Factors associated with the intrinsic capacity in older adults: A scoping review.

INTRODUCTION: In 2015, the term 'intrinsic capacity' (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain. AIM: We aim to synthesise the factors connected with IC. METHODS: This scoping review followed the five-stage framework of Arksey and O'Malley and was reported using PRISMA-ScR guidelines. RESULTS: In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults. CONCLUSIONS: This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults. RELEVANCE TO CLINICAL PRACTICE: The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well-being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline. NO PATIENT OR PUBLIC CONTRIBUTION: As this is a scoping review, no patient or public contributions are required.

Risk assessment of nitrate groundwater contamination using GIS-based machine learning methods: A case study in the northern Anhui plain, China.

Long-term agricultural activities have affected the sustainable development of groundwater in the Northern Anhui Plain, East China. It is, therefore, important to identify areas at high groundwater pollution risk in the Northern Anhui Plain to ensure effective protection of regional water resources. In this study, 60 groundwater samples were collected from the shallow aquifer of the plain and analyzed for nitrate (NO3-) concentrations. In addition, 10 environmental and geological factors including the elevations, distances-to-rivers, slope angles, orientations of slopes, land cover types, topographic wetness index (TWI), geomorphology, lithology, soil types, and precipitation amounts in the study area were selected as input layers. The light gradient boosting machine (LightGBM) and random forest (RF) algorithms, combined with the geographic information system (GIS), were performed to generate the groundwater pollution occurrence probability maps. The descriptive statistics showed that the NO3- concentrations in the shallow groundwater ranged from 4.3 to 73.6 mg/L. Most sampling wells exhibited NO3- concentrations above the threshold of 18.3 mg/L. The prediction results of the LightGBM and RF algorithms indicated a high groundwater NO3- pollution risk in the southern part of the plain. However, the LightGBM algorithm had a better prediction performance than RF, with a higher Kappa value of 0.84. Moreover, the frequency ratio method revealed that the precipitation amounts contributed to the groundwater NO3- pollution risk in the study area by 38.14%, followed by the elevations, slope angles, TWI, land cover types, and slope aspects, with contributions of 21.4, 13.02, 8.37, 7.44, and 6.51%, respectively. In the future, sampling of additional wells and further anthropogenic factors shall be considered for the development of more effective groundwater nitrate pollution prevention strategies provided to decision makers.

Deep Learning-Based Quantitative Blastocyst Assessment.

Selecting the single best blastocyst based on morphological appearance for implantation is a crucial part of in vitro fertilization (IVF). Various deep learning and computer vision-based methods have recently been applied for assessing blastocyst quality. However, to the best of our knowledge, most previous works utilize classification networks to give a qualitative evaluation. It would be challenging to rank blastocyst quality with the same qualitative result. Thus, this paper proposes a regression network combined with a soft attention mechanism for quantitatively evaluating blastocyst quality. The network outputs a continuous score to represent blastocyst quality precisely rather than some categories. As to the soft attention mechanism, the attention module in the network outputs an activation map (attention map) localizing the regions of interest (ROI, i.e., inner cell mass (ICM)) of microscopic blastocyst images. The generated activation map guides the entire network to predict ICM quality more accurately. The experimental results demonstrate that the proposed method is superior to traditional classification-based networks. Moreover, the visualized activation map makes the proposed network decision more reliable.

External quality assessment scheme for sperm DNA fragmentation: a pilot study in China.

BACKGROUND: The aim of this article is to establish an external quality assessment (EQA) scheme for sperm Deoxyribonucleic acid (DNA) fragmentation (SDF) detection, and to assess the feasibility of the scheme. In addition, this article provides some case analysis of abnormal results in order to really help improve the performance of the laboratory. RESULTS: In 2021 and 2022, 10 and 28 laboratories in China volunteered to participate in the EQA program respectively. Two samples were selected for EQA each year, a large spread of results was obtained for the four samples, and the highest values were 13.7, 4.2, 8.0 and 4.0 times the lowest respectively. The coefficients of variation (CVs) were very high for the four samples, at 46.6%, 30.1%, 26.7% and 30.3%, respectively. The CVs of the samples with high SDF values were lower than those of the samples with low SDF values. There was no significant difference between the results of sperm chromatin structure assay (SCSA) and sperm chromatin dispersion (SCD). For the 10 laboratories that participated in EQA in 2021 and 2022, the CVs of low SDF value samples and high SDF value samples decreased from 46.6% and 30.1% in 2021 to 32.5% and 22.7% in 2022, respectively. CONCLUSION: This is the first study to evaluate the EQA program on SDF, which involved a number of laboratories and was demonstrated to be feasible. It is recommended that all laboratories participate in the EQA of SDF to ensure the accuracy of the results.

RéSUMé: CONTEXTES: L'objectif de cet article est d'établir un système externe d'évaluation de la qualité (EEQ) pour la détection de la fragmentation de l'ADN des spermatozoïdes (SDF) et d'évaluer la faisabilité de ce système. En outre, cet article fournit une analyse de cas de résultats anormaux afin d'aider réellement à améliorer les performances du laboratoire. RéSULTATS: En 2021 et 2022, respectivement 10 et 28 laboratoires en Chine se sont portés volontaires pour participer au programme EEQ. Deux échantillons ont été sélectionnés chaque année pour l'EEQ ; un large éventail de résultats a été obtenu pour les quatre échantillons, et les valeurs les plus élevées étaient respectivement de 13,7, 4,2, 8,0 et 4,0 fois les plus faibles. Les coefficients de variation (CV) étaient très élevés pour les quatre échantillons, soit respectivement 46,6 %, 30,1 %, 26,7 % et 30,3 %. Les CV des échantillons avec des valeurs de SDF élevées étaient inférieurs à ceux des échantillons avec de faibles valeurs de SDF. Il n'y avait pas de différence significative entre les résultats du test de structure de la chromatine des spermatozoïdes (SCSA) et ceux de la dispersion de la chromatine des spermatozoïdes (SCD). Pour les 10 laboratoires qui ont participé à l'EEQ en 2021 et 2022, les CV des échantillons à faible valeur de SDF et ceux des échantillons à valeur élevée de SDF ont diminué, passant respectivement de 46,6 % et 30,1 % en 2021 à 32,5 % et 22,7 % en 2022. CONCLUSIONS: Il s'agit de la première étude à évaluer le programme externe d'évaluation de la qualité (EEQ) de l'analyse de la SDF, qui a impliqué un certain nombre de laboratoires, et qui s'est avéré réalisable. Il est recommandé que tous les laboratoires participent à l'EEQ de la SDF afin d'en assurer l'exactitude des résultats.

Groundwater pollution source identification and health risk assessment in the North Anhui Plain, eastern China: Insights from positive matrix factorization and Monte Carlo simulation.

Groundwater contaminants from natural and anthropogenic sources pose a serious threat to the ecological environment and public health. In this study, 30 groundwater samples were collected from shallow wells at a large central water source in the North Anhui Plain, eastern China. Hydrogeochemical methods, positive matrix factorization (PMF) model, and Monte Carlo simulation were used to determine the characteristics, sources, and human health risks of inorganic and organic analytes in groundwater. The groundwater was weakly alkaline with high total hardness and was dominated by HCO3-Mg·Ca, HCO3-Ca·Mg, and HCO3-Ca·Mg·Na hydrochemical facies. The concentration of naphthalene was at a safe level, while the concentrations of F-, NO3- and Mn in 16.7 %, 26.7 % and 40 % of the samples, respectively, exceeded threshold risk-based values based on Chinese groundwater quality standards. Hydrogeochemical methods revealed that water-rock interactions (including weathering of silicate minerals, dissolution of carbonates, and cation exchange), acidity, and runoff conditions control the migration and enrichment of these analytes in groundwater. The PMF model indicated that local geogenic processes, hydrogeochemical evolution, agricultural activities, and petroleum-related industrial sources were the main factors affecting groundwater quality, with contributions of 38.2 %, 33.7 %, 17.8 %, and 10.3 %, respectively. A health risk evaluation model based on Monte Carlo simulation indicated that 77.9 % of children were exposed to a total noncarcinogenic risk above safe thresholds, about 3.4 times higher than the risk to adults. The main contributor to human health risk was F- originating from geogenic processes; thus, F- was identified as a priority for control. This study demonstrates the feasibility and reliability of combining source apportionment techniques and health risk assessment to evaluate groundwater quality.

Continuous Room-Temperature Spin-Injection Modulation Achieved by Spin-Filtering Competition in Molecular Spin Valves.

Abundant spin-related phenomena that originate from interfaces between ferromagnetic electrodes and molecular semiconductors have greatly enriched research in spintronics, and they are considered promising for realizing novel spintronic functionalities in the future. However, despite great effort, the interfacial effect cannot be precisely controlled to achieve steady and predictable functions, especially at room temperature, and this has gradually become a significant bottleneck in the development of molecular spintronics. In this study, an innovative spin-filtering-competition mechanism is proposed to continuously modulate the interfacial effect in molecular spin valves at room temperature. To form this novel mechanism, the original spin-filtering effect from pure cobalt competes with the newly generated one, which is induced by the bonding effect between cobalt and lithium fluoride. Subsequently, by precisely controlling competition through lithium fluoride coverage on the cobalt surface, continuous modulation of the spin-injection process can be successfully achieved at room temperature. Spin polarization of the injected current and magnetoresistance effect can be actively controlled or their sign can be completely reversed through this novel mechanism. This study provides an innovative approach and theory for precisely controlling spin-related interfacial effects, which may further promote the scientific and technological development of spintronics.

Impact of Vitiligo on Life Quality of Patients: Assessment of Currently Available Tools.

BACKGROUND: How different tools for evaluating health-related quality of life (QoL) reflect the burden of vitiligo has rarely been compared. In this study, we aim to evaluate the impact of vitiligo on QoL using currently available tools. METHODS: A single-center, cross-sectional study of vitiligo patients was performed. QoL was evaluated using the dermatology life quality index (DLQI), short form-36 (SF-36), and willingness to pay (WTP). As the original DLQI cutoff score (>10) indicating aginificantly impated QoL was found to underestimate QoL, receiver operating characteristic (ROC) curve was use to determine a new cutoff point discriminating vitiligo patients with positive mental stress (SF-36 mental health ≤ 52). RESULTS: Of the 143 patients enrolled, 24.5% were identified having significant mental stress by SF-36 mental health domain score ≤ 52 while there were only 13.3% patients with significantly hampered QoL indicated by DLQI >10. Using ROC analysis, DLQI ≥ 7 was found to be a more appropriate DLQI cutoff value for identifying mental stress in vitiligo patients. Additionally, the median WTP for treating vitiligo was comparable to other inflammatory skin diseases. CONCLUSIONS: There exist discrepancies in the outcomes identifying significant disease burden of vitiligo using DLQI and SF-36, making the current DLQI cutoff score (>10) for identifying significantly affected QoL inappropriate for these patients.

Explainable Deep-Learning-Assisted Sweat Assessment via a Programmable Colorimetric Chip.

Multianalytes and individual differences of biofluids (such as blood, urine, or sweat) pose enormous complexity and challenges to rapid, facile, high-throughput, and accurate clinical analysis or health assessment. Deep-learning (DL)-assisted image analysis has been demonstrated to be an efficient big data process which shows accurate individual identification. However, the data-driven "black boxes" of current DL algorithms are suffering from the nontransparent inner working mechanism. In this work, we designed a programmable colorimetric chip with explainable DL to approach accurate classification and quantification analysis of sweat samples. Gel (sodium alginate) capsules with different indicators were adopted to combinate as designed programmable colorimetric chips. We collected 4600 colorimetric response images as the data set and assessed two DL algorithms and seven machine learning (ML) algorithms. Glucose, pH, and lactate in human sweat could be facilely and 100% accurately classified and quantified by the convolutional neural network (CNN) DL algorithm, and the testing results of actual sweat via the DL-assisted colorimetric approach match 91.0-99.7% with the laboratory measurements. Class activation mapping (CAM) was processed to visualize the inner working mechanism of CNN operation, which could help to verify and explicate the design rationality of colorimetric chips. The explainable DL-assisted programmable colorimetric chip provided an "end-to-end" strategy to ascertain the black box of the DL algorithm, promoted software design or principium optimization, and contributed facile indicators for clinical monitoring, disease prevention, and even new scientific discoveries.

Cost-Effectiveness of Presbyopia Correction Among Seven Strategies of Bilateral Cataract Surgery Based on a Prospective Single-Blind Two-Center Trial in China.

INTRODUCTION: The aim of this study was to explore a method to rank the cost-effectiveness of presbyopia correction in diverse strategies of bilateral cataract surgery to provide references for healthcare policymakers in rationalizing resource utilization and surgeons in customizing patient management. METHODS: The cost-effectiveness analysis based on a prospective single-blind two-center clinical trial included seven strategies in bilateral cataract surgery: monofocal, monovision, diffractive bifocal, blended, refractive bifocal, trifocal, and extended depth of focus (EDOF) strategies. The effectiveness according to the objective spectacle independence rate (hereafter "rate", a novel indicator defined as the proportion of patients with binocular uncorrected distance, intermediate and near visual acuity all better than 0.1 logMAR, logarithm of the minimum angle of resolution), costs, average cost-effectiveness ratios (ACERs, $/1% rate), and incremental cost-effectiveness ratios (ICERs, $/1% incremental rate) were estimated. RESULTS: In 194 participants (388 eyes), the trifocal strategy achieved the highest rate [93.10% (95% confidence interval (CI) 83.8-102.35%)]. The refractive bifocal strategy had the minimum ACER [$45.54/1% rate (95% CI 34.57-56.50)], followed by the blended [$59.10/1% rate (95% CI 31.72-86.48)], diffractive bifocal [$69.06/1% rate (95% CI 30.89-107.21)], EDOF [$72.85/1% rate (95% CI 52.02-93.70)], trifocal [$93.01/1% rate (95% CI 83.23-102.79)], monovision [$136.83/1% rate (95% CI - 55.40 to 329.14)], and monofocal [$264.45/1% rate (95% CI - 97.45 to 626.55)] strategies. Compared with the refractive bifocal strategy, the probabilities that the trifocal strategy (ICER $289.74/1% incremental rate) is very cost-effective and cost-effective were 81.7% and 93.2%, respectively, at the wiliness-to-pay threshold of one and three times China's annual disposable income per capita in 2021 per 10% incremental rates. CONCLUSIONS: Cost-effectiveness analysis with ACER and ICER according to objective spectacle independence rate is a helpful tool to identify highly cost-effective presbyopia-correcting strategies in cataract surgery for clinical and policy decisions. TRIAL REGISTRATION: Clinicaltrials.gov (NCT04265846).

Quality assessment and prediction of municipal drinking water using water quality index and artificial neural network: A case study of Wuhan, central China, from 2013 to 2019.

The sanitary security of drinking water is closely related to human health, but its quality assessment mainly focused on limited types of indicators and relatively restricted time span. The current study was aimed to evaluate the long-term spatial-temporal distribution of municipal drinking water quality and explore the origin of water contamination based on multiple water indicators of 137 finished water samples and 863 tap water samples from Wuhan city, China. Water quality indexes (WQIs) were calculated to integrate the measured indicators. WQIs of the finished water samples ranged from 0.24 to 0.92, with the qualification rate and excellent rate of 100 % and 96.4 %, respectively, while those of the tap water samples ranged from 0.09 to 3.20, with the qualification rate of 99.9 %, and excellent rate of 95.5 %. Artificial neural network model was constructed based on the time series of WQIs from 2013 to 2019 to predict the water quality thereafter. The predicted WQIs of finished and tap water in 2020 and 2021 qualified on the whole, with the excellent rate of 87.5 % and 92.9 %, respectively. Except for three samples exceeding the limits of free chlorine residual, chloroform and fluoride, respectively, the majority of indicators reached the threshold values for drinking. Our study suggested that municipal drinking water quality in Wuhan was generally stable and in line with the national hygiene standards. Moreover, principal component analysis illustrated that the main potential sources of drinking water contamination were inorganic salts and organic matters, followed by pollution from distribution systems, the use of aluminum-containing coagulants and turbidity involved in water treatment, which need more attention.

Exploring the relationship between depression and different multimorbidity patterns among older people covered by long-term care insurance in Shanghai, China.

BACKGROUND: Depression is common in patients with multimorbidity, but little is known about the relationship between depression and multimorbidity. The purpose of our research was to investigate multimorbidity patterns and their association with depression in a sample of older people covered by long-term care insurance in Shanghai, China. METHOD: This was a population-based cross-sectional study, with 1871 participants aged ≥60 years old who are covered by Shanghai long-term care insurance. Multimorbidity was defined as the presence of two or more chronic diseases at the same time. We collected information on chronic conditions using a self-reported medical history, and we used the 30-item Geriatric Depression Scale (GDS-30) to evaluate depressive symptoms. Patterns of multimorbidity were identified with exploratory factor analysis, using oblimin rotation. Logistic regression was used to estimate the relationship between multimorbidity patterns and depressive symptoms. RESULTS: Among the participants, the prevalence of multimorbidity was 64.7%, and the prevalence of depression was 64.6%. Hypertension, cardiovascular disease, cerebrovascular disease (CVD), and cataracts showed strong associations with depression when co-occurring with other conditions. Three patterns of multimorbidity were identified: a musculoskeletal pattern, cardiometabolic pattern, and degenerative disease pattern. Among these, the cardiometabolic (adjusted odds ratio (AOR) 1.223; 95% confidence interval (CI) 1.102, 1.357) and degenerative disease (AOR 1.185; 95% CI 1.071, 1.311) patterns were associated with a higher risk of depressive symptoms. CONCLUSION: Two of three multimorbidity patterns were found to be associated with depression. Physical and psychological dimensions require greater attention in the care of older adults who are covered by long-term care insurance.

Association between multimorbidity patterns and disability among older people covered by long-term care insurance in Shanghai, China.

BACKGROUND: Functional disability and multimorbidity are common among older people. However, little is known about the relationship between functional disability and different multimorbidity combinations. We aimed to identify multimorbidity patterns and explore the associations between these patterns and functional disability. METHODS: We investigated a multi-stage random sample of 1871 participants aged ≥60 years and covered by long-term care insurance in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases in an individual. Participants completed scales to assess basic and instrumental activities of daily living (BADL and IADL, respectively). Multimorbidity patterns were identified via exploratory factor analysis. Binary logistic regression models were used to determine adjusted associations between functional disability and number and patterns of multimorbidity. RESULTS: Multimorbidity was present in 74.3% of participants. The prevalence of BADL disability was 50.7% and that of IADL disability was 90.7%. There was a strong association between multimorbidity and disability. We identified three multimorbidity patterns: musculoskeletal, cardio-metabolic, and mental-degenerative diseases. The cardio-metabolic disease pattern was associated with both BADL (OR 1.28, 95%CI 1.16-1.41) and IADL (OR 1.41, 95%CI 1.19-1.68) disability. The mental-degenerative disease pattern was associated with BADL disability (OR 1.55, 95%CI 1.40-1.72). CONCLUSIONS: Multimorbidity and functional disability are highly prevalent among older people covered by long-term care insurance in Shanghai, and distinct multimorbidity patterns are differentially associated with functional disability. Appropriate long-term healthcare and prevention strategies for older people may help reduce multimorbidity, maintain functional ability, and improve health-related quality of life.

Research on the impact of environmental regulation on enterprise technology innovation-an empirical analysis based on Chinese provincial panel data.

Under the pressure of environmental degradation and resource depletion, Chinese companies are confronted with the need for transformation and upgrading promoted by technological innovation. However, environmental regulation can help to promote technological innovation. Based on the panel data of China's 30 provincial levels during 2009-2016, firstly, this paper describes the connotation of environmental regulation and measurement intensity of the regulation. Then, the anti-driving effect of environmental regulation on enterprise technology innovation is analyzed. Finally, this paper analyzes the spatial heterogeneity of environmental regulation on enterprise technology innovation. The empirical results are as follows: (1) formal environmental regulation has effectively enhanced technological innovation of enterprises. However, informal environmental regulation generally can positively drive enterprise technology innovation. (2) The impact of environmental regulation on technological innovation of enterprises is spatially heterogeneous. On the one hand, the impact of formal environmental regulation on technological innovation has significant regional differences. The Eastern China generally supports the "Porter hypothesis," while the Middle of China and Western China have the opposite performance. On the other hand, there is a threshold effect between environmental regulation and technological innovation. When the economic development level of the first lagging period is used as the threshold variable, with the gradual improvement of the economic development level, the technological innovation of the enterprise has the effect of first suppressing and promoting, and then verifying the threshold characteristics of environmental regulation on technology innovation.

Prevalence and risk factors of physical inactivity among middle-aged and older Chinese in Shenzhen: a cross-sectional study.

OBJECTIVE: Investigations on physical inactivity are common around the world; however, little is known about the status of physical inactivity in mainland China. The aim of this study was to examine the prevalence and risk factors associated with physical inactivity in Shenzhen in Southern China. DESIGN: A community-based, cross-sectional study. SETTING: A multistage-stratified, random cluster survey was conducted in Xixiang Street, Bao'an District of Shenzhen in Southeast China. PARTICIPANTS: 3920 adults aged 40 years or more were recruited to the study and completed the International Physical Activity Questionnaire Short Form between 1 March 2015 and 30 July 2016. MAIN OUTCOME MEASURES: Physical inactivity was defined as engaging in physical activity levels insufficient to reach the current guidelines. Bivariate and multivariate analyses were undertaken to assess the prevalence and risk factors associated with physical inactivity. RESULTS: The prevalence of physical inactivity was 63.1% for all participants, 63.9% for women and 61.9% for men, respectively. Participants who were older (OR=1.31, 95% CI 1.11 to 1.54), who were female (OR=1.22, 95% CI 1.04 to 1.43), who had higher education experience (OR=1.38, 95% CI 1.19 to 1.61), who are under economic pressure (OR=2.17, 95% CI 1.48 to 3.17), who ever smoked a cigarette (OR=1.44, 95% CI 1.13 to 1.82) and drank alcohol (OR=1.42, 95% CI 1.14 to 1.77), and participants in the lowest body mass index category (OR=1.40, 95% CI 1.03 to 1.89), were more likely to report physical inactivity. CONCLUSIONS: These findings indicate that physical inactivity is prevalent in Southern China. Interventions and programmes aimed at increasing physical activity among middle-aged and older Chinese adults may also be tailored to participants under economic pressure and those with unhealthy behaviours such as smoking and drinking.

Catastrophic health expenditure: a comparative analysis of empty-nest and non-empty-nest households with seniors in Shandong, China.

OBJECTIVE: The aim of this study was to compare the catastrophic health expenditure (CHE) prevalence and its determinants between empty-nest and non-empty-nest elderly households. SETTING: Shandong province of China. PARTICIPANTS: A total of 2761 elderly households are included in the analysis. RESULTS: CHE incidence among elderly households was 44.9%. The CHE incidence of empty-nest singles (59.3%, p=0.000, OR=3.19) and empty-nest couples (52.9%, p=0.000, OR=2.45) are both statistically higher than that of non-empty-nest elderly households (31.4%). An inverse association was observed between CHE incidence and income level in all elderly household types. Factors including 1 or more household elderly members with non-communicable chronic diseases in the past 6 months, 1 or more elderly household members being hospitalised in the past year and lower household income, are significant risk factors for CHE in all 3 household types (p<0.05). Health insurance status was found to be a significant determinant of CHE among empty-nest singles and non-empty-nest households (p<0.05). CONCLUSIONS: CHE incidence among elderly households is high in China. Empty-nest households are at higher risk for CHE than non-empty-nest households. Based on these findings, we suggest that special insurance be developed to broaden the coverage of health services and heighten the reimbursement rate for empty-nest elderly in the existing health insurance schemes. Financial and social protection interventions are also essential for identified at-risk subgroups among different types of elderly households.

Tobacco smoking, NBS1 polymorphisms, and survival in lung and upper aerodigestive tract cancers with semi-Bayes adjustment for hazard ratio variation.

PURPOSE: Although single nucleotide polymorphisms (SNPs) of NBS1 have been associated with susceptibility to lung and upper aerodigestive tract (UADT) cancers, their relations to cancer survival and measures of effect are largely unknown. METHODS: Using follow-up data from 611 lung cancer cases and 601 UADT cancer cases from a population-based case-control study in Los Angeles, we prospectively evaluated associations of tobacco smoking and 5 NBS1 SNPs with all-cause mortality. Mortality data were obtained from the Social Security Death Index. We used Cox regression to estimate adjusted hazard ratios (HR) for main effects and ratios of hazard ratios (RHR) derived from product terms to assess hazard ratio variations by each SNP. Bayesian methods were used to account for multiple comparisons. RESULTS: We observed 406 (66 %) deaths in lung cancer cases and 247 (41 %) deaths in UADT cancer cases with median survival of 1.43 and 1.72 years, respectively. Ever tobacco smoking was positively associated with mortality for both cancers. We observed an upward dose-response association between smoking pack-years and mortality in UADT squamous cell carcinoma. The adjusted HR relating smoking to mortality in non-small cell lung cancer (NSCLC) was greater for cases with the GG genotype of NBS1 rs1061302 than for cases with AA/AG genotypes (semi-Bayes adjusted RHR = 1.97; 95 % limits = 1.14, 3.41). CONCLUSIONS: A history of tobacco smoking at cancer diagnosis was associated with mortality among patients with lung cancer or UADT squamous cell carcinoma. The HR relating smoking to mortality appeared to vary with the NBS1 rs1061302 genotype among NSCLC cases.