Plasma angiopoietin-like protein 2 levels and mortality risk among younger-old Japanese people: a population-based case-cohort study

Aging is important medical and social problem. Excessive angiopoietin-like protein (ANGPTL)-2 signaling causes chronic tissue inflammation, promoting development and progression of aging-related diseases. Moreover, circulating ANGPTL2 levels reportedly predict risk of some aging-related diseases and subsequent death. However, there are as yet no reports of whether circulating ANGPTL2 levels predict vital prognosis in younger-old, community-dwelling populations. This study investigated associations between plasma ANGPTL2 levels and all-cause and specific-cause mortality in this population. The case-cohort study was abstracted from an on-going, age-specific prospective cohort study: the New Integrated Suburban Seniority Investigation Project. This project enrolled 3073 participants aged 64 years at the beginning of the investigation from 1996 through 2005. A sub-cohort of 714 randomly sampled participants plus 387 cases representing deceased participants followed through 2015 underwent survival analysis. Plasma ANGPTL2 concentrations were positively associated with >80% and 100% higher risk of all-cause mortality and cancer mortality, respectively, after adjustment for gender, smoking, alcohol consumption, walking time, sleep duration, caloric intake, medical status, disease history, BMI, and triglyceride, creatinine, uric acid, and high sensitivity C-reactive protein levels. More robust association between ANGPTL2 levels and all-cause and cancer mortality was seen in subjects with either frailties or with lifestyles of heavier drinking or current smoking. Elevated plasma ANGPTL2 levels are associated with high all-cause and cancer mortality in a community-dwelling sample of younger-old adults. These findings expand our knowledge of human aging and associated diseases.

The impact of current smoking, regular drinking, and physical inactivity on health care-seeking behavior in China

Background People with lifestyle behaviors, such as current smoking, regular drinking, and physical inactivity, may experience a lack of or delayed health care, leading to severe sickness and higher health care expenditures in the future. Hence, the current study aims to ascertain the effects of current smoking, regular drinking, and physical inactivity on health care-seeking behavior among adults who report physical discomfort in China. Methods The data used in this study were obtained from the China Family Panel Studies (CFPS). The final sample consisted of 44,362 individuals who participated in all five waves of data collection. Logistic regression models were used for the analysis. Results The results of fixed effects logistic regression showed that among those who reported physical discomfort, adults who currently smoked cigarettes were 0.65 times less likely to seek health care than those who formerly smoked. Compared to nondrinkers, adults who regularly drank alcohol had a decreased likelihood of seeking health care. Adults who never engaged in physical exercise had 24% lower odds of seeking health care than those who engaged in physical exercise. Conclusions Current smoking, regular drinking, and physical inactivity decreased the probability of seeking health care among adults who reported physical discomfort. Therefore, screening and brief advice programs should be delivered by primary-level care and should pay more attention to individuals who engage in lifestyle behaviors such as current smoking, regular drinking, and physical inactivity, thus avoiding missed opportunities to treat chronic conditions and detect new diseases early.

Efficacy of Twice a Day Bismuth Quadruple Therapy for Second-Line Treatment of Helicobacter pylori Infection

Bismuth quadruple therapy (BQT) is an effective treatment for Helicobacter pylori infection. However, frequent dosing schedules of BQT regimen often compromise drug adherence and may affect treatment outcomes. This retrospective study aimed to investigate the efficacy of twice-daily BQT compared to that of four times a day therapy. From August 2018 to November 2020, adult patients who failed first-line standard triple therapy and underwent BQT were eligible. Patients were categorized into two groups according to dosing schedule: (i) the BQT group (n = 213) who received standard BQT administered four times a day; and (ii) the BQTb group (n = 141) who received proton pump inhibitor, bismuth 600 mg, metronidazole 500 mg, and tetracycline 1 g twice a day. The eradication rate did not differ between the BQT (92.5%) and the BQTb groups (90.1%) (p = 0.441). Adherence and adverse event rate were similar between the two groups. Multivariate analysis showed that current smoking was associated with eradication failure; however, dosing frequency was not associated with the efficacy of eradication therapy. This study suggested that twice a day BQT is as effective as four times a day therapy for second-line treatment of H. pylori infection.

Comparitive Study of Glutathione-S-Transferase Isoenzyme and Vitamin D Levels in Smokers and Non-smokers

Background: In developed countries, cigarette smoking is the leading preventable cause of morbidity and mortality. In the second half of this century, dramatic changes in the prevalence of cigarette smoking in the United States reduced current smoking levels to approximately one quarter of the adult population, reducing gender differences in smoking prevalence and smoking-attributable diseases. Cigarette smoking is a serious risk factor for lung cancer, which is the leading cause of cancer-related deaths in both men and women in the United States and around the world. Aim: Comparative Study of Glutathione-S-Transferase Isoenzyme mu and Vitamin-D Levels in Smokers and Non-Smokers. Materials and Methods: A total of 100 people aged 20 to 55 years old who came to Shalinitai Meghe hospital in Nagpur for a health check-up were chosen for the research. Non-smokers make up the control group, while smokers make up the research group. There are 50 patients in each group. ELISA was used to determine vitamin D status. An enzyme-linked immunosorbent assay was used to detect GST-µ in heparinized whole blood. Results: GST-µ was found to be mostly positive in smokers, and it was also found to be raised in heavy smokers (6.39±3.2) than light smokers (4.56±0.78). GST-µ is positive in light smokers. GST-µ is nearly equal in smokers (5.24±0.95) and heavy smokers relative to others. Conclusion: Quitting smoking for a longer period of time was related to higher vitamin D levels than current smoking. Furthermore, the GST-µ measure used in our research may be used to show differences in cytogenetic damage between smokers who have a genetically defined detoxification enzyme and those who do not.

The association of workplace smoke-free policies on individual smoking and quitting-related behaviours

Background Our study aims to provide information about workplace smoke-free (SF) policy coverage in mainland China and to assess the relationship between workplace SF policies and secondhand smoke (SHS) exposure, current smoking, smoking harm awareness and quitting intention among smokers. Method Data from the 2018 Asia Best Workplace Mainland China programme were used to address these aims. This cross-sectional study included 14,195 employees from the 2018 survey and 14,953 employees from the 2019 survey. Logistic regression with year-fixed effects was applied to these data. The dependent variables were SHS exposure, smoking or smoking harm awareness. The explanatory variable was the SF workplace policy. Results A total of 21,275 participants (73.0%) reported working under SF policies. The overall prevalence of smoking and SHS exposure were 20.3% and 52.5%, respectively. The workplace SF policy was significantly associated with lower SHS exposure (OR: 0.48, 95% CI: 0.45–0.51), lower current smoking employees (OR: 0.81, 95% CI: 0.76–0.87) and higher awareness of smoking harm (OR: 1.76, 95% CI: 1.61–1.91). However, workplace SF policy was not significantly associated with quitting intention (OR: 0.99, 95% CI: 0.84–1.16). Conclusion Our study identified that although most companies had established workplace SF policies, the overall prevalence of SHS exposure remained very high. Workplace SF policy is associated with lower SHS exposure, lower overall current smoking and higher awareness of smoking harm. These findings provide valuable evidence to promote such policies in all workplaces.

Epidemiology of Peripheral Vascular Disease in the Long Life Family Study (LLFS)

Atherosclerotic occlusion of peripheral arteries is a major contributor to morbidity and mortality in older adults. Our aim was to describe the epidemiology of peripheral artery disease (PAD) and other peripheral vascular disease (OPD) in the LLFS. 3248 individuals from 509 families (1182 probands, mean age 89; 2066 offspring, mean age 60) had doppler ankle-brachial index (ABI) assessment. Measures were performed twice for each posterior tibial artery and minimum of the mean ABI was used. PAD was defined as any ABI<0.9. OPD was defined as any ABI >1.4 or ≥1 non-compressible artery. Stepwise linear or logistic regression determined significant independent clinical and demographic predictors (P<0.05) after adjustment for age, sex, study center, and familial relatedness. Overall, ABI had a median of 1.2 with 7.4% PAD (18.1% probands, 1.2% offspring; P<0.001). OPD prevalence was 10.6% and was more common than PAD in offspring (8.1%). Age-adjusted OPD was higher in men (13.3%) than women (8.3%, P<0.001), while age-adjusted PAD did not did not differ by sex (P=0.45). Predictors of PAD included greater age and systolic blood pressure, lower diastolic blood pressure, prevalent kidney disease, antihypertensive use, and current smoking. Predictors of OPD included greater age, male sex, and current smoking. In these exceptionally long-lived families, PAD was low compared to other epidemiologic studies. However, OPD including non-compressible arteries, a marker of arterial stiffness, was more prevalent than PAD. These findings in long-lived families highlight a need for more epidemiologic research in other peripheral vascular disease in adults from the general population.

Sociodemographic, Lifestyle, Physical, and Psychosocial Determinants of Cognitive Reserve

Background: Cognitive reserve aims to explain individual differences in the susceptibility to the functional impact of dementia in the presence of equal amount of neuropathological damage. It is thought to be shaped by a combination of innate individual differences and lifetime exposures. Which determinants are associated with cognitive reserve remains unknown. Objective: The objective of this study was to investigate the associations of sociodemographic, lifestyle, physical, and psychosocial determinants with cognitive reserve, and potential sex differences. Methods: This cross-sectional study included 4,309 participants from the Rotterdam Study (mean age 63.9±10.7) between 2006–2016. Participants completed five cognitive tests and a brain MRI-scan. Cognitive reserve was defined as a latent variable that captures variance common across five cognitive tests, while adjusting for demographic and MRI-inferred neuropathological factors. The associations of potential determinants and cognitive reserve, adjusted for relevant confounders, were assessed with structural equation models. Results: Current smoking (adjusted mean difference: –0.31, 95%confidence interval –0.42; –0.19), diabetes mellitus (–0.25, –0.40; –0.10) and depressive symptoms (–0.07/SD, –0.12; –0.03) were associated with a lower cognitive reserve whereas alcohol use (0.07/SD, 0.03; 0.12) was associated with higher cognitive reserve. Only smoking was associated with cognitive reserve in both men and women. Employment, alcohol use, diabetes, history of cancer, COPD, and depressive symptoms were only associated with cognitive reserve in women. Conclusion: Our study found that current smoking, diabetes mellitus, and depressive symptoms were associated with a lower cognitive reserve, whereas more alcohol use was associated with a higher cognitive reserve, but with clear differences between men and women.

Workplace violence against frontline clinicians in emergency departments during the COVID-19 pandemic

Background Frontline clinicians working in emergency departments (ED) were at disportionate risk of workplace violence (WPV). We investigated the prevalence of WPV and its relationship with quality of life (QOL) in this group of health professionals in China during the COVID-19 pandemic. Methods A cross-sectional, online study was conducted. The nine-item Workplace Violence Scale measured WPV. Results A total of 1,103 ED clinicians participated in this study. The overall prevalence of WPV against ED clinicians was 29.2% (95% CI [26.5%-31.9%]). Having family/friends/colleagues infected with COVID-19 (Odds Ratio (OR) = 1.82, P = 0.01), current smoking (OR = 2.98, P < 0.01) and severity of anxiety symptoms (OR = 1.08, P < 0.01) were independently and positively associated with WPV, while working in emergency intensive care units (OR = 0.45, P < 0.01) was negatively associated with WPV. After controlling for covariates, clinicians experiencing WPV had a lower global QOL compared to those without (F(1, 1103) = 10.9,P < 0.01). Conclusions Prevalence of workplace violence against ED clinicians was common in China during the COVID-19 pandemic. Due to the negative impact of WPV on QOL and quality of care, timely preventive measures should be undertaken for ED clinicians.