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Background: Socioeconomic development and population growth have led to canal pollution, a challenge in Ho Chi Minh City (HCMC), Vietnam. In HCMC, diffuse pollution of rivers and canals makes applying pollution control measures at the source challenging. Poor sanitation, insufficient safe drinking water, and poor hygiene practices are the leading causes of the emergence of waterborne diseases. Methods: A cross-sectional survey was done to investigate the knowledge, behavior, and factors associated with sanitation and hygiene of residents living along the side of canals in HCMC. This study also investigated the pollution of canal water in the primary canal systems in HCMC. Results: The canal water systems at Ho Chi Minh City exceeded the permissible thresholds of Vietnam's discharge limit standards of total coliforms and E. coli. Among the 640 households interviewed, 60% of residents perceived that the polluted canal environment affected their lives. Most residents (99%) used tap water for daily activities, but 25% of households did not filter water before drinking. The hygiene behavior is uneven; more than 30% of households discharged wastewater into the canal, and nearly 60% of children have the conditions to contact flood water on the street. The causes of water pollution in canals are people's low awareness, with only 38.4% of respondents interested in canal-environmental protection activities, inadequate infrastructure (59%), and the ineffective management of surface water resources (57.8%). Conclusion: The study indicated incorrect knowledge and behavior toward sanitation and protecting the canal environment of the local people caused increasing pollution of canal water. Hence, measures must be implemented to protect the canal water environment and the community's health, such as training about sanitation and hygiene for local people.

Celiac disease (CeD) is a common autoimmune condition, with a prevalence of ~1%. Currently, a gluten-free diet (GFD) is the only treatment option. Due to fortification rules excluding gluten-free products in the United States of America (U.S.A.), understanding the nutritional adequacy of a GFD is important for promoting optimal health among those with CeD. Cross-sectional examination of multiple 24 h dietary recalls from a study sample of 50 adults and 30 teens with CeD was used to determine nutritional adequacy and excesses according to U.S.A. recommendations. The results were compared with those of 15,777 adults and 2296 teens from a nationally representative sample not reporting CeD, the National Health and Nutrition Examination Survey (NHANES) 2009–2014. Compared with NHANES, our study population was more at risk of low folate and carbohydrate (adults) consumption, and of excessive niacin and vitamin A (teens), as well as saturated and total fat consumption (adults). Overall, though, compared with NHANES, our study participants had similar nutrient concerns but fewer nutritional imbalances, with some notable exceptions. In addition to maintaining a GFD, individuals with CeD should be counseled to maintain a balanced diet and to pay attention to nutrient-dense foods. Special attention should be given to teens in providing dietary counseling to potentially mitigate the risk of future morbidity.

Air pollution is one of the leading risk factors for death but also a significant contributor to the global disease burden, affecting quality of life. According to a World Health Organisation (WHO) report, seven million people die from air pollution every year, and 9 out of 10 people worldwide breathe polluted air. Any person can be affected by exposure to polluted air, especially the elderly, children, pregnant women, and people with comorbidities. Some studies indicate that the diseases most affected by air pollution are respiratory infections, chronic obstructive pulmonary disease (COPD), lung cancer, and cardiovascular diseases. The degree of effect on the body depends on the pollutant composition, source and dose, level and duration of exposure to polluted air. Particulate matter (PM10 and PM2.5), carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), and sulphur dioxide (SO2) could lead to air pollution. Long-term exposure to air pollution can affect every organ in the body and worsen existing health conditions. Short-term exposure to contaminants can include unpleasant sensations such as coughing, wheezing, shortness of breath, eye, nose, and throat irritation, headache, dizziness, and fatigue. Community and individual solutions such as using clean fuel, wearing personal masks, filtering indoor air, and ventilating need to be taken to reduce the impact of air pollution.

Adherence to Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) may lower the risk of dementia by impacting immunity and cholesterol, which are pathways also implicated by genome-wide association studies of Alzheimer’s Dementia (AD). We examined whether adherence to the MIND diet could modify the association of genetic risk for AD with incident dementia. We used three ongoing US cohorts: Chicago Health and Aging Project (CHAP, n = 2449), Rush Memory and Aging Project (MAP, n = 725), and Women’s Health Initiative Memory Study (WHIMS, n = 5308). Diagnosis of dementia was based on clinical neurological examination and standardized criteria. Repeated measures of global cognitive function were available in MAP and CHAP. Self-reported adherence to MIND was estimated using food-frequency questionnaires. Global and pathway-specific genetic scores (GS) for AD were derived. Cox proportional hazard, logistic regression, and mixed models were used to examine associations of MIND, GS, and GS-MIND interactions with incident dementia and cognitive decline. Higher adherence to MIND and lower GS were associated with a lower risk of dementia in MAP and WHIMS and a slower rate of cognitive decline in MAP (p < 0.05). MIND or GS were not associated with incident dementia or cognitive decline in CHAP. No gene−diet interaction was replicated across cohorts. Genetic risk and MIND adherence are independently associated with dementia among older US men and women.

IntroductionDuring the coronavirus disease 2019 pandemic, high levels of burnout were reported among healthcare workers. This study examines the association of work absenteeism and frequency of thoughts in leaving current job with burnout among a cohort of healthcare workers during the COVID-19 pandemic.MethodsA cross-sectional survey of healthcare workers was conducted from April-May, 2022 on healthcare workers from 10 hospitals, 18 immediate care centers, and 325 outpatient practices in the Chicago area and surrounding Illinois suburbs. Logistic regression models were used to assess the association of burnout scores (Oldenburg Burnout Inventory—OLBI) and its sub-scores (exhaustion and disengagement scores) with work absenteeism and thoughts of leaving work.ResultsOne-fifth and 60% of respondents (n = 1,825) reported unplanned absenteeism and thoughts of leaving their job, respectively. After adjusting for covariates, higher burnout scores, especially exhaustion scores, were associated with increased odds of unplanned absenteeism (OR = 1.04, 95% CI: 1.01–1.08). Burnout scores and both sub-scores were also positively associated with the frequency of thoughts of leaving work, e.g., each unit increase in the OLBI burnout score was associated with 1.39 (95% CI: 1.34–1.43) times higher odds of thinking about leaving work “a lot/constantly” vs. “never”.DiscussionOverall, this study cohort showed a positive association between burnout scores and unplanned work absenteeism (and frequency of thoughts in leaving job) during the COVID-19 pandemic. More research is needed to support healthcare worker well-being during times of stress and direct solutions to addressing unplanned absenteeism in the light of a pandemic.

Introduction Cognitive dysfunction, a leading cause of mortality and morbidity in the USA and globally, has been shown to disproportionately affect the socioeconomically disadvantaged and those who identify as black or Hispanic/Latinx. Poor sleep is strongly associated with the development of vascular and metabolic diseases, which correlate with cognitive dysfunction. Therefore, sleep may contribute to observed disparities in cognitive disorders. The Epidemiologic Study of Disparities in Sleep and Cognition in Older Adults (DISCO) is a longitudinal, observational cohort study that focuses on gathering data to better understand racial/ethnic sleep disparities and illuminate the relationship among sleep, race and ethnicity and changes in cognitive function. This investigation may help inform targeted interventions to minimise disparities in cognitive health among ageing adults.Methods and analysis The DISCO study will examine up to 495 individuals aged 55 and older at two time points over 24 months. An equal number of black, white and Hispanic/Latinx individuals will be recruited using methods aimed for adults traditionally under-represented in research. Study procedures at each time point will include cognitive tests, gait speed measurement, wrist actigraphy, a type 2 home polysomnography and a clinical examination. Participants will also complete self-identified assessments and questionnaires on cognitive ability, sleep, medication use, quality of life, sociodemographic characteristics, diet, substance use, and psychological and social health.Ethics and dissemination This study was approved by the Northwestern University Feinberg School of Medicine Institutional Review Board. Deidentified datasets will be shared via the BioLINCC repository following the completion of the project. Biospecimen samples from the study that are not being analysed can be made available to qualified investigators on review and approval by study investigators. Requests that do not lead to participant burden or that conflict with the primary aims of the study will be reviewed by the study investigators.

PurposeTo examine cross-sectional associations between perceived neighborhood environment and cognitive function among middle-aged and older Hispanic/Latino women and men.MethodsData from the Hispanic Community Health Study/Study of Latinos (2008-2011) and its Sociocultural Ancillary Study (2009-2010) were used. Participants were Hispanic/Latino women (n = 1812) and men (n = 1034) aged 45-74 years. Survey-weighted linear regression models were used to examine associations between self-reported perceived neighborhood environment (i.e., neighborhood social cohesion and problems categorized as quintiles, and neighborhood safety from crime categorized as low, medium, or high) with cognitive function (i.e., global cognition, verbal learning, memory, verbal fluency, and processing speed scores) in women and men. Final model adjusted for age, Hispanic/Latino background, language, field site, household income, education, years lived in neighborhood, and depressive symptoms.ResultsWomen in the lowest quintile of perceived neighborhood problems (vs. highest quintile) had higher global cognition (β 0.48, 95% CI 0.03, 0.94, p trend 0.229) and memory scores (0.60, 95% CI 0.11, 1.09, p trend: 0.060). Women in the highest quintile of perceived neighborhood social cohesion (vs. lowest quintile) had lower global cognition (β - 0.56, 95% CI - 1.02, - 0.09, p trend 0.004), verbal learning (B - 1.01, 95% CI - 2.00, - 0.03, p trend 0.015), verbal fluency (B - 2.00, 95% CI - 3.83, - 0.16, p trend 0.006), and processing speed (B - 2.11, 95% CI - 3.87, - 0.36, p trend 0.009). There was no association between perceived neighborhood safety from crime and cognition among women, or between any perceived neighborhood environment measure and cognition among men.ConclusionsMiddle-aged and older Hispanic/Latina women living in neighborhoods with the lowest perceived problems had higher global cognition and memory. Women living in neighborhoods with the highest perceived social cohesion had lower global cognition, verbal learning, verbal fluency, and processing speed.

More than ever, schools and families are embracing technology as positive aspects of creativity and collaboration. In a recent study, 78% of parents perceived technology as a constructive learning tool that has the potential to propel children toward highly successful lives and careers (Family Online Safety Institute, 2015). The increase in one-to-one device programs and recent government initiatives calling for upgraded connectivity, access to learning devices, increased support for teachers, and greater digital learning resources are evidence of a growing acceptance of technology in schools. While digital technology use continues to increase, what remains unclear is if students actually know how to use these tools safely, responsibly, and ethically. Similarly, many adults are not up-to-date with changing technological developments, nor are they prepared to have Internet safety and ethics discussions with young technology users. With the growing presence of Internet dangers, such as cyber victimization and sexting, it becomes evident that adults need to be aware of and understand Internet safety, as well as accept joint responsibility to keep youngsters safe. Using a qualitative, conversation analysis, the authors focused on the ways in which parents and teachers were invited to an Internet safety and digital citizenship professional development workshop, which included investigation of the structures of interactions between these two. The results provided insight into how adults view their role in providing safe online and offline learning environments for children, as well as beliefs for increasing their self-awareness of Internet safety and knowledge.

Objective: To determine the prevalence and determinants of electronic nicotine delivery systems (ENDS) use among Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: Cross-sectional data collected between the years 2015–2017 were analyzed to assess ENDS use (ever (current: use ≤ past 30 days; former: use > past 30 days) and never) among 11,623 adults (mean age 47 years±0.3 years; 52% women). Weighted prevalence estimates were reported, and age-adjusted logistic regression models were used to examine associations between sociodemographic and clinical exposures with ENDS use. Results: The prevalence of current and former ENDS use was 2.0% and 10.4%, respectively. Having ever used ENDS was associated with prevalent coronary artery disease. Current ENDS use was higher in males and associated with higher education, English language preference, and Puerto Rican background compared with nonsmokers and cigarette-only smokers (all p

This work presents the controlled synthesis of TiO2/graphene photocatalysts by hydrothermal method using TiCl4 as a precursor. The influence of the precursor concentration and the reaction time on the growth of TiO2 nanoparticles on graphene was studied, showing the ability to achieve the catalysts with desired TiO2 loadings and dispersion. By means of XPS, Raman, and UV-VIS diffuse reflectance spectroscopies, the chemical composition, the interaction between TiO2 and graphene, and the optical properties of the photocatalysts were investigated. The results reveal that the coupling with graphene considerably narrows the bandgap of TiO2, which stimulates the photocatalytic activity of TiO2/graphene under visible light irradiation. The photocatalytic performance of TiO2/graphene was studied by the degradation of RhB, which was carried out for the catalysts with TiO2 loadings in the range of 5–84%. The highest performance is achieved for the catalysts containing well-dispersed TiO2 nanoparticles on the graphene surface with loadings in the range between 16.5 and 26%. The degradation mechanism of RhB is further elucidated by using carrier and radical scavengers, which reveal the dominating role of holes and OH∗ radicals.

BackgroundHigher fibroblast growth factor-23 (FGF23) concentrations have been found to be associated with incident heart failure (HF). Experimental data suggest FGF23 directly stimulates myocardial hypertrophy. FGF23 may also enhance renin-angiotensin-aldosterone system activity. Whether FGF23 is associated with increased HF risk in populations with hypertension and whether this association is weaker in the presence of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy is unknown.MethodsWe studied 2,858 adults with hypertension free of cardiovascular disease at baseline (65.6 ± 9.5 years, 46.2% male) participating in the Multi-Ethnic Study of Atherosclerosis (MESA). We investigated the association of baseline serum intact FGF23 with incident HF over a 14-year median follow-up and whether ACEI/ARB therapy modified this risk. We also investigated the relationship of FGF23 with aldosterone and plasma renin activity in a random subgroup of the entire MESA cohort with available assays (N = 1,642).ResultsIn adjusted Cox regression models, higher FGF23 was associated with a 63% greater hazard of incident HF (hazard ratio: 1.63, 95% confidence interval: [1.13-2.36] per 1-unit increase in log-transformed FGF23), which persisted after exclusion of participants with chronic kidney disease (hazard ratio: 1.94 [1.10-3.43]). There was no heterogeneity by ACEI/ARB use (Pinteraction = 0.438). FGF23 improved model fit over covariables (likelihood ratio χ2 = 6.67, P = 0.010). In multivariable linear regression models, there was no association between FGF23 and aldosterone or plasma renin activity.ConclusionsHigher FGF23 concentrations are associated with a significantly increased risk of HF in hypertension but this risk did not differ by ACEI/ARB treatment status. FGF23 may be a useful biomarker for HF risk in hypertensive populations.

Abstract Video games have long been considered an effective educational tool. Environmental education studies have found that games positively affect the feeling of nature connectedness, producing pro-environmental attitudes and behaviors. With growing urbanization, video games also provide chances to interact with nature. During the COVID-19 lockdown, Nintendo’s Animal Crossing: New Horizon (ACNH) became a household name, with millions of copies sold worldwide. The article used the Bayesian multilevel model to analyze 640 survey responses of ACNH game players from various online communities. The correlations between the perception of limited resources and virtual planting and exploiting behaviors with the varying effect among ethnicities were explored. The findings suggested positive correlations between the perception and in-game actions among all ethnicities, regardless of whether the actions are planting or exploiting. While further evidence is needed, the findings suggest the restraints of game mechanics. To foster a pro-environmental culture, stakeholders can consider video games a novel technological aid to environmental education.

Hydroxyapatite is widely used for the reconstruction of defective bones due to its similarity with the composition of bone mineral. In this research, nanocrystalline hydroxyapatite (HA) was synthesised using calcium hydroxide and phosphoric acid as starting precursors. Different concentrations of the reactants, viz. 0.5, 1.0, 1.5 and 2.0 mol/L, were considered to investigate their effect on the thermal stability and morphology of the synthesised HA. The results showed that the synthesised HA exhibited rod-like shaped particles having sizes in the range of 73.4 to 114.5 nm in length and 14.9 to 20.7 nm in width. The HA produced at the reactant concentration of 0.5 and 1.0 mol/L was thermally stable up to 1200 °C and did not exhibit any secondary phase. However, the HA prepared at the 1.5 mol/L concentration decomposed into tricalcium phosphate at 1000 °C while the HA prepared at 2.0 mol/L decomposed at 1200 °C. It was also found that the size of the particles increased with increasing reactant concentrations. The HA produced from the reactant concentration of 1.0 mol/L was found to be optimum in terms of the powder characteristics and the in vitro cell studies indicated that osteoblast cells proliferated well on the synthesised HA, thus confirming the biocompatible nature of the produced bioceramic.

Statins have shown promise as anticancer agents in experimental and epidemiologic research. However, any benefit that they provide is likely context-dependent, for example, applicable only to certain cancers or in combination with specific anticancer drugs. We report that inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) using statins enhances the proapoptotic activity of the B cell lymphoma-2 (BCL2) inhibitor venetoclax (ABT-199) in primary leukemia and lymphoma cells but not in normal human peripheral blood mononuclear cells. By blocking mevalonate production, HMGCR inhibition suppressed protein geranylgeranylation, resulting in up-regulation of proapoptotic protein p53 up-regulated modulator of apoptosis (PUMA). In support of these findings, dynamic BH3 profiling confirmed that statins primed cells for apoptosis. Furthermore, in retrospective analyses of three clinical studies of chronic lymphocytic leukemia, background statin use was associated with enhanced response to venetoclax, as demonstrated by more frequent complete responses. Together, this work provides mechanistic justification and clinical evidence to warrant prospective clinical investigation of this combination in hematologic malignancies.

High-risk subtypes of B-cell acute lymphoblastic leukemia (B-ALL) include Philadelphia chromosome-positive (Ph+) B-ALL driven by the BCR-ABL1 oncogene and a more recently identified subtype known as BCR-ABL-like or Ph-like B-ALL. A hallmark of both Ph+ and Ph-like B-ALL is constitutive activation of tyrosine kinase signaling that is potentially targetable with tyrosine kinase inhibitors (TKIs). B-ALL cells also receive extracellular signals from the microenvironment that can maintain proliferation and survival following treatment with TKIs. Therefore, there is strong rationale for combining TKIs with other therapies targeting signal transduction pathways. Here we show that combinations of the ABL-directed TKI dasatinib with mTOR kinase inhibitors (TOR-KIs) are more effective than TKI alone against patient-derived Ph-like B-ALL cells harboring rearrangements of ABL1 or ABL2. We also report the establishment of a new human Ph-like B-ALL cell line that is stromal cell-independent in vitro and can be used for xenograft experiments in vivo. These findings provide rationale for clinical testing of TKI plus TOR-KIs in children and adults with Ph-like B-ALL and a new experimental tool to test promising therapeutic strategies in this poor prognosis subtype of B-ALL.

Treatment-resistant glioma stem cells are thought to propagate and drive growth of malignant gliomas, but their markers and our ability to target them specifically are not well understood. We demonstrate that podoplanin (PDPN) expression is an independent prognostic marker in gliomas across multiple independent patient cohorts comprising both high- and low-grade gliomas. Knockdown of PDPN radiosensitized glioma cell lines and glioma-stem-like cells (GSCs). Clonogenic assays and xenograft experiments revealed that PDPN expression was associated with radiotherapy resistance and tumor aggressiveness. We further demonstrate that knockdown of PDPN in GSCs in vivo is sufficient to improve overall survival in an intracranial xenograft mouse model. PDPN therefore identifies a subset of aggressive, treatment-resistant glioma cells responsible for radiation resistance and may serve as a novel therapeutic target.

Elevated activity of mTOR is associated with poor prognosis and higher incidence of relapse in B-cell acute lymphoblastic leukemia (B-ALL). Thus, ongoing clinical trials are testing mTOR inhibitors in combination with chemotherapy in B-ALL. However, the combination of mTOR inhibitors with standard of care chemotherapy drugs has not been studied extensively in high-risk B-ALL subtypes. Therefore, we tested whether mTOR inhibition can augment the efficacy of current chemotherapy agents in Ph+ and Ph-like B-ALL models. Surprisingly, inhibiting mTOR complex 1 (mTORC1) protected B-ALL cells from killing by methotrexate and 6-mercaptopurine, two antimetabolite drugs used in maintenance chemotherapy. The cytoprotective effects correlated with decreased cell-cycle progression and were recapitulated using cell-cycle inhibitors, palbociclib or aphidicolin. Dasatinib, a tyrosine kinase inhibitor currently used in Ph+ patients, inhibits ABL kinase upstream of mTOR. Dasatinib resistance is mainly caused by ABL kinase mutations, but is also observed in a subset of ABL unmutated cases. We identified dasatinib-resistant Ph+ cell lines and patient samples in which dasatinib can effectively reduce ABL kinase activity and mTORC1 signaling without causing cell death. In these cases, dasatinib protected leukemia cells from killing by 6-mercaptopurine. Using xenograft models, we observed that mTOR inhibition or dasatinib increased the numbers of leukemia cells that emerge after cessation of chemotherapy treatment. These results demonstrate that inhibitors targeting mTOR or upstream signaling nodes should be used with caution when combined with chemotherapeutic agents that rely on cell-cycle progression to kill B-ALL cells. Mol Cancer Ther; 16(9); 1942-53. ©2017 AACR.

Introduction E-cigarettes are the most popular tobacco product among youth. Although harm perceptions have been linked to youth e-cigarette use, little research focuses on vulnerable populations, such as Appalachian youth. This study examines associations between e-cigarette harm perceptions and tobacco use among a sample of Appalachian youth. Methods Using data from the 2014–2016 Youth Appalachian Tobacco Study (n=1074), distributions of six e-cigarette harm perceptions by tobacco use (never, ever non-e-cigarette, ever e-cigarette) were examined, and multivariable multinomial logistic regression was used. Results Nearly one-fourth (23.4%) of the sample were ever e-cigarette users. More e-cigarette users were male (53.4%) and in high school (57.0%). Fewer e-cigarette users strongly agreed that e-cigarettes cause health problems (15.1%), breathing problems (20.3%), and oral health problems (18.7%) and that e-cigarettes are addictive (25.1%), compared to never and non-e-cigarette users. More e-cigarette users strongly agreed (32.3%) that e-cigarettes are healthier alternatives to cigarettes compared to never (24.1%) and non-e-cigarette (25.7%) users. Regression models indicate that e-cigarette users had greater odds of strongly disagreeing with e-cigarettes being harmful or addictive, compared to never users. E-cigarette users had approximately six-fold odds of strongly disagreeing with e-cigarettes causing health problems (OR=6.12; 95% CI: 3.16–11.90) and two times greater odds of disagreeing with e-cigarettes being addictive (OR=2.09; 95% CI: 1.07–4.08) compared to never users. Conclusions Appalachian youth ever e-cigarette users perceive e-cigarettes as less harmful and less addictive compared to never users. Better informing youth, especially youth tobacco users, of the harms associated with e-cigarettes is vital.

Background and Objectives: Zinc is a micronutrient that plays an important role in metabolism, cell growth regulation, and differentiation. Vietnam has many population groups living in poverty. The daily food of Vietnamese people is mainly rice, which contains very little zinc. This cross-sectional study was conducted to determine the prevalence of, and factors related to, zinc deficiency in women of reproductive age.Methods and Study Design: The sample population was non-pregnant women of reproductive age (18–49 years old) who visited Nguyen Tri Phuong Hospital Gynecological Outpatient Clinic. The subjects were interviewed and data on background characteristics, anthropometric measurements, and blood tests (serum zinc concentration, complete blood count, albumin, and ferritin) were collected.Results: The prevalence of zinc deficiency, as defined by the International Zinc Nutrition Consultative Group (IZiNCG), was 85% [61/72; 95% confidence interval (CI) = 74–91%], and the prevalence of severe zinc deficiency was 37% (27/72; 95% CI = 26–50%). There were significant associations of albumin concentration, marital status, and past pregnancy history with severe zinc deficiency.Conclusions: More than three-fourths of Vietnamese women of reproductive age had zinc deficiency at our study site in Ho Chi Minh City. This health issue requires greater attention in order to swiftly promote preventive actions, and further surveillance to confirm our study findings.

Background Cigarette smoking is significantly associated with premature death related and not related to cardiovascular disease (CVD). Whether risk associated with smoking is similar across CVD subtypes and how this translates into years of life lost is not known. Methods and Results We pooled and harmonized individual‐level data from 9 population‐based cohorts in the United States. All participants were free of clinical CVD at baseline with available data on current smoking status, covariates, and CVD outcomes. We examined the association between smoking status and total CVD and CVD subtypes, including fatal and nonfatal coronary heart disease, stroke, congestive heart failure, and other CVD deaths. We performed (1) modified Kaplan–Meier analysis to estimate long‐term risks, (2) adjusted competing Cox models to estimate joint cumulative risks for CVD or noncardiovascular death, and (3) Irwin’s restricted mean to estimate years lived free from and with CVD. Of 106 165 adults, 50.4% were women. Overall long‐term risks for CVD events were 46.0% (95% CI, 44.7–47.3) and 34.7% (95% CI, 33.3–36.0) in middle‐aged men and women, respectively. In middle‐aged men who reported smoking compared with those who did not smoke, competing hazard ratios (HRs) were higher for the first presentation being a fatal CVD event (HR, 1.79 [95% CI, 1.68–1.92]), with a similar pattern among women (HR,1.82 [95% CI, 1.68–1.98]). Smoking was associated with earlier CVD onset by 5.1 and 3.8 years in men and women. Similar patterns were observed in younger and older adults. Conclusions Current smoking was associated with a fatal event as the first manifestation of clinical CVD.

Studies reporting clinical symptoms related to electronic nicotine delivery systems (ENDS) usage, especially types of devices and e-liquids, are sparse. The sample included 1,432 current ENDS users, ages 18–64, from a nationwide online survey conducted in 2016. ENDS use included device types, nicotine content, flavors, and e-liquid used. Outcomes included any e-cigarette, or vaping, product use-associated lung injury (EVALI)-like symptoms (e.g., cough, shortness of breath, nausea) as well as any clinical symptoms. Of the sample, 50% were female, 23% non-Hispanic (NH) White, 23% NH Black, 54% Hispanic, 18% aged 18–24, 17% LGBTQ, 41% with

Enzymes (PI3K and PTEN) controlling cellular levels of 3-phosphorylated phosphoinositides are known as important drivers or suppressors of tumorigenesis in various cancers. In this issue of Cancer Discovery, Kofuji and colleagues and Chew and colleagues identify the lipid phosphatase INPP4B as a context-specific tumor suppressor that controls phosphoinositide levels and AKT2 activation in PTEN-deficient cells.

Leber congenital amaurosis (LCA) and juvenile retinitis pigmentosa (RP) are severe hereditary diseases that causes visual impairment in infants and children. SPATA7 has recently been identified as the LCA3 and juvenile RP gene in humans, whose function in the retina remains elusive. Here, we show that SPATA7 localizes at the primary cilium of cells and at the connecting cilium (CC) of photoreceptor cells, indicating that SPATA7 is a ciliary protein. In addition, SPATA7 directly interacts with the retinitis pigmentosa GTPase regulator interacting protein 1 (RPGRIP1), a key connecting cilium protein that has also been linked to LCA. In the retina of Spata7 null mutant mice, a substantial reduction of RPGRIP1 levels at the CC of photoreceptor cells is observed, suggesting that SPATA7 is required for the stable assembly and localization of the ciliary RPGRIP1 protein complex. Furthermore, our results pinpoint a role of this complex in protein trafficking across the CC to the outer segments, as we identified that rhodopsin accumulates in the inner segments and around the nucleus of photoreceptors. This accumulation then likely triggers the apoptosis of rod photoreceptors that was observed. Loss of Spata7 function in mice indeed results in a juvenile RP-like phenotype, characterized by progressive degeneration of photoreceptor cells and a strongly decreased light response. Together, these results indicate that SPATA7 functions as a key member of a retinal ciliopathy-associated protein complex, and that apoptosis of rod photoreceptor cells triggered by protein mislocalization is likely the mechanism of disease progression in LCA3/ juvenile RP patients.

Objective: 2014 marked a rising public commitment to universal health coverage in Vietnam to eliminate the financial burden for patients, but there are lots of hindrances. It is evident that patients met difficulties to validate their insurances, so health insurance does not significantly address out-of-pocket payments issues. Furthermore, the unequal geographical distribution of hospitals in Vietnam has created an inequality between non-residing patients and residing patients; the former usually pay more. This calls into question how the validity of healthcare insurance and patient’s residence could be related to patient’s financial status and their satisfaction with health insurance. Methods: Bayesian regression models are employed to analyze a data set of 1042 inpatients in hospitals of all levels in Northern Vietnam. Result: The results show that living in the same region as the hospital and having valid insurance is negatively correlated with the impoverishing risk. Regarding patients’ satisfaction with health insurance, it is negatively correlated with having a residence in the same region as the hospital but positively correlated with higher socioeconomic status and insurance validity. Finally, on average, the satisfaction of patients who have already recovered from the illness and those who quit early is lower than that of patients who needed follow-up in medical care or stop in the middle. Conclusion: This article suggests that policymakers consider addressing the unequal geographical distribution of hospitals and healthcare quality to help patients avoid going to hospitals outside their regions, which may generate a financial burden for patients and lower their satisfaction with health insurance.

We present an inquiry-based, aquatic science professional development (PD) for upper-elementary, middle, and high school teachers and examine changes in student outcomes in light of participating teachers' characteristics and the grade band of the students. Our study lends support to the assertion that inquiry- and content-focused PD, paired with classroom implementation, can effectively improve student learning. Our findings indicate that students improved in their nature of science (NOS) and aquatic science content knowledge and that these changes depended in some ways on the participating teachers' characteristics and adherence to the program. The students' improvements were amplified when their teachers adhered more closely to the PD activities during their classroom implementation. The teachers' previous science PD experience and pre-PD understanding of inquiry-based teaching also explained some of the variability in student growth. In both NOS and content, students of teachers with less prior science-PD experience benefited more. Grade band also explained variation in student outcomes through interactions with teacher-characteristic variables. In high school, students of teachers with lower pre-PD inquiry knowledge appeared to learn more about NOS. Our results suggest that inquiry and content training through PD may minimize disparities in teaching due to inexperience and lack of expertise. Our study also demonstrates the value of PD that teaches a flexible approach to inquiry and focuses on underrepresented, interdisciplinary content areas, like aquatic science.

During the COVID-19 pandemic, significantly fewer of New York City’s (NYC’s) 1.1 million public school children participated in emergency grab-and-go meals—heightening the risk of inadequate nutrition security for many of NYC’s most vulnerable residents. This study sought to examine student families’ facilitators and barriers to participation in the grab-and-go meal service and their experiences with pandemic-electronic benefit transfer (P-EBT) funds, a cash benefit distributed when schools were closed. We recruited 126 parents of children in NYC public schools who had participated in the grab-and-go service. Using opened-ended questions, we interviewed 101 parents in 25 1-h online focus groups. We identified four main themes which broadly impacted school meal participation: communication, logistics, meal appeal, and personal circumstances. Key facilitating subthemes included clear communication, ease of accessing sites, and high variety. Key sub-themes negatively impacting participation included limited communication and low meal variety. Accurate, timely communication; easily accessible distribution locations; and convenient distribution times could have increased participation and satisfaction. For P-EBT, parents welcomed the funds and used them readily, but some experienced difficulties obtaining payments. The simultaneous inclusion of community-based research in the evaluation of emergency feeding programs could improve future outcomes for school meal participation and electronic benefits.

Adherence to Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) may lower the risk of dementia by impacting immunity and cholesterol, which are pathways also implicated by genome-wide association studies of Alzheimer’s Dementia (AD). We examined whether adherence to the MIND diet could modify the association of genetic risk for AD with incident dementia. We used three ongoing US cohorts: Chicago Health and Aging Project (CHAP, n = 2449), Rush Memory and Aging Project (MAP, n = 725), and Women’s Health Initiative Memory Study (WHIMS, n = 5308). Diagnosis of dementia was based on clinical neurological examination and standardized criteria. Repeated measures of global cognitive function were available in MAP and CHAP. Self-reported adherence to MIND was estimated using food-frequency questionnaires. Global and pathway-specific genetic scores (GS) for AD were derived. Cox proportional hazard, logistic regression, and mixed models were used to examine associations of MIND, GS, and GS-MIND interactions with incident dementia and cognitive decline. Higher adherence to MIND and lower GS were associated with a lower risk of dementia in MAP and WHIMS and a slower rate of cognitive decline in MAP (p < 0.05). MIND or GS were not associated with incident dementia or cognitive decline in CHAP. No gene–diet interaction was replicated across cohorts. Genetic risk and MIND adherence are independently associated with dementia among older US men and women.

This study aims to evaluate the effectiveness of a web-based intervention to reduce alcohol consumption among hazardous drinkers. A two-group parallel randomized controlled trial was conducted among adults identified as hazardous drinkers according to the Alcohol Use Disorders Identification Test. The intervention delivers personalized normative feedback and some general information about alcohol. Participants can review their motivations and fears regarding reducing their alcohol intake, set individual goals and monitor their progress via a consumption diary and other tools. Within the control group, participants were provided with the same diary but could not access other services from the program. The primary outcome measure was the absolute difference in weekly alcohol intake (WAI) between baseline and 6-week follow-up. Secondary outcome measures included: relative difference in WAI; difference in excessive drinking and significant WAI reduction (decrease of 10% or more in WAI). One thousand one hundred and forty-seven people participated in the trial and 339 subjects completed it. Relative to the control group, participants in the intervention group reported a significantly greater mean absolute reduction in WAI (-3.3 versus -1.2, P = 0.03). Secondary outcomes also presented significant effects. This trial provides preliminary support to the effectiveness of this program in helping hazardous drinkers reduce their drinking, provided it is completely and regularly used.

Background: Based on our recently reported associations between specific dietary behaviors and the risk of COVID-19 infection in the UK Biobank (UKB) cohort, we further investigate whether these associations are specific to COVID-19 or extend to other respiratory infections. Methods: Pneumonia and influenza diagnoses were retrieved from hospital and death record data linked to the UKB. Baseline, self-reported (2006–2010) dietary behaviors included being breastfed as a baby and intakes of coffee, tea, oily fish, processed meat, red meat (unprocessed), fruit, and vegetables. Logistic regression estimated the odds of pneumonia/influenza from baseline to 31 December 2019 with each dietary component, adjusting for baseline socio-demographic factors, medical history, and other lifestyle behaviors. We considered effect modification by sex and genetic factors related to pneumonia, COVID-19, and caffeine metabolism. Results: Of 470,853 UKB participants, 4.0% had pneumonia and 0.2% had influenza during follow up. Increased consumption of coffee, tea, oily fish, and fruit at baseline were significantly and independently associated with a lower risk of future pneumonia events. Increased consumption of red meat was associated with a significantly higher risk. After multivariable adjustment, the odds of pneumonia (p ≤ 0.001 for all) were lower by 6–9% when consuming 1–3 cups of coffee/day (vs. p = 0.001 for interaction). Conclusions: In the UKB, consumption of coffee, tea, oily fish, and fruit were favorably associated with incident pneumonia/influenza and red meat was adversely associated. Findings for coffee parallel those we reported previously for COVID-19 infection, while other findings are specific to these more common respiratory infections.

Open Access (OA) publishing, with ambitious movements such as Plan S, is engendering radical changes among academic publishers. Emerging countries need to keep publishing as well as adopt open access to catch up with the changes. Using exclusive data from the Social Sciences & Humanities Peer Awards (SSHPA) database, the study employed both descriptive statistics and a Bayesian linear regression model to examine the journals and publishers in which Vietnamese social scientists published during the period 2008–2019, and the potential of pursuing the OA movement in Vietnam. We found an increasing diversification in the publishing sources of Vietnamese social science researchers with growth rates of 9.8% and 14.1% per annum in the number of publishers and journals, respectively. Given that the proportion of Gold OA articles had a fourfold increase over the examined period, it seems that the Vietnamese academic community is adopting OA. Furthermore, Bayesian analysis results hint at positive associations of internal and external collaborative power (number of domestic and foreign authors, respectively) with the decision to publish in OA (βb_TotalVN_OpenAccess = 0.22; βb_TotalForeign_OpenAccess = 0.15). The results and its implications suggest that Vietnamese policymakers and university director boards should facilitate as well as control the quality of the scientific publishing and the OA movement.