Use of Electronic Nicotine Delivery Systems and Age of Asthma Onset Among US Adults and Youths.

Importance: The association of use of electronic nicotine delivery systems (ENDS) with the age of asthma onset is unknown. Objective: To explore the association of past 30-day ENDS use with the age of asthma onset in adults and youths who did not have asthma or chronic obstructive pulmonary disease and never used cigarettes. Design, Setting, and Participants: This cohort study was a secondary analysis of waves 1 to 6 of the US nationally representative Population of Tobacco and Health Study (2013-2021). Eligible participants included adults (≥18 years) and youths (12-17 years) who did not have asthma or chronic obstructive pulmonary disease at the first wave of participation. Data analysis was conducted from September 2022 to April 2024. Exposure: Past 30-day ENDS use at the first wave of participation in the study preceding the onset of asthma. Main outcome and measures: Lower and upper age limits were estimated using the age reported at the first wave of participation and the number of weeks between follow-up waves until asthma was first reported or censored. The association of past 30-day ENDS use with the age of asthma onset was estimated using weighted interval-censoring Cox regression. The cumulative hazard function for the age of asthma onset was estimated using interval-censoring survival analysis. Results: A total of 24 789 participants were included, with 7766 adults (4461 female [weighted percentage, 59.11%] and 3305 male [weighted percentage, 40.89%]), representing 80.0 million adults, and 17 023 youths (8514 female [weighted percentage, 50.60%] and 8496 male [weighted percentage 49.32%]), representing 33.9 million youths. By age 27 years, 6.2 per 1000 adults reported asthma incidence (hazard ratio [HR], 0.62%; 95% CI, 0.46%-0.75%). While controlling for covariates, there was a 252% increased risk of the onset of asthma at earlier ages for adults who used ENDS in the past 30 days vs adults who did not (adjusted HR, 3.52; 95% CI, 1.24-10.02). For youths, there was no association of ENDS use in the past 30 days with age of asthma onset (adjusted HR, 1.79; 95% CI, 0.67-4.77), which could be due to a lack of statistical power. Conclusion and relevance: In this cohort study, past 30-day ENDS use among adults was associated with earlier ages of asthma onset. These findings suggest that prevention and cessation programs directed to adults who use ENDS are needed to educate the public, protect public health, prevent adverse health outcomes, and motivate users to stop. Furthermore, modifying symptom-screening asthma guidelines, resulting in earlier asthma detection and treatment, may reduce morbidity and mortality due to asthma.

Application of inverse weighting analysis to assess the association of youth perceptions with the age of initiation of tobacco products.

Introduction: To examine if perceptions of harmfulness and addictiveness of hookah and cigarettes impact the age of initiation of hookah and cigarettes, respectively, among US youth. Youth (12-17 years old) users and never users of hookah and cigarettes during their first wave of PATH participation were analyzed by each tobacco product (TP) independently. The effect of perceptions of (i) harmfulness and (ii) addictiveness at the first wave of PATH participation on the age of initiation of ever use of hookah was estimated using interval-censoring Cox proportional hazards models. Methods: Users and never users of hookah at their first wave of PATH participation were balanced by multiplying the sampling weight and the 100 balance repeated replicate weights with the inverse probability weight (IPW). The IPW was based on the probability of being a user in their first wave of PATH participation. A Fay's factor of 0.3 was included for variance estimation. Crude hazard ratios (HR) and 95% confidence intervals (CIs) are reported. A similar process was repeated for cigarettes. Results: Compared to youth who perceived each TP as "a lot of harm", youth who reported perceived "some harm" had younger ages of initiation of these tobacco products, HR: 2.53 (95% CI: 2.87-4.34) for hookah and HR: 2.35 (95% CI: 2.10-2.62) for cigarettes. Similarly, youth who perceived each TP as "no/little harm" had an earlier age of initiation of these TPs compared to those who perceived them as "a lot of harm", with an HR: 2.23 (95% CI: 1.82, 2.71) for hookah and an HR: 1.85 (95% CI: 1.72, 1.98) for cigarettes. Compared to youth who reported each TP as "somewhat/very likely" as their perception of addictiveness, youth who reported "neither likely nor unlikely" and "very/somewhat unlikely" as their perception of addictiveness of hookah had an older age of initiation, with an HR: 0.75 (95% CI: 0.67-0.83) and an HR: 0.55 (95% CI: 0.47, 0.63) respectively. Discussion: Perceptions of the harmfulness and addictiveness of these tobacco products (TPs) should be addressed in education campaigns for youth to prevent early ages of initiation of cigarettes and hookah.

Effects of the tetravanadate [V4O12]4- anion on the structural, magnetic, and biological properties of copper/phenanthroline complexes.

The aim to access linked tetravanadate [V4O12]4- anion with mixed copper(II) complexes, using α-amino acids and phenanthroline-derived ligands, resulted in the formation of four copper(II) complexes [Cu(dmb)(Gly)(OH2)]2[Cu(dmb)(Gly)]2[V4O12]·9H2O (1) [Cu(dmb)(Lys)]2[V4O12]·8H2O (2), [Cu(dmp)2][V4O12]·C2H5OH·11H2O (3), and [Cu(dmp)(Gly)Cl]·2H2O (4), where dmb = 4,4'-dimethioxy-2,2'-bipyridine; Gly = glycine; Lys = lysine; and dmp = 2,9-dimethyl-1,10-phenanthroline. The [V4O12]4- anion is functionalized with mixed copper(II) units in 1 and 2; while in 3, it acts as a counterion of two [Cu(dmp)]2+ units. Compound 4 crystallized as a unit that did not incorporate the vanadium cluster. All compounds present magnetic couplings arising from Cu⋯O/Cu⋯Cu bridges. Stability studies of water-soluble 3 and 4 by UV-Vis spectroscopy in cell culture medium confirmed the robustness of 3, while 4 appears to undergo ligand scrambling over time, resulting partially in the stable species [Cu(dmp)2]+ that was also identified by electrospray ionization mass spectrometry at m/z = 479. The in vitro cytotoxicity activity of 3 and 4 was determined in six cancer cell lines; the healthy cell line COS-7 was also included for comparative purposes. MCF-7 cells were more sensitive to compound 3 with an IC50 value of 12 ± 1.2 nmol. The tested compounds did not show lipid peroxidation in the TBARS assay, ruling out a mechanism of action via reactive oxygen species formation. Both compounds inhibited cell migration at 5 µM in wound-healing assays using MCF-7, PC-3, and SKLU-1 cell lines, opening a new window to study the anti-metastatic effect of mixed vanadium-copper(II) systems.

Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019-2020 Texas School Physical Activity and Nutrition Survey.

BACKGROUND: Nutrition labels are a tool to inform and encourage the public to make healthier food choices, but little information is available about use in multi-ethnic adolescent populations in the U.S. The purpose of this study was to examine associations between the level of nutrition label usage and healthy/unhealthy eating behaviors among a statewide representative sample of 8th and 11th-grade students in Texas. METHODS: We analyzed cross-sectional associations between the Nutrition Facts label use and eating behaviors from a statewide sample of 8th and 11th-grade students in Texas, (n = 4730, weighted n = 710,731, mean age = 14.7 ± 1.6 years; 49% female, 51% Hispanic), who completed the 2019-2020 Texas School Physical Activity and Nutrition (TX SPAN) survey. Students self-reported their level of nutrition label usage to make food choices (5-point Likert scale from "Never" to "Always") and previous day consumption of 26 food items (13 healthy, 13 unhealthy). The 26 food items were used to calculate a Healthy Eating Index (HEI) score (0-100), a Healthy Foods Index (HFI) score (0-100), and an Unhealthy Foods Index (UFI) score (0-100). Weighted linear regression models were employed to examine the associations between self-reported use of nutrition labels to make food choices and HEI, HFI, and UFI scores. Marginal predicted means of HEI, HFI, and UFI scores were calculated post hoc from linear regression models. The odds of consuming specific individual food items for nutrition label usage were also calculated from weighted logistic regression models. All linear and logistic regression models were adjusted for grade, sex, Body Mass Index (BMI), race/ethnicity, economic disadvantage, and percentage of English language learners by school. RESULTS: A total of 11.0% of students reported always/almost always using nutrition labels to make food choices, 27.9% reported sometimes using them, while 61.0% indicated they never/almost never used nutrition labels to make food choices. The average HEI score among students in the sample was 47.7 ± 5.9. Nutrition Facts label usage was significantly and positively associated with HEI (b = 5.79, 95%CI: 4.45, 7.12) and HFI (b = 7.28, 95%CI:4.48, 10.07), and significantly and negatively associated with UFI (b = -4.30, 95%CI: -6.25, -2.34). A dose-response relationship was observed between nutrition label usage and HEI, HFI, and UFI scores, such that the strength of these associations increased with each one-point increase in nutrition label usage. Students who reported using nutrition labels always/almost always to make food choices had significantly higher odds of consuming healthy foods including baked meat, nuts, brown bread, vegetables, whole fruit, and yogurt (ORrange = 1.31-3.07), and significantly lower odds of consuming unhealthy foods including chips, cake, candy, and soda (ORrange = 0.48-0.68) compared to students who reported never/almost never using the Nutrition Facts label. CONCLUSIONS: Using the Nutrition Facts labels to make food choices is beneficially associated with healthy and unhealthy eating among 8th and 11th-grade students, although the proportion of students using nutrition labels to make their food choices was low. Public health efforts should be made to improve nutrition literacy and encourage nutrition label use among secondary students in the United States.

Selection of clinically relevant drug concentrations for in vitro studies of candidates drugs for cancer repurposing: a proposal.

Drug repurposing of widely prescribed patent-off and cheap drugs may provide affordable drugs for cancer treatment. Nevertheless, many preclinical studies of cancer drug repurposing candidates use in vitro drug concentrations too high to have clinical relevance. Hence, preclinical studies must use clinically achievable drug concentrations. In this work, several FDA-approved cancer drugs are analyzed regarding the correlation between the drug inhibitory concentrations 50% (IC50) tested in cancer cell lines and their corresponding peak serum concentration (Cmax) and area under the curve (AUC) reported in clinical studies of these drugs. We found that for most targeted cancer drugs, the AUC and not the Cmax is closest to the IC50; therefore, we suggest that the initial testing of candidate drugs for repurposing could select the AUC pharmacokinetic parameter and not the Cmax as the translated drug concentration for in vitro testing. Nevertheless, this is a suggestion only as experimental evidence does not exist to prove this concept. Studies on this issue are required to advance in cancer drug repurposing.

The Integration of Community Voice in the Implementation of a Mobile Health Program.

BACKGROUND: Health care access is vital to advancing health equity. The purpose of this paper was to use a community-based participatory research approach to engage underserved communities in the development of a new mobile health clinic (MHC) program and to discuss the lessons learned from the conversations. Community conversations helped identify barriers to access to health care, community strengths, and health concerns. They also helped the MHC leaders develop programming. METHODS: The community-based participatory research approach guided five community conversations conducted (N = 51 participants) from 2018 to 2019. Participants provided input on their personal experiences with a) existing facilitators and barriers to health, b) priority health issues and needs, and c) recommendations for MHC program development. RESULTS: Barriers to health care access were identified, as were many community strengths. Recommendations directly informed MHC program development and implementation, including availability of services at no cost, mammogram referrals, mental health screening, eye exams, and nutrition counseling. CONCLUSIONS: This project highlights the importance of collaboration between academic partners and communities to inform health care programs and the implementation of a MHC based on community voice and input.

The validity of self-rated alcohol susceptibility in predicting alcohol use in early adolescents in Latin America.

BACKGROUND: The measurement of substance use susceptibility was first conceived as part of the preparatory stage that precedes youth smoking initiation and is defined as the lack of a firm commitment not to smoke in the future. Despite being a consistent and validated predictor of smoking initiation, there has been little research on whether susceptibility can predict alcohol use. This study assessed the validity of an adapted alcohol susceptibility measure to predict alcohol consumption among early adolescent students in Argentina and Mexico who had not previously consumed alcohol. METHODS: A school-based longitudinal study was conducted among first-year students in 33 secondary schools in Argentina and 57 in Mexico. The baseline sample included 1504 never-drinker adolescents in Argentina and 5264 in Mexico, of whom 1055 and 3540, respectively, completed a follow-up survey one and a half years later. Logistic regression with school as a random effect was used to estimate the adjusted odds ratios for the transitions from never-drinker to ever-drinker, current drinker, and binge drinker. RESULTS: At baseline, 34% and 23.6% of adolescent never-users in Argentina and Mexico, respectively, were susceptible to alcohol. After controlling for other known predictors of alcohol use initiation, alcohol susceptibility was positively associated with ever-drinking (OR = 3.23, 95% CI 2.38-4.36 in Argentina, OR = 1.73, 95% CI 1.43-2.10 in Mexico), current drinking (OR = 2.41, 95% CI 1.71-3.4 in Argentina, OR = 1.77, 95% CI 1.37-2.28 in Mexico), and binge drinking (OR = 2.27, 95% CI 1.78-2.91 in Argentina, OR = 1.89, 95% CI 1.32-1.99 in Mexico). CONCLUSIONS: The susceptibility measure adapted for use with alcohol appears valid for identifying individuals or groups at risk of drinking initiation and problematic drinking among early adolescents in Argentina and Mexico.

PaSTe. Blockade of the Lipid Phenotype of Prostate Cancer as Metabolic Therapy: A Theoretical Proposal.

BACKGROUND: Prostate cancer is the most frequently diagnosed malignancy in 112 countries and is the leading cause of death in eighteen. In addition to continuing research on prevention and early diagnosis, improving treatments and making them more affordable is imperative. In this sense, the therapeutic repurposing of low-cost and widely available drugs could reduce global mortality from this disease. The malignant metabolic phenotype is becoming increasingly important due to its therapeutic implications. Cancer generally is characterized by hyperactivation of glycolysis, glutaminolysis, and fatty acid synthesis. However, prostate cancer is particularly lipidic; it exhibits increased activity in the pathways for synthesizing fatty acids, cholesterol, and fatty acid oxidation (FAO). OBJECTIVE: Based on a literature review, we propose the PaSTe regimen (Pantoprazole, Simvastatin, Trimetazidine) as a metabolic therapy for prostate cancer. Pantoprazole and simvastatin inhibit the enzymes fatty acid synthase (FASN) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), therefore, blocking the synthesis of fatty acids and cholesterol, respectively. In contrast, trimetazidine inhibits the enzyme 3-b-Ketoacyl-CoA thiolase (3-KAT), an enzyme that catalyzes the oxidation of fatty acids (FAO). It is known that the pharmacological or genetic depletion of any of these enzymes has antitumor effects in prostatic cancer. RESULTS: Based on this information, we hypothesize that the PaSTe regimen will have increased antitumor effects and may impede the metabolic reprogramming shift. Existing knowledge shows that enzyme inhibition occurs at molar concentrations achieved in plasma at standard doses of these drugs. CONCLUSION: We conclude that this regimen deserves to be preclinically evaluated because of its clinical potential for the treatment of prostate cancer.

Longitudinal Transition Patterns of Tobacco Use Among Youth and Young Adults Never Tobacco Product Users: Findings From the Population Assessment of Tobacco and Health Study, 2014-2019.

Aims: To identify, visualize, and describe the prevalence of within-product patterns of tobacco use behaviors for e-cigarettes, cigarettes, and hookah (TP) by 3 age groups (ie, 12-14-year-old, 15-17-year-old, and 18-20-year-old) with U.S. nationally representative data. Methods: In 2014-2015, never users of each (TP) and age group were followed-up longitudinally between 2015-2019 using five transition states: non-susceptible to (TP) use, susceptible to (TP) use, ever (TP) use, past 30-day (TP) use, and discontinued past 30-day (TP) use. Sankey diagrams were used to graphically visualize patterns in tobacco use behaviors across time. Results: Among 12-14-year-old who were never users and susceptible to each TP from 2014-2017, 7% initiated ever e-cigarette use and 9.4% first reported past 30-day use by 2018-2019; 5.8% initiated ever cigarette use and 3% first reported past 30-day cigarette use by 2018-2019; and, 4.5% initiated ever hookah use and 1.0% first reported past 30-day hookah use by 2018-2019. Among 15-17-year-old who were never users and susceptible to each TP from 2014-2017, 4.2% initiated ever e-cigarette use and 9.0% first reported past 30-day use by 2018-2019; 4.5% initiated ever cigarette use and 3% first reported past 30-day cigarette use by 2018-2019; and, 4.5% initiated ever hookah use and 2.4% first reported past 30-day hookah use by 2018-2019. Among 18-20-year-old who were never users and susceptible to each TP from 2014-2017, 3.2% initiated ever e-cigarette use and 3.6% first reported past 30-day e-cigarette use by 2018-2019; 3.0% initiated ever cigarette use and 2.3% first reported past 30-day cigarette use; and, 2.8% initiated ever hookah use and 1.0% first reported past 30-day hookah use by 2018-2019. Conclusions: From 2014 to 2019, onset and progression of e-cigarette, cigarette, and hookah use occurred more frequently in 12-14 and 15-17-year-old than in young adults 18-20-year-old.

Does Therapeutic Repurposing in Cancer Meet the Expectations of Having Drugs at a Lower Price?

Therapeutic repurposing emerged as an alternative to the traditional drug discovery and development model (DDD) of new molecular entities (NMEs). It was anticipated that by being faster, safer, and cheaper, the development would result in lower-cost drugs. As defined in this work, a repurposed cancer drug is one approved by a health regulatory authority against a non-cancer indication that then gains new approval for cancer. With this definition, only three drugs are repurposed for cancer: Bacillus Calmette-Guerin (BCG) vaccine (superficial bladder cancer, thalidomide [multiple myeloma], and propranolol [infantile hemangioma]). Each of these has a different history regarding price and affordability, and it is not yet possible to generalize the impact of drug repurposing on the final price to the patient. However, the development, including the price, does not differ significantly from an NME. For the end consumer, the product's price is unrelated to whether it followed the classical development or repurposing. Economic constraints for clinical development, and drug prescription biases for repurposing drugs, are barriers yet to be overcome. The affordability of cancer drugs is a complex issue that varies from country to country. Many alternatives for having affordable drugs have been put forward, however these measures have thus far failed and are, at best, palliative. There are no immediate solutions to the problem of access to cancer drugs. It is necessary to critically analyze the impact of the current drug development model and be creative in implementing new models that genuinely benefit society.

Associations Between Perceptions of e-Cigarette Harmfulness and Addictiveness and the Age of E-Cigarette Initiation Among the Population Assessment of Tobacco and Health (PATH) Youth.

Introduction: Youth perceptions of harmfulness and addictiveness of e-cigarettes may impact the age that they initiate e-cigarette use, but this has not been investigated previously. Methods: Youth (12-17 years old) never e-cigarette users at their first wave of PATH participation (waves 1-3, 2013-2016) were included. PATH questions on absolute perceptions of e-cigarette harmfulness and addictiveness were used as exposures. Interval-censored Cox proportional hazards models were used to estimate the impact of perceptions of harmfulness, and perceptions of addictiveness on (i) the age of initiation of e-cigarette use and (ii) age of first reporting past 30-day e-cigarette use, while controlling for covariates. Results: Youth who perceive e-cigarettes as having no/little harm had increased risk of initiating both ever e-cigarette use (AHR = 2.04; 95%CI = 1.74-2.40) and past 30-day e-cigarette use (AHR = 2.64; 95%CI = 2.07-3.37) at earlier ages compared to youth who perceive e-cigarettes as having a lot of harm. Youth who perceive the likelihood of becoming addicted to e-cigarettes to be very/somewhat unlikely had increased risk of an earlier age of both ever (AHR = 1.28; 95%CI = 1.07-1.52) and past 30-day (AHR = 1.36; 95%CI = 1.04-1.79) e-cigarette initiation compared to youth who perceived the likelihood of becoming addicted to e-cigarettes to be somewhat/very likely. Conclusion: These results highlight the importance of communicating to youth the potential for health harms and addiction from e-cigarette use in prevention and intervention campaigns, as those with the lowest perceptions of harmfulness and addictiveness had the earliest ages of e-cigarette initiation.

The association of perceptions of harmfulness and addictiveness on the age of initiation of cigar product use among youth: Findings from the Population Assessment of Tobacco and Health (PATH) study, 2013-2017.

Background: Perceptions of cigar products' harmfulness and addictiveness in youth are associated with subsequent cigar product initiation, but their association on the age of initiation of cigar product use is unknown. Methods: The association of perceptions of harmfulness and addictiveness at youth's first wave of PATH participation (waves 1 or 2 in years 2013-2015) on the age of initiation of (i) ever. (ii) past 30-day, and (iii) fairly regular use of any cigar products (cigarillos, filtered cigars, or traditional cigars) during the followed-up in PATH waves 2-4 (2014-2017) was estimated using weighted interval-censored Cox proportional hazards models. Also, the association of the interaction between perceptions of harmfulness and addictiveness and the age of initiation of any cigar use are reported. Hazard ratios (HR) and 95% confidence intervals (CI) are reported. Results: Among youth who had ever heard of cigar products, youth who perceived cigars to be "low-medium harmfulness and low-medium addictiveness" had 60% (HR: 1.60, 95%CI: 1.36-1.89) higher hazard risk to initiate ever cigar product use at an earlier age, and had 46% (HR:1.46, 95%CI: 1.14-1.86) higher hazard risk to initiate past 30-day cigar product use at younger ages than those who perceived cigars to be "high harmfulness and high addictiveness." Moreover, youth who perceived cigars to be "low-medium harmfulness and high addictiveness" had 33% (HR: 1.33, 95%CI: 1.15-1.53) higher hazard risk to initiate ever cigar product use at younger ages than those who perceived cigars to be "high harmfulness and high addictiveness." Youth who reported "high harmfulness and low-medium addictiveness" (HR: 0.24, 95% CI: 0.07-0.83) had 76% lower hazard risk to initiate fairly regular use of cigar products at younger ages compared to youth who reported "high harmfulness and high addictiveness." Conclusions: Prevention and awareness campaigns should reinforce the unique potential for harm and addiction of cigar products to curb cigar product initiation among US youth.

Internalizing and externalizing problems on the age of e-cigarette initiation in youth: Findings from the Population Assessment of Tobacco and Health (PATH), 2013-2017.

Previous research has established an association between internalizing and externalizing problems with e-cigarette use in youth. Secondary analysis of Population Assessment of Tobacco and Health youth waves 1-4(2013-2017). Age of initiation of ever e-cigarette use and age of first report of past 30-day e-cigarette use were prospectively estimated among never e-cigarette users(waves 1-3). Weighted interval-censoring multivariable Cox proportional hazard models were fit to assess differences in each e-cigarette outcome among youth with internalizing and externalizing problems, as well as the interaction between internalizing and externalizing problems, while adjusting for covariates. Weighted interval-censoring survival analyses estimated the age of initiation of ever and age of first report of past 30-day e-cigarette use stratified by internalizing and externalizing problems. Among youth never e-cigarette users, those with high internalizing problems and high externalizing problems had increased risk of initiating ever e-cigarette use at earlier ages compared to youth with none/low internalizing and externalizing problems, respectively. Youth with high internalizing problems and high externalizing problems had increased risk of first reporting past 30-day e-cigarette use at earlier ages compared to youth with none/low internalizing problems, respectively. By age 17, 36.3% of youth with high internalizing problems and 38.5% of youth with high externalizing problems initiated ever e-cigarette use. By age 17, 16.8% of youth with high internalizing and 18.7% of youth with high externalizing problems first reported past 30-day e-cigarette use. Youth with internalizing and externalizing problems should be screened for e-cigarette use and provided with proper resources to prevent onset of e-cigarette use.

Restricting Tobacco Retail Outlets Around Middle and High Schools as a Way to Reduce Tobacco Marketing Disparities: A Simulation Study.

INTRODUCTION: Communities with more people of color and economically disadvantaged residents are disproportionately exposed to tobacco marketing from tobacco companies. This study examined if banning tobacco retail outlets (TROs) within 1000 ft of schools would reduce these marketing disparities through a greater reduction in the amount of tobacco advertising around schools in these communities. METHODS: Data from objectively audited advertisement data from 106 convenience stores and gas stations around 42 middle and high schools located in the four major metropolitan areas of Texas were linked with schools' enrollment data. ArcGIS (Aeronautical Reconnaissance Coverage Geographic Information System) was used to simulate a 1000-ft ban of tobacco sales around the schools. Independent sample T-tests and Mann-Whitney U tests were used to test mean differences where appropriate. RESULTS: Schools with a higher enrollment of Hispanic/Latino (mean = 171.6, SD = 96.9) and economically disadvantaged students (mean = 168.9, SD = 102.3) were surrounded with significantly greater advertising at TROs than schools with lower enrollment of these groups (mean = 82.8, SD = 49.1 and mean = 89.2, SD = 50.6, respectively). A simulated 1000 ft ban of TROs around schools led to greater advertising reduction around schools with a higher enrollment of Hispanic/Latino students (13.3%-29.4% reductions) in comparison to schools with lower Hispanic/Latino student enrollment. However, the more economically disadvantaged schools had a smaller reduction in the number of advertisements (5.9%-21.9% reductions) in comparison to schools with less economically disadvantaged students. CONCLUSION: The implementation of a ban of tobacco sales at TROs within 1000 ft of schools is one policy approach to reduce youth exposure to tobacco marketing, particularly among students of color. STUDY IMPLICATION: Tobacco retail outlets (TROs) around schools with a higher enrollment of Hispanic/Latino and economically disadvantaged students had significantly more tobacco advertisements in comparison to schools with lower enrollment of these student groups. A simulated ban of TROs within 1000 ft of schools led to greater advertising reduction around schools with a higher enrollment of Hispanic/Latino students. For schools with more economically disadvantaged students, the ban led to a smaller reduction in advertisements in comparison to schools with less economically disadvantaged students. This proposed place-based strategy could be a successful means to reduce tobacco advertising and marketing disparity among communities of color.

Desarrollo e instituciones en la década de los sesentas: reflexiones sobre los discursos del Banco Interamericano de Desarrollo en la cumbre de Bogotá (abril de 1968) / Development and institutions in the Sixties: Reflections on the Speeches of the Inter-American Development Bank at the Bogota Summit (April 1968)

Resumen El presente artículo indaga sobre los fundamentos y las características del discurso de desarrollo acuñado por el Banco Interamericano de Desarrollo a finales de la década de los sesenta del siglo pasado en América Latina. La perspectiva histórica que abordó, permitió comprender cómo desde la celebración del encuentro de gobernadores en Bogotá en 1969, el Banco adelantó una acción estratégica en la región basada en reformas institucionales y vinculadas con las agendas gubernamentales alineadas con las políticas de seguridad provenientes de Washington durante la guerra fría.

Abstract: This article investigates the foundations and features of the development discourse coined by the Inter-American Development Bank at the end of the 1960s in Latin America. The historical perspective that it addressed, allowed to understand how since the celebration of the Governorsı meeting in Bogota in 1969, the Bank advanced a strategic action in the region based on institutional reforms and linked to governmental agendas aligned with the security policies coming from Washington during the Cold War.

The Effect of Perceptions of Hookah Harmfulness and Addictiveness on the Age of Initiation of Hookah Use among Population Assessment of Tobacco and Health (PATH) Youth.

Despite the negative health consequence of hookah, hookah risk perceptions are misguided among youth. Secondary data analysis of 12-17-year-old never hookah users at their first wave of PATH participation (2013-2019) was performed. The effect of perceptions of hookah harmfulness and addictiveness on the age of initiation ever, past 30-day, and fairly regular hookah use were estimated using interval-censored Cox proportional hazards models. The distribution of the age of initiation of hookah outcomes by perception levels of harmfulness and addictiveness are reported as cumulative incidence and 95% CI. Youth who perceived hookah to be neither harmful nor addictive were 173% more likely to initiate ever, 166% more likely to first report past 30-day use, and 142% more likely to first report fairly regular hookah use at earlier ages compared to youth who considered hookah to be both harmful and addictive. By age 18, 25.5% of youth who perceived hookah as neither harmful nor addictive were estimated to initiate ever hookah use while 9.3% of youth who perceived hookah as harmful and addictive were estimated to initiate ever hookah use. These findings indicate the need to provide prevention and education campaigns to change perceptions of the harmfulness and addictiveness of hookah to delay the age of initiation of hookah use.

The Longitudinal Impact of Seeing and Posting Tobacco-related Social Media on Tobacco Use Behaviors Among Youth (Aged 12-17): Findings From the 2014-2016 Population Assessment of Tobacco and Health (PATH) Study.

Introduction: This study examined the impact of seeing and posting tobacco-related content on social media on tobacco use outcomes in youth. Methods: Longitudinal secondary analyses of youth in the nationally representative 2014-2015 Population Assessment of Tobacco and Health (PATH) study were conducted to examine the association between the interaction of (i) seeing and (ii) posting tobacco-related social media content with previous ever use of each tobacco product, and 3 outcomes in 2015-2016: past 30-day e-cigarette use, past 30-day combustible product use, and past 30-day dual use of e-cigarettes and at least one combustible product. Six weighted multiple logistic regression models (2 interaction exposures*3 outcomes) were used to assess these associations, while adjusting for covariates. Results: Among youth never users in 2014-2015, seeing tobacco-related social media content was significantly associated with past 30-day e-cigarette use (AOR 1.92; 95% CI= 1.36-2.71), and past 30-day dual use of e-cigarettes and at least one combustible product (AOR= 2.11; 95% CI= 1.08- 4.13) in 2015-2016. Among youth ever users in 2014-2015, posting tobacco-related content on social media was significantly associated with all 3 outcomes: past 30-day day e-cigarette use (AOR= 2.09;95%CI=1.23-3.55), past 30-day combustible product use (AOR=2.86; 95%CI=1.67-4.88), and past 30-day dual use of these products (AOR=3.02;95%CI=1.45-6.31), after adjusting for covariates. Conclusions: Seeing and posting tobacco-related content on social media predicts tobacco use among youth, nationwide. Results suggest that interventions and policies prohibiting tobacco-related content on social media are needed to curb the impact of social media on youth tobacco-use.

Progress in Metabolic Studies of Gastric Cancer and Therapeutic Implications.

BACKGROUND: Worldwide, gastric cancer is ranked the fifth malignancy in incidence and the third malignancy in mortality. Gastric cancer causes an altered metabolism that can be therapeutically exploited. OBJECTIVE: The objective of this study is to provide an overview of the significant metabolic alterations caused by gastric cancer and propose a blockade. METHODS: A comprehensive and up-to-date review of descriptive and experimental publications on the metabolic alterations caused by gastric cancer and their blockade. This is not a systematic review. RESULTS: Gastric cancer causes high rates of glycolysis and glutaminolysis. There are increased rates of de novo fatty acid synthesis and cholesterol synthesis. Moreover, gastric cancer causes high rates of lipid turnover via fatty acid ß-oxidation. Preclinical data indicate that the individual blockade of these pathways via enzyme targeting leads to antitumor effects in vitro and in vivo. Nevertheless, there is no data on the simultaneous blockade of these five pathways, which is critical as tumors show metabolic flexibility in response to the availability of nutrients. This means tumors may activate alternate routes when one or more are inhibited. We hypothesize there is a need to simultaneously block them to avoid or decrease the metabolic flexibility that may lead to treatment resistance. CONCLUSION: There is a need to explore the preclinical efficacy and feasibility of combined metabolic therapy targeting the pathways of glucose, glutamine, fatty acid synthesis, cholesterol synthesis, and fatty acid oxidation. This may have therapeutical implications because we have clinically available drugs that target these pathways in gastric cancer.

Age of initiation of smokeless tobacco use among young adults: Findings from the population assessment of tobacco and health (PATH) study, 2013-2017.

INTRODUCTION: Smokeless tobacco (SLT) use, across all age groups, is most prevalent among young adults in the US. A study estimating the age of initiation of SLT use among young adults is needed amid the changing landscape of tobacco products. METHODS: Secondary analyses of PATH young adults across waves 1-4 were conducted. A total of 10595 young adults who were never SLT users at their first wave of adult participation in PATH (waves 1-3) were included in the analysis. Age of initiation outcomes of ever, past 30-day, and fairly regular SLT use, were assessed prospectively in waves 2-4. Interval censoring Cox regression models were used to assess differences in the age of initiation of each outcome by sex and race/ethnicity, adjusting for other tobacco product use. RESULTS: By the age of 27 years, 4.9%, 3.0%, and 1.9% of young adults reported initiating ever, past 30-day, and fairly regular SLT use, respectively. After controlling for demographic factors and other tobacco use, males initiated each of the SLT outcomes at earlier ages than females; non-Hispanic Blacks initiated each of the SLT use at later ages than non-Hispanic Whites; and Hispanic and non-Hispanic others initiated ever use at later ages than non-Hispanic Whites. CONCLUSIONS: These data suggest that three young adult groups are more likely to initiate use of SLT at earlier ages: males, non-Hispanic Whites, and poly-tobacco users. Knowing the age of SLT initiation outcomes among young adults will educate the public domain, inform SLT use prevention campaigns, and provide a baseline to measure the success of the Tobacco 21 legislation from December 2019.