The relationship between comprehensive geriatric assessment on the pneumonia prognosis of older adults: a cross-sectional study.

BACKGROUND: The mortality of pneumonia in older adults surpasses that of other populations, especially with the prevalence of coronavirus disease 2019 (COVID-19). Under the influence of multiple factors, a series of geriatric syndromes brought on by age is one of the main reasons for the poor prognosis of pneumonia. This study attempts to analyze the impact of geriatric syndrome on the prognosis of pneumonia. METHODS: This is a prospective cross-sectional study. Patients over 65 years old with COVID-19 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative community-acquired pneumonia (SN-CAP) were included in the research. General characteristics, laboratory tests, length of stay (LOS), and comprehensive geriatric assessment (CGA) were collected. Multivariate regression analysis to determine the independent predictors of the severity, mortality, and LOS of COVID-19. At the same time, the enrolled subjects were divided into three categories by clustering analysis of 10 CGA indicators, and their clinical characteristics and prognoses were analyzed. RESULTS: A total of 792 subjects were included in the study, including 204 subjects of SN-CAP (25.8%) and 588 subjects (74.2%) of COVID-19. There was no significant difference between non-severe COVID-19 and SN-CAP regarding mortality, LOS, and CGA (P > 0.05), while severe COVID-19 is significantly higher than both (P < 0.05). The Barthel Index used to assess the activities of daily living was an independent risk factor for the severity and mortality of COVID-19 and linearly correlated with the LOS (P < 0.05). The cluster analysis based on the CGA indicators divided the geriatric pneumonia patients into three groups: Cluster 1 (n = 276), named low ability group, with the worst CGA, laboratory tests, severity, mortality, and LOS; Cluster 3 (n = 228), called high ability group with the best above indicators; Cluster 2 (n = 288), named medium ability group, falls between the two. CONCLUSION: The Barthel Index indicates that decreased activities of daily living are an independent risk factor for the severity, mortality, and LOS of geriatric COVID-19. Geriatric syndrome can help judge the prognosis of pneumonia in older adults.

Spatio-temporal pattern and the evolution of the distributional dynamics of county-level agricultural economic resilience in China.

Because the complexity of the external environment has put great pressure on the agricultural economy, making it vulnerable, it is necessary to promote a system of resilience in the agricultural economy so that Chinese agriculture can continue to persevere in the face of serious external uncertainties. Therefore, this paper investigates the spatio-temporal pattern and evolution of the distributional dynamics of China's county-level agricultural economic resilience based on 2000-2020 data covering 2,545 counties. The results are as follows: first, from 2000 to 2020, the mean value of China's county-level agricultural economic resilience showed an obvious upward trend, which indicates that China's agricultural economy gradually increased its ability to resist risks and continued to develop in a favourable manner. Specifically, the county-level agricultural economic resilience index of the northeast region grew the most significantly, while the index of county units in the western region was relatively low. Second, the centre of gravity of the spatial distribution of China's agricultural economic resilience gradually migrated to the northwest, showing a dominant direction from northeast to southwest and a tendency to develop from southeast to northwest. Third, the spatial differences in China's agricultural economic resilience generally showed an upward trend, while county-level differences were the main source of the overall differences, followed by inter-provincial differences, inter-municipal differences and inter-regional differences. Additionally, the contribution of county-level differences to the overall differences fluctuated within the range of 54%-58%. Fourth, there is a possibility of localized convergence in China's agricultural economic resilience, which is continuous in spatial effects and has obvious positively correlated spatial effects at different times and in different county spaces.

Recruiting Latino young adults into a vaping cessation study via social media: Feasibility and cost analysis.

INTRODUCTION: This study aims to assess the feasibility and cost of recruiting young Latino adults (aged 18-25 years) to participate in a vaping cessation study via social media and to describe the baseline characteristics of participants enrolled via social media. METHODS: Paid advertisements were launched using the Meta Ads platform, which serves ads to users on Facebook and Instagram. Key measures of audience targeting included ages 18-25 years, all genders, and the following interests: 'electronic cigarettes', 'vape', 'Latin pop', and 'Latin music'. The advertisements invited young Latino adults to join a text messaging vaping cessation study. By clicking on the advertisements, interested individuals were directed to a website to fill in a contact form. The study team contacted individuals who filled in the form, assessed them for study eligibility, and, if eligible, enrolled them in the study. RESULTS: A total of 164 individuals completed the contact form, and 26 were successfully enrolled in the study. The enrollment efficiency ratio was 15.9% (26/164). The cost per enrollment was US$94.14. The participants' mean age was 22.7 years (SD=1.6). Half of the participants (50%) were male, 38.5% were female, and 11.5% were gender non-conforming/non-binary. Two-thirds of the participants (69.2%) were born in the US, 23.1% in Puerto Rico, and 7.7% in Mexico. Eight participants (30.7%) selected Spanish as their language of preference. In terms of the type of vaping device, 16 participants (61.5%) indicated using disposables, 6 (23.1%) cartridges/pods, and 4 (15.4%) tanks/refillable. Sixteen participants (61.5%) reported using marijuana in e-cigarettes. Six participants (23.1%) had high e-cigarette dependence. Twenty participants (76.9%) had attempted to quit e-cigarettes in the past year. CONCLUSIONS: It is feasible to recruit young Latino adults for a vaping cessation study via social media. Social media offers a relatively low-cost approach to recruiting a diverse sample of Latino young adults who vape.

The economic effect of financial compensation in China's healthcare system: comprehensive insights regarding supply and demand factors.

OBJECTIVES: We aim to analyse the effects of government subsidies on residents' health and healthcare expenditure from the perspectives of supply and demand. DATA AND METHODS: According to the regional division adopted in the data query system of the National Bureau of Statistics, this study divides 31 provinces and cities into three regions: eastern, central, and western. The data used are from public databases, such as the "China Statistical Yearbook," "China Health Statistical Yearbook," and "Government Final Account Report". In this study, mathematical model derivation is used to construct a fixed effects model, and an empirical study based on cross-sectional data and general linear regression is conducted. To prevent endogeneity issues, this study introduces instrumental variables and uses 2SLS regression to further analyse the output results. RESULTS: For every 1% increase in supplementary funding on the supply side, the perinatal mortality rate decreases by 1.765%, while for every 1% increase in financial compensation on the demand side, per capita outpatient expenses increase by 0.225% and per capita hospitalization expenses increase by 0.196%. Regarding medical resources, for every 1% increase in the number of beds per 1,000 people, per capita hospitalization expenses decrease by 0.099%. In the central and eastern regions, where economic levels are higher, supply-side government funding is more effective than demand-side funding. In contrast, demand-side funding is more effective in the western region. CONCLUSIONS: The roles of multiple influencing factors and significant regional heterogeneity are clarified. Increasing financial compensation to providers positively impacts perinatal mortality but leads to higher per capita outpatient and hospital expenditures. Finally, this study provides targeted policy recommendations and solid theoretical support for policymakers.

Radioactivity of inert construction and demolition waste from Hong Kong and environmental assessment for marine trial reclamation in Guanghai Bay.

Inert construction and demolition waste from Hong Kong (HK public fills) has been used for marine trial reclamation in the Guanghai Bay (GHWT) of the Chinese Mainland. However, an environmental assessment of HK public fills is necessary due to higher radioactivity in HK soils than typical global levels. Here, radiation dose rate, gamma radionuclides and gross beta of HK public fills were analyzed. The origin information was explored using natural primordial radionuclides as fingerprints. Our data show that radiation dose rate of HK public fills before disposal was 0.14-0.54 (0.33 ± 0.03) µSv/h (n = 16,722 data with 2787 ships) in 2014, which is less than the GHWT background. Monthly detection of 238U, 226Ra, 210Pb, 232Th, 228Th, 40K, and gross beta in HK public fills was conducted on three random ships. Their specific activities were <6.27-155.5, 58.7-98.7, <7.83-238.2,97.9-168.6, 87.1-136.0, 463.1-1,018, and 1047-1658 Bq/kgDW, respectively. These results suggest that the radioactivity levels of HK public fills are essentially the same as the GHWT background. The study assessed potential risks using various indices icluding Raeq (Radium equivalent activity), Hex (External radiation hazard index), Hin (Internal radiation hazard index), Iγ (Gamma index), AUI (Activity utilization index), AUI (Activity utilization index), E (Annual effective dose), AGDE (Annual gonadal dose equivalent), RLI (Representative level index), Din (Indoor air absorbed dose rate), Dout (Outdoor air absorbed dose rate), and ELCR (Excess lifetime cancer risk). The study suggests that HK public fills should be used for the trial reclamation rather than building-house materials. This provides valuable insights for the resource utilization and minimizing environmental pollution of HK public fills. The aim is to offer fundamental technical assistance for future waste resource utilization, ecological protection, and restoration in the Guangdong-Hong Kong-Macao Greater Bay Area.

Fertility care for all: impact of New York State's Medicaid expansion on infertility care.

PURPOSE: To assess whether the New York State (NYS) mandate expanding Medicaid coverage of fertility diagnostic testing and treatment is successfully increasing patient access to and utilization of fertility care. METHODS: A retrospective chart review was performed of NYS Medicaid patients who presented for fertility services to a large academic reproductive endocrinology and infertility (REI) clinic. Information on patient demographics, medical history, diagnostic testing, treatments, and outcomes was collected. Patients presenting to the clinic in the 1 year prior to the mandate (October 1, 2018-September 30, 2019) were compared to patients presenting in the 1 year after the mandate (October 1, 2019-September 30, 2020). Primary outcomes of the study were differences in presentation to the clinic between the two cohorts and differences in utilization of infertility diagnostic testing and treatment. Secondary outcomes were differences in treatment outcomes. RESULTS: A significantly larger percentage of Medicaid patients presented to the clinic for fertility assessment post-mandate (22%) as compared to pre-mandate (9%, p < 0.05). There were no demographic differences between the pre- and post-mandate patient groups. A similar percentage of patients completed diagnostic testing pre- vs. post-mandate. Post-mandate patients underwent more treatment cycles with ovulation induction medications compared to natural treatment cycles. There was no significant difference in pregnancy rates pre- vs. post-mandate. CONCLUSION: The NYS Medicaid mandate allowed a significantly larger percentage of Medicaid patients to present for fertility evaluation. The patients in the post-mandate cohort underwent more treatment cycles with ovulation induction medications compared to natural cycles.

Assessment of left ventricular energy loss in patients with mild coronary artery stenosis by using vector flow mapping combined with exercise stress echocardiography.

OBJECTIVES: To evaluate the left ventricular energy loss (EL), energy loss reserve (EL-r), and energy loss reserve rate in patients with mild coronary artery stenosis by using vector flow mapping (VFM) combined with exercise stress echocardiography. METHODS: A total of 34 patients (case group) with mild coronary artery stenosis and 36 sex and age matched patients (control group) without coronary artery stenosis according to coronary angiogram were prospectively enrolled. The total energy loss (ELt), basal segment energy loss (ELb), middle segment energy loss (ELm), apical segment energy loss (ELa), energy loss reserve (EL-r), and energy loss reserve rate were recorded in the isovolumic systolic period (S1), rapid ejection period (S2), slow ejection period (S3), isovolumic diastolic period (D1), rapid filling period (D2), slow filling period (D3), and atrial contraction period (D4). RESULTS: Compared with the control group, some of the EL in the resting case group were higher; some of the EL in the case group were lower after exercise, and those during D1 ELb and D3 ELb were higher. Compared with the resting state, the total EL and the EL within the time segment in the control group were higher after exercise, except during D2 ELb. In the case group, except for during D1 ELt, ELb and D2 ELb, the total and segmental EL of each phase was mostly higher after exercise (p < .05). Compared with the control group, most of the EL-r and EL reserve rates in the case group were lower (p < .05). CONCLUSION: The EL, EL-r, and energy loss reserve rate have a certain value in the evaluation of cardiac function in patients with mild coronary artery stenosis.

Efficiency evaluation of urban employee's basic endowment insurance expenditure in China based on a three-stage DEA model.

With the deepening of population aging, the expenditure of basic endowment insurance in China is increasing. The urban employees' basic endowment insurance(UEBEI) system for is an important part of China's basic social endowment insurance system, which is the most important institutional guarantee for the basic needs of employees after retirement. It not only relates to the living standards of retired employees but also relates to the stability of the whole society. Especially considering the acceleration of urbanization process, the financial sustainability of the basic endowment insurance for employees is of great significance for safeguarding the pension rights of retired employees and realizing the normal operation of the whole system, and the operation efficiency of urban employees' basic endowment insurance(UEBEI) fund inevitably becomes the focus of increasing attention. Based on the panel data of 31 provinces in China from 2016 to 2020, this paper established a three-stage DEA-SFA model, and compared the differences of comprehensive technical efficiency, pure technical efficiency and scale efficiency with radar chart, aiming to explore the operating efficiency of the UEBEI in China and how environmental factors affect it. The empirical results show that at present, the overall level of the expenditure efficiency of the UEBEI fund for urban workers is not high, and all provinces have not reached the efficiency frontier level, and there is still a certain space for efficiency improvement. Fiscal autonomy and elderly dependency ratio are negatively correlated with fund expenditure efficiency, while urbanization level and marketization level are positively correlated with fund expenditure efficiency. The regional difference of fund operation efficiency is significant, from high to low, it is East China, Central China and West China. Reasonable control of environmental variables and narrowing of regional economic development and fund expenditure efficiency differences can provide some enlightenment for better realization of common prosperity.

Public Perceptions of the Food and Drug Administration's Proposed Rules Prohibiting Menthol Cigarettes on Twitter: Observational Study.

BACKGROUND: On April 28, 2022, the Food and Drug Administration (FDA) proposed rules that prohibited all menthol-flavored cigarettes and other flavored cigars to prevent the initiation of tobacco use in youth and reduce tobacco-related diseases and death. OBJECTIVE: The objective of this study was to investigate public perceptions of the FDA's proposed menthol cigarette rules on Twitter. METHODS: Through the Twitter streaming application programming interface, tobacco-related tweets were collected between April 28, 2022, and May 27, 2022, using a set of keywords, such as smoking, cigarette, and nicotine. Furthermore, 1941 tweets related to the FDA's proposed menthol cigarette rules were extracted. Based on 300 randomly selected example tweets, the codebook for the attitudes toward the FDA's proposed rules and related topics was developed by 2 researchers and was used to label the rest of the tweets. RESULTS: Among tweets related to the FDA's proposed menthol cigarette rules, 536 (27.61%) showed a positive attitude, 443 (22.82%) had a negative attitude, and 962 (49.56%) had a neutral attitude toward the proposed rules. Social justice (210/536, 39%) and health issues (117/536, 22%) were two major topics in tweets with a positive attitude. For tweets with a negative attitude, alternative tobacco or nicotine products (127/443, 29%) and racial discrimination (84/536, 16%) were two of the most popular topics. CONCLUSIONS: In general, the public had a positive attitude toward the FDA's proposed menthol cigarette rules. Our study provides important information to the FDA on the public perceptions of the proposed menthol cigarette rules, which will be helpful for future FDA regulations on menthol cigarettes.

How do carbon emissions, economic growth, population growth, trade openness and employment influence food security? Recent evidence from the East Africa.

East Africa has a substantially greater rate of food insecurity than other regions of the world. Scenarios of climate change and other macroeconomic variables are important contributors to food insecurity in East Africa. Using data spanning from 1990 to 2020, this study looked into the influence of carbon dioxide (CO2) emissions, economic growth, population growth, trade openness, and agricultural employment on food security in the East Africa. The fully modified ordinary least square (FMOLS) and dynamic ordinary least square (DOLS) models were used in this study. The heterogeneous panel cointegration test's findings indicated that the study variables have an equilibrium long-term connections. The estimation findings from the FMOLS and DOLS models showed that an increase in CO2 emissions increases food security in the East Africa over the long term. According to other findings, long-term food security is positively impacted by economic expansion, population growth, trade openness, and employment in agriculture. However, trade openness has a detrimental long-lasting effect on food security. Future research directions, research limitations, and policy implications are discussed.

Reliability and Validity of the Repeatable Battery for Assessment of Neuropsychological Status Scale in Evaluation of Vascular Cognitive Impairment in Elderly Han Population.

Introduction: Vascular cognitive impairment (VCI) and Alzheimer's disease are the most common cognitive impairment diseases in the elderly. This study aimed to apply the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) scale to evaluate VCI in elderly patients and analyze its reliability and validity. Methods: We enrolled 278 VCI patients admitted to our hospital, from June 2017 to June 2018. The basic clinical information of each patient was documented, and the Mini-Mental State Examination (MMSE) and the RBANS scales were suggested to complete. Results: We found significant correlations between the RBANS total score and age, diabetes, hypertension, coronary heart disease and years of education. The internal consistency of the RBANS scale Cronbach αsuggested a good agreement with the total score and the single score at two time points. Moreover, the RBANS total score and the score of each dimension in the RBANS scale were positively correlated with the MMSE immediate memory, calculation ability, delayed memory, commanding ability, reading comprehension ability, command execution, sentence making, and pattern duplicating ability. Conclusion: In conclusion, the RBANS has good reliability and validity for the assessment of cognitive dysfunction in elderly VCI patients. It can be used as a routine clinical and research tool, for the simplicity in operation and superior acceptance.

Assessment and Implication of PAHs and Compound-Specific δ13C Compositions in a Dated Marine Sediment Core from Daya Bay, China.

PAHs in a sediment core covering ~120 years from Daya Bay in South China Sea were extracted using Soxhlet and high performance thin layer chromatography, and the compound-specific δ13C were analyzed using gas chromatography-combustion-isotopic ratio mass spectrometry. The concentrations of PAHs ranged from 99.3 to 676 ng g-1, with high molecular weight PAHs as a key component. PAHs' compound-specific δ13C ranged from -35.02‱ to -16.14‱. The patterns of 16 PAHs, molecular ratios, and compound specific δ13C compositions indicate important pyrolytic and petrogenic sources: PAHs derived predominantly from pyrogenic sources (including coal and wood incomplete combustion) before the 1960s, while after the 1960s, they derived predominantly from mixed pyrogenic and petrogenic sources (including automotive exhaust emissions, oil spills, and coal and wood incomplete combustion). Our results can provide important insights into organic pollution emissions influenced by human activities and the urbanization of Daya Bay.

Marine Debris in the Beilun Estuary Mangrove Forest: Monitoring, Assessment and Implications.

A modified approach for marine debris investigation in mangrove forests is developed, including some practical programs, viz., sampling location, time, area, materials, size and sources data processing. The marine debris method was practiced in the Beilun Estuary mangrove forest region in Fangchenggang in 2019, viz., the debris items were classified, counted, weighed and recorded, and the marine debris pollution was assessed to understand the impact of human activities. The results show that the mass density is 21.123 (2.355~51.760) g/m2, and more than 90% came from the land-based and human activities. More than 60% of the total debris weights are plastics, followed by fabrics (17.91%) and Styrofoam (10.07%); the big-size and oversize debris account for 76.41% and 13.33%, respectively. The quantity density is 0.163 (0.013~0.420) item/m2, and ~95% came from land-based human activities. More than 75% of the total debris items were plastics, followed by Styrofoam (14.36%), fabrics (4.10%) and glass (3.59%); the big-size, medium-size and oversize debris are 76.41%, 13.33% and 10.26%, respectively. The results suggest that mangrove forests are barriers for the medium-/big-size marine debris, acting as traps for marine debris. Our study provides recommendations and practical guidance for establishing programs to monitor and assess the distribution and abundance of marine debris. The results show that mangrove areas in the Beilun Estuary are filled with some plastic debris (plastics plus Styrofoam) and that the density and type at Zhushan and Rongshutou near the China-Vietnam border are more than those at Shijiao and Jiaodong. The results of this study are also expected to not only provide baseline data for the future assessment of Beilun Estuary mangroves but also to help China and Vietnam strengthen marine land-based pollution control and promote coastal wetland and mangrove conservation, marine species conservation and sustainable use.

Blepharochalasis: clinical and epidemiological characteristics, surgical strategy and prognosis-- a retrospective cohort study with 93 cases.

BACKGROUND: Blepharochalasis is a rare eyelid disorder but eventually leading to destructive eyelid deformation. Until now the clinical and epidemiological data are unavailable. This study aimed to report the manifestations, epidemiological characteristics and surgical strategy of a large series of blepharochalasis patients with long-term follow-up. The prognosis of different clinical deformities was also investigated. METHODS: This was a retrospective cohort study, including consecutive patients diagnosed with blepharochalasis in a single center. Blepharoplasty and other surgical approaches were performed according to manifestations, after a 2-year quiescent period with no recurrent attacks and exacerbation of lesions. Prognosis after surgery was recorded. RESULTS: A total of 93 patients, with a mean age of 30.77 ± 14.04 (range: 9.00-70.00) years were included. Of all those 93 patients, 72.04% were females (67, P = 0.02). The mean follow-up was 5.29 ± 2.07 (range: 3-10) years before surgery, and 2.07 (range:1.54-4.22)years follow-up after surgery. The mean age of onset of blepharochalasis symptoms was 10.09 ± 3.32 (range: 5-16) years, and 83.87% patients got symptoms in puberty. With an average of 5 times per year, the mean duration of each acute attack was 28.12 ± 1.01 (rang: 2-192) hours. The mean duration from the onset of acute attack to the quiescent stage lasted for 7.33 ± 2.05 (range: 4-10) years. Most of the cases (88, 94.62%) had more than one manifestation at the end of the last follow-up before surgery. Ptosis (48.39%) was the most common deformity. Followed by lacrimal gland prolapse (44.09%), canthal angle deformity (29.04%), lower eyelid retraction (17.20%). After surgery, the functional and cosmetically acceptable results were achieved in all patients except for overcorrection in 5 (11.90%) patients with ptosis. The lacrimal gland prolapse recurred in two (4.00%) patients at 29 and 36 months after surgery. CONCLUSIONS: Blepharochalasis is rare but mostly occurred in adolescent females. The process from the onset to the stable stage usually lasted for about 7 years, which might be associated with the onset of puberty. Surgical management of clinical manifestations after at least 2-year follow-up period of quiescence would be appropriate in order to observe a great plastic effect, low overcorrection and recurrence rate.

Assessment of Radioactivity Level in the Terrestrial and Marine Organisms in Yangjiang and Its Adjacent Areas (China).

In order to assess the radioactive level in the terrestrial and marine organisms in Yangjiang and the adjacent areas, 90Sr, gross beta and gamma-emitting radionuclides (238U, 226Ra, 228Th, 226Ra, 40K, 137Cs, 51Cr, 55Fe, 54Mn, 58Co, 60Co and 65Zn) were analyzed from 2011 to 2012. The annual effective doses were estimated in the high natural radioactive background areas in Yangjiang (HBRAYJ). The specific activities of 238U, 228Th, 226Ra, 40K and 137Cs in all organisms were <0.05-5.20, 0.30-14.50, 0.11-3.58, 11.1-148.0 and <0.003-0.088 Bq/kg, whilst 51Cr, 55Fe, 54Mn, 58Co, 60Co, 65Zn and 110mAg were below the minimum detectable activity. 90Sr and gross beta specific activities were 20.0-143.0 and 0.021-0.316 Bq/kg. Results show that 228Th was significantly higher than 238U and 226Ra of natural U series in organisms due to the rich-Th soils in the HBRAYJ; 228Th, 226Ra, 40K, 137Cs and 90Sr were greatly lower than the limited concentrations in Chinese foods. The internal dose mainly contributes to natural 40K, 226Ra and 228Th. It is useful to provide some basic data and assess the radiological risk from the HBRAYJ and Yangjiang nuclear power plants in future.

Cross-Sectional Associations of Smoking and E-cigarette Use with Self-Reported Diagnosed Hypertension: Findings from Wave 3 of the Population Assessment of Tobacco and Health Study.

Following their introduction a decade ago, electronic cigarettes (e-cigarettes) have grown in popularity. Given their novelty, knowledge of the health consequences of e-cigarette use remains limited. Epidemiologic studies have not comprehensively explored associations between e-cigarette use and hypertension, a highly prevalent health condition and major contributor to cardiovascular disease burden. In this study, cross-sectional associations of cigarette smoking and e-cigarette use (vaping) with self-reported diagnosed hypertension were evaluated among 19,147 18-55 year old respondents in Wave 3 (2015-2016) of the Population Assessment of Tobacco and Health Study. Multivariable analyses first modeled smoking and vaping as separate 2-category variables, then as a 6-category composite variable accounting for former smoking. After adjusting for potential confounders, current vaping (aOR = 1.31; 95%CI: 1.05-1.63) and current smoking (aOR = 1.27; 95%CI: 1.10-1.47) were both associated with higher odds of hypertension. In analyses modeling smoking and vaping compositely, respondents who were concurrently smoking and vaping had the highest odds of hypertension (aOR = 1.77; 95%CI: 1.32-2.39 [referent: never smokers]). These results differ somewhat from prior epidemiologic studies of vaping and respiratory outcomes, which consistently report smaller point estimates for current vaping than for current smoking. Our findings reinforce the uncertainty surrounding long-term health consequences of vaping, as well as highlight important distinctions between respiratory and cardiovascular outcomes when considering the harm reduction potential of e-cigarettes.

Three-dimensional periorbital asymmetry assessment of congenital microphthalmia children with a structured light 3D scanning system.

Congenital microphthalmia is a rare phenotype characterized by eye growth retardation. Due to the lack of eyeball stimulation, children suffering from congenital microphthalmia always have bony orbital maldevelopment, which leads to facial asymmetry. In the present study, a structured light 3D scanning system was used as a novel method to measure the three-dimensional periorbital asymmetry in children with congenital microphthalmia. Children with unilateral congenital microphthalmia of 0-6 years old were enrolled in the present study. All participants underwent an ultrasound scan to measure the axial length, and accepted the structured light 3D scanning system for their periorbital appearance. The degree of periorbital asymmetry was evaluated using 17 facial landmarks within a three-dimensional cartesian coordinate system (the X-axis represented the horizontal direction, the Y-axis represented the vertical direction, and the Z-axis represented the sagittal direction). Paired student t-test and ANOVA were used in the present study. A three-dimensional periorbital topography was also established to further illustrate the periorbital asymmetry. A total of 67 children were recruited, which included 31 boys and 34 girls. The axial length on the affected side (12.28 ± 3.35 mm) was generally smaller than that on the unaffected side (20.54 ± 1.65 mm, P < 0.001). When grouped by age, the periorbital asymmetry mainly manifested in the Y-axis and Z-axis directions. The unaffected side had a higher orbitale superior (5.09 ± 0.35 vs. 3.02 ± 0.30, P < 0.001) and a lower orbitale inferior (-19.52 ± 0.51 vs. -16.90 ± 0.53, P < 0.001) in 0-1 year old group. Same performances were also found in the 1-3 and 3-6 age groups. When grouped according to the proportion of axial length on the bilateral sides, seven of the 12 Y-values and all 12 Z-values had statistical differences. The structured Light 3D scanning system may serve as a beneficial complementary tool for computed tomography, in order to better understand the periorbital deformities caused by congenital microphthalmia.

Age-Dependent Assessment of Genes Involved in Cellular Senescence, Telomere, and Mitochondrial Pathways in Human Lung Tissue of Smokers, COPD, and IPF: Associations With SARS-CoV-2 COVID-19 ACE2-TMPRSS2-Furin-DPP4 Axis.

BACKGROUND: Aging is one of the key contributing factors for chronic obstructive pulmonary diseases (COPD) and other chronic inflammatory lung diseases. Here, we determined how aging contributes to the altered gene expression related to mitochondrial function, cellular senescence, and telomeric length processes that play an important role in the progression of COPD and idiopathic pulmonary fibrosis (IPF). METHODS: Total RNA from the human lung tissues of non-smokers, smokers, and patients with COPD and IPF were processed and analyzed using a Nanostring platform based on their ages (younger: <55 years and older: >55 years). RESULTS: Several genes were differentially expressed in younger and older smokers, and patients with COPD and IPF compared to non-smokers which were part of the mitochondrial biogenesis/function (HSPD1, FEN1, COX18, COX10, UCP2 & 3), cellular senescence (PCNA, PTEN, KLOTHO, CDKN1C, TNKS2, NFATC1 & 2, GADD45A), and telomere replication/maintenance (PARP1, SIRT6, NBN, TERT, RAD17, SLX4, HAT1) target genes. Interestingly, NOX4 and TNKS2 were increased in the young IPF as compared to the young COPD patients. Genes in the mitochondrial dynamics and quality control mechanisms like FIS1 and RHOT2 were decreased in young IPF compared to their age matched COPD subjects. ERCC1 and GADD45B were higher in young COPD as compared to IPF. Aging plays an important role in various infectious diseases including the SARS-CoV-2 infection. Lung immunoblot analysis of smokers, COPD and IPF subjects revealed increased abundance of proteases and receptor/spike protein like TMPRSS2, furin, and DPP4 in association with a slight increase in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor ACE2 levels. CONCLUSIONS: Overall, these findings suggest that altered transcription of target genes that regulate mitochondrial function, cellular senescence, and telomere attrition in the pathobiology of lung aging in COPD and IPF is associated with alterations in SARS-CoV-2 ACE2-TMPRSS2-Furin-DPP4 axis as pharmacological targets for COVID-19.

Association of flavored electronic nicotine delivery system (ENDS) use with self-reported chronic obstructive pulmonary disease (COPD): Results from the Population Assessment of Tobacco and Health (PATH) study, Wave 4.

INTRODUCTION: Flavors other than tobacco flavor have been identified as a major reason for electronic nicotine delivery system (ENDS) initiation in youth and are thought to contribute to the continued use of ENDS in users of all ages. Our previous research showed a significant association between overall ENDS use and COPD. This study aims to identify the association of ENDS flavor categories with self-reported COPD. METHODS: The data analysis included 4909 adults from Population Assessment of Tobacco and Health (PATH) Wave 4 data who were ever established ENDS users and responded to an item about diagnosis of COPD. Weighted multivariable logistic regression models were used to examine the association between different ENDS flavors and self-reported COPD considering complex sampling design. RESULTS: Among 4909 ever established ENDS users, 418 adults (weighted percentage 9.8%) had self-reported COPD. Self-reported COPD prevalence differed between different ENDS flavor categories, with the highest (weighted percentage 19.9%) occurring among tobacco flavor users. Compared to non-tobacco flavor categories, tobacco flavor category showed significantly higher association with self-reported COPD (AOR=2.05; 95% CI: 1.20-3.53), after adjusting for potential confounding variables. No significant associations with self-reported COPD were found for other examined ENDS flavor categories including menthol/mint, fruit, candy/ desserts/other-sweets, and other flavors, compared to their corresponding non-users. CONCLUSIONS: Tobacco flavored ENDS use was significantly associated with self-reported COPD. Future studies are needed to confirm the biological and epidemiological association of flavored ENDS use with COPD.

Home smoking and vaping policies among US adults: results from the Population Assessment of Tobacco and Health (PATH) study, wave 3.

We examined the prevalence of home smoking and vaping restrictions among US adults, and compared home policy differences for smoking and vaping among vapers, smokers, and dual users. Secondary data from the Population Assessment of Tobacco and Health (PATH) Study Wave 3 (2015-2016) with 28,148 adults were analyzed using weighted multivariable logistic regression models that account for complex sampling design to compare differences in home policies among non-users, vapers only, smokers only, and dual users. Compared to never-users, current vapers who were ex-smokers and dual users were more likely to allow home vaping (aOR = 11.06, 95% CI: 8.04-15.21; aOR = 6.44, 95% CI: 5.01-8.28) and smoking (aOR = 1.62, 95% CI: 1.19-2.22; aOR = 3.58, 95% CI: 2.88-4.45). Current smokers were more likely to allow vaping (aOR = 3.53, 95% CI: 3.06-4.06) and smoking (aOR = 4.27, 95% CI: 3.73-4.89) inside the home than never-users. Current vapers who never smoked were more likely to allow vaping inside the home than never-users (aOR = 2.45, 95% CI: 1.53-3.93). Vapers reported much lower rates of vape-free home policies relative to both their smoke-free home policies and to vape-free home policies among smokers. Vapers may be using e-cigarettes in hopes of harm reduction, but interpreting "harm reduction" as safe, thus exposing non-users in their homes to second- and thirdhand aerosols. This underscores the need to healthcare providers to extend intervention with vapers to include implementing vape-free home policies.