Perceived Social Support and Cardiovascular Risk Among Nonelderly Adults in the United States.

Hypertension, diabetes mellitus, dyslipidemia, and obesity are major risk factors of cardiovascular diseases. A recent study projected a marked surge in these cardiometabolic conditions in the United States by the year 2060, posing a challenge for cardiovascular disease management in the coming years. This study aimed to explore and quantify the relation of a key psychosocial factor, social support, with the cardiovascular risk factors among nonelderly US adults (aged 18 to 64 years). Using data on 19,827 adults from the 2021 National Health Interview Survey, we assessed whether lower level of social support was associated with higher likelihood of having cardiovascular risks. We found that for subjects who "rarely/never" received social support, the adjusted odds of having hypertension, high cholesterol, and diabetes were 1.42 (95% confidence interval [CI] 1.20 to 1.67), 1.39 (95% CI 1.18 to 1.65), and 1.53 (95% CI 1.22 to 1.91) times those of subjects "always" receiving support, respectively. Further, compared with the base outcome of no CV risk, the adjusted relative risks of having 3+ cardiovascular risks for subjects "rarely/never" receiving support were 1.91 (95% CI 1.49 to 2.46) times that of those "always" receiving support. These results were robust across socioeconomic status condition sub-groups manifested by educational attainment and income. In conclusion, our findings suggest that social support may be considered as a critical part of the comprehensive efforts to mitigate the future burden of cardiovascular diseases in the United States.

Inhalant Cannabidiol Inhibits Glioblastoma Progression Through Regulation of Tumor Microenvironment.

Introduction: Glioblastoma (GBM) is the most common invasive brain tumor composed of diverse cell types with poor prognosis. The highly complex tumor microenvironment (TME) and its interaction with tumor cells play important roles in the development, progression, and durability of GBM. Angiogenic and immune factors are two major components of TME of GBM; their interplay is a major determinant of tumor vascularization, immune profile, as well as immune unresponsiveness of GBM. Given the ineffectiveness of current standard therapies (surgery, radiotherapy, and concomitant chemotherapy) in managing patients with GBM, it is necessary to develop new ways of treating these lethal brain tumors. Targeting TME, altering tumor ecosystem may be a viable therapeutic strategy with beneficial effects for patients in their fight against GBM. Materials and Methods: Given the potential therapeutic effects of cannabidiol (CBD) in a wide spectrum of diseases, including malignancies, we tested, for the first time, whether inhalant CBD can inhibit GBM tumor growth using a well-established orthotopic murine model. Optical imaging, histology, immunohistochemistry, and flow cytometry were employed to describe the outcomes such as tumor progression, cancer cell signaling pathways, and the TME. Results: Our findings showed that inhalation of CBD was able to not only limit the tumor growth but also to alter the dynamics of TME by repressing P-selectin, apelin, and interleukin (IL)-8, as well as blocking a key immune checkpoint-indoleamine 2,3-dioxygenase (IDO). In addition, CBD enhanced the cluster of differentiation (CD) 103 expression, indicating improved antigen presentation, promoted CD8 immune responses, and reduced innate Lymphoid Cells within the tumor. Conclusion: Overall, our novel findings support the possible therapeutic role of inhaled CBD as an effective, relatively safe, and easy to administer treatment adjunct for GBM with significant impacts on the cellular and molecular signaling of TME, warranting further research.

Racial and Ethnic Inequities in Financial Hardship Among CVD Patients in the USA During the Pre- and Post-Affordable Care Act Era.

The Affordable Care Act (ACA) has substantially expanded access to health insurance coverage, resulting in a reduction in financial hardship, defined as ability to pay medical bills, among cardiovascular disease (CVD) patients in the post-ACA era. However, it is not known whether implementation of the ACA improved the racial and ethnic inequity in financial hardship among CVD patients. As such, using data from the 2011 to 2018 waves of the National Health Interview Survey (NHIS), this paper aims to assess the odds of facing financial hardship among non-Hispanic-White, -Black, -Asian, and Hispanic CVD patients, before and after the implementation of the ACA. Our sample consists of 12,688 CVD patients in pre-ACA (2011-2013), 9128 CVD patients in early (2014-2015), and 11,863 CVD patients in later phase of the ACA (2016-2018). We performed multivariable logistic regressions to examine how the odds, in favor of facing financial hardship, varied between non-Hispanic White and other race/ethnic categories across the pre- and post-ACA periods. Though the overall prevalence of financial hardship was reduced from 22 to 18%, a considerable disparity between Black and Hispanic, and White CVD patients persisted from pre-ACA to post-ACA periods. The odds of experiencing financial hardship for Black and Hispanic CVD patients were, respectively, 2.25 to 2.16 and 1.52 to 1.78 times that of their White counterparts across the periods. Though the ACA is a positive step towards improving healthcare access and affordability, further initiatives are needed to reduce inequities across racial and ethnic minorities.

Nationwide analysis of plastic and reconstructive procedural volume in the United States during the COVID-19 pandemic.

INTRODUCTION: This study aims to define the impact of the novel Coronavirus Disease 2019 (COVID-19) pandemic on the volume of common plastic and reconstructive procedures in the United States. METHODS: TrinetX is a national, federated database that was utilized in surveying plastic and reconstructive procedural volumes among 53 Healthcare organizations (HCO) between March 2018 and May 2021. This timeframe was divided into pre-pandemic (March 2018 to February 2020) and pandemic periods (March 2020 to May 2021). Each period was then sub-divided into four seasons of the year and the mean monthly procedural volume per HCO was compared. A student's t-tests comparing pre-pandemic and pandemic seasonal mean procedural volumes were used for statistical analysis. RESULTS: A total of 366,032 patient encounters among 53 HCO were included. The average seasonal volume per HCO of all procedures reduced from 872.11 procedures during pre-pandemic seasons to 827.36 during pandemic seasons. Spring 2020 vol declined for most procedures as 15 of 24 (63%) assessed procedure categories experienced statistically significant decreases. Spring 2021 experienced rebounds with 15 of 24 (63%) assessed procedures showing statistically significant increases. CONCLUSION: During the pandemic period, the average procedural volume per HCO of 14 procedure categories was significantly less than the pre-pandemic average procedural volume. Overall, an inverse relationship was observed between novel COVID-19 cases and plastic and reconstructive surgery procedure volumes in the United States.