found that the expression level of the BoFBX gene in the cold-tolerant cultivar "ZG" was higher than that in cold-sensitive "YC" with the extension of stress duration, while expression levels of each gene in "ZG" were higher than "YC" at 24 h. Knowledge of the various functions provided by BoFBXs genes and their expression patterns provides a firm theoretical foundation for explaining the functions of BoFBXs, thereby contributing to the molecular breeding process of cabbage.

Paper test strip for fluorescence detection of iron ion based on nitrogen, zinc and copper codoped carbon dots.

In this study, a test strip for fluorometric analysis of iron ion (Fe3+) was constructed based on nitrogen, zinc and copper codoped carbon dots (NZC-CDs) as fluorescence probes. NZC-CDs were synthesized by hydrothermal method. The morphology, size, components, crystal state and optical properties of NZC-CDs were characterized by transmission electron microscope (TEM), Fourier-transform infrared (FT-IR), x-ray photoelectron spectroscopy (XPS), x-ray diffraction (XRD), UV-vis absorption and fluorescence spectroscopy techniques, respectively. NZC-CDs exhibited bright blue fluorescence under UV lamp with a quantum yield at 17.76%. The fluorescence of NZC-CDs was quenched by Fe3+possibly due to the static quenching. The possible fluorescence quenching mechanism was also discussed. The quenching fluorescence was linear with the concentration of Fe3+in the range of 2.5-400µM with a low detection limit of 0.5µM. For the convenient detection, the test strips based on filter paper were employed for Fe3+assay. Moreover, the present approach was successfully applied in the determination of Fe3+in real samples including black fungus, duck blood and pork liver. The sensing method had the potential application in more food analysis.

ExoCounter Assays Identify Women Who May Develop Early-Onset Preeclampsia From 12.5 µL First-Trimester Serum by Characterizing Placental Small Extracellular Vesicles.

BACKGROUND: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality worldwide. Identifying women with high risk of developing preeclampsia in early pregnancy remains challenging. Extracellular vesicles released from the placenta offer an attractive biomarker but have been elusive to quantify. METHODS: Here, we tested ExoCounter, a novel device that immunophenotypes size-selected small extracellular vesicles <160 nm, for its ability to perform qualitative and quantitative placental small extracellular vesicles (psEV) analysis. To investigate disease-specific and gestational age-specific changes, we analyzed psEV counts in maternal plasma samples taken at each of the 3 trimesters from women who had (1) normal pregnancy (n=3); (2) women who developed early-onset preeclampsia (EOPE; n=3); and (3) women who developed late-onset preeclampsia (n=4) using 3 antibody pairs, CD10-placental alkaline phosphatase (PLAP), CD10-CD63, and CD63-PLAP. We further validated the findings in first-trimester serum samples among normal pregnancy (n=9), women who developed EOPE (n=7), and women who developed late-onset preeclampsia (n=8). RESULTS: We confirmed that CD63 was the major tetraspanin molecule coexpressed with PLAP-a known placental extracellular vesicles marker on psEV. Higher psEV counts for all 3 antibody pairs were detected in the plasma of women who developed EOPE than the other 2 groups in the first trimester, which persisted through the second and third trimesters. Significantly higher CD10-PLAP (P<0.01) and CD63-PLAP (P<0.01) psEV counts were validated in the serum of the first trimester of women who developed EOPE compared with normal pregnancy. CONCLUSIONS: Application of the ExoCounter assay developed here could identify patients at risk of developing EOPE in the first trimester, thereby providing a window of opportunity for early intervention.

A cross-sectional analysis of syncytiotrophoblast membrane extracellular vesicles-derived transcriptomic biomarkers in early-onset preeclampsia.

Background: Preeclampsia (PE) is a pregnancy-specific hypertensive disorder affecting 2%-8% of pregnancies worldwide. Biomarker(s) for the disorder exists, but while these have excellent negative predictive value, their positive predictive value is poor. Extracellular vesicles released by the placenta into the maternal circulation, syncytiotrophoblast membrane extracellular vesicles (STB-EVs), have been identified as being involved in PE with the potential to act as liquid biopsies. Objective: The objective of this study was to identify the difference in the transcriptome of placenta and STB-EVs between preeclampsia and normal pregnancy (NP) and mechanistic pathways. Methods/study design: We performed RNA-sequencing on placental tissue, medium/large and small STB-EVs from PE (n = 6) and NP (n = 6), followed by bioinformatic analysis to identify targets that could be used in the future for EV-based diagnostic tests for preeclampsia. Some of the identified biomarkers were validated with real-time polymerase chain reactions. Results: Our analysis identified a difference in the transcriptomic STB-EV cargo between PE and NP. We then identified and verified the differential expression of FLNB, COL17A1, SLC45A4, LEP, HTRA4, PAPP-A2, EBI3, HSD17B1, FSTL3, INHBA, SIGLEC6, and CGB3. Our analysis also identified interesting mechanistic processes via an in silico prediction of STB-EV-based mechanistic pathways. Conclusions: In this study, using comprehensive profiling of differentially expressed/carried genes of three linked sample subtypes in PE, we identified potential biomarkers and mechanistic gene pathways that may be important in the pathophysiology of PE and could be further explored in future studies.

Regional Internet Access and Mental Stress Among University Students: A Representative Nationwide Study of China.

Background: The Internet changed the lives of average citizens in the early part of the twenty-first century, and it has now become an essential part of daily life. Many studies reported that accessibility of Internet use is associated with mental health. However, previous studies examining this association were confined to local and community subpopulations and limited at the individual level, which increases the potential bias from the selection effect at a different level. Regional variables would be a stable estimate of people's socioeconomic and cultural environments and how these variables affect mental health needed to be studied. The objective of this study was to evaluate the association between regional Internet access, and mental stress among university students. Methods: Participants were 11,954 students, who were identified through a multistage survey sampling process conducted in 50 Chinese universities. Regional Internet access was retrieved from a national database, and mental stress was measured using the Perceived Stress Scale (Chinese Version) (CPSS). Both unadjusted and adjusted methods were considered in the analyses. Results: More than one-third 36.9% (95% CI: 24.4-49.5%) of university students in this study suffered from severe mental stress (SMR). The multilevel logistic regression model found that university students studied in low-level universities had 2.52 (95% C.I. 1.17 to 6.37) times the prevalence of SMR than those in high-level universities. Compared with small cities, students in a large city had a lower prevalence of SMR (OR 0.25; 95%C.I. 0.06 to 0.77). Most importantly, regional Internet access was negatively associated with students' SMR (OR 0.25; 95%C.I. 0.08 to 0.76). Conclusions: This study indicated that regional Internet access and other environmental factors including city size and type of universities contribute to students' mental health. The findings underscore that efforts to control excessive mental stress among students in China should pay greater attention to environmental determinants of stress and particularly to improve internet access.

Cigarette sharing and gifting in China: Patterns, associated factors, and behavioral outcomes.

INTRODUCTION: The purpose of this study was to investigate the patterns and factors associated with cigarette sharing and gifting, and to explore whether smoking can be predicted by these social practices. METHODS: A cross-sectional survey using a multi-stage sampling design was conducted online from 30 April to 30 July 2020 in China. A sample of 982 household heads from Guangdong Province and 530 household heads from Shaanxi province were involved in the data analysis. Demographic characteristics, social participation, beliefs and behaviors related to cigarette sharing and gifting were assessed. Chi-squared analysis and multiple logistic regression analysis were used to explore the key factors associated with cigarette sharing and gifting, and to identify their relationship with smoking. RESULTS: The shared and gift cigarettes were both mainly offered to friends, and receiving gift cigarettes mostly occurred during the holidays. Gender and province were associated with cigarette sharing, and marital status and social participation were associated with cigarette gifting. Cigarette gifting beliefs and smoking status were prominent predictors for both sharing and gifting cigarettes. Cigarette gifting beliefs were significantly higher among smokers than non-smokers, and people with high cigarette gifting beliefs were 1.68 (adjusted odds ratio, AOR=19.17; 95% CI: 13.31-27.61) times more likely to be a smoker. Offering shared cigarettes has been found to significantly predict tobacco use (AOR=19.17; 95% CI: 13.31-27.61), while people who received shared and gift cigarettes were 1.50 (95% CI: 1.08-2.09) and 2.58 (95% CI: 1.66-4.00) times more likely to be a current smoker than those who did not receive cigarettes, respectively. CONCLUSIONS: Cigarette sharing and gifting were especially pervasive among male smokers and married people in Shaanxi Province. Offering shared cigarettes and receiving shared/gift cigarettes might facilitate cigarette use. This study provides evidence-based data to support the design and implementation of tobacco control programs for the denormalization of gifting and sharing cigarettes.

Family influences on older adults' problem drinking: A representative nationwide study of China.

Aim: It is reported that problem drinking is severe among the elderly. The family environment has been regarded as a significant effecting factor in alcohol consumption of the drinker. With the increasing number of older people, paying more attention to this vulnerable group's drinking status and its' influencing factors is substantial for improving older adults' health and the quality of health services. Methods: This study used data from the Chinese Longitudinal Healthy and Longevity Study (CLHLS), which was a representative survey covering 23 provinces in mainland China. Cross-sectional analyses were conducted with 15,142 older individuals (aged ≥65 years). Three self-reported questions about drinking behavior were examined to calculate alcohol consumption and categorize problem drinkers. Three multi-level models were utilized while adjusting for numerous socio-demographic and self-reported health factors to analyze the effect of family factors associated with problem drinking among the elderly. Results: A total of 1,800 problem drinkers (12%) were identified in the sample. Key factors for the problem drinker were assessed such as Hukou (governmental household registration system), current marital status, years of schooling, primary caregivers, and financial sources of living were associated with problem drinking. The older population who live in rural areas (OR = 1.702, CI = 1.453, 1.994), with advanced years of education (OR = 1.496, CI = 1.284, 1.744), and making life by themselves (OR = 1.330, CI = 1.139, 1.552) were more likely to engage in problem drinking while those participants who are widowed (OR = 0.678, CI = 0.574, 0.801), cared for by children or other relatives (OR = 0.748, CI = 0.642, 0.871), adult care giver (OR = 0.348, CI = 0.209, 0.578) or by no one (OR = 0.539, CI = 0.348, 0.835), provided with financial support from their children (OR = 0.698, CI = 0.605, 0.806), other relatives (OR = 0.442, CI = 0.332, 0.587), or the government/community (OR = 0.771, CI = 0.650, 0.915), with insufficient financial support (OR = 0.728, CI = 0.608, 0.872) were at lower risk of problem drinking. Conclusions: This study provides a strong correlation of various family factors that were associated with problem drinking among the elderly. The findings underscore the effort to promote healthy behaviors, including the importance of positive family factors and appropriate levels of alcohol consumption.