Electronic Cigarette Use Prevalence, Associated Factors, and Pattern by Cigarette Smoking Status in the United States From NHANES (National Health and Nutrition Examination Survey) 2013-2014

BACKGROUND: To examine the prevalence and patterns of recent electronic cigarette (e-cigarette) use in a nationally representative sample of US adults and adolescents. METHODS AND RESULTS: Using tobacco information from NHANES (National Health and Nutrition Examination Survey) 2013-2014, 5423 adults and 895 adolescents (aged 13-17 years) were included in this analysis. Demographic, tobacco use, and drug use information were self-reported. Recent e-cigarette use (within the previous 5 days) was stratified by smoking status. Of 125 e-cigarette users, 116 participants were aged ≥18 years, corresponding to 2.6% (95% confidence interval [CI], 2.0-3.1) and 1.21% (95% CI, 0.3-2.1) prevalence of e-cigarette use among US adults and adolescents, respectively. E-cigarette adult users were current smokers (68.1%), former smokers (23.7%), and never smokers (8.2%). The highest prevalence of e-cigarette use was among current smokers (8.2%; 95% CI, 6.3-10.1), followed by former smokers (2.7%; 95% CI, 1.4-4.1), and then never smokers (0.4%; 95% CI, 0.2-0.6). After adjusting for age, sex, and ethnicity, e-cigarette users had higher odds of being exposed to secondhand smoke (odds ratio: 6.3; 95% CI, 3.6-11.1) and drinking alcohol (odds ratio: 4.2; 95% CI, 1.8-10.0) and lower odds of having at least a college education or a higher income, compared with tobacco nonusers. CONCLUSIONS: Between 2013 and 2014, e-cigarette use in the United States was more common among younger people, those with low socioeconomic status, and current and former smokers. These findings will help inform future research as well as public policy and regulatory actions

Transcriptional profiling of livers from different strain of mice treated with Asparaginase

Asparaginase (ASNase) is widely used to treat acute lymphoblastic leukemia (ALL) in children but it causes metabolic complications related to liver toxicity. ASNase results in the synthesis of some factors such as ATF4. The eIF2-ATF4 pathway is essential for cell survival during amino acid starvation conditions. Activation of the AAR in the liver requires the eIF2 kinase called general control nonderepressible 2 kinase (GCN2). To what extent activation of the GCN2-eIF2-AAR is mediated by ATF4 is unknown. Our objective and hypothesis are addressed in our aim to describe the liver response to ASNase in mice deleted for Atf4. RNA sequencing alongside complementary biochemical approaches was performed in the livers of mice treated with eight daily injections of ASNase or saline excipient. Differences in gene expression were evaluated. We also explored the relationship between the different treatment groups and strains. This research provides insight into the importance of genetic background of patients in choosing ASNase as a treatment

Determinants of Waterpipe and Cigarette Smoking Progression among a School Based Sample of Adolescents in Irbid, Jordan: A Three-Year Longitudinal Study (2008-2011)

The prevalence of waterpipe smoking exceeds that of cigarettes among adolescents in the Middle East where waterpipe is believed as less harmful, less addictive and can be a safer alternative to cigarettes. This dissertation tested the gateway hypothesis that waterpipe can provide a bridge to initiate cigarette smoking, identified the predictors of cigarette smoking progression, and identified predictors of waterpipe smoking progression among a school-based sample of Jordanian adolescents (mean age ± SD) (12.7 ±0.61) years at baseline. Data for this research have been drawn from Irbid Longitudinal Study of smoking behavior, Jordan (2008-2011). The grouped-time survival analysis showed that waterpipe smoking was associated with a higher risk of cigarette smoking initiation compared to never smokers (P \u3c 0.001) and this association was dose dependent (P \u3c 0.001). Predictors of cigarette smoking progression were peer smoking and attending public schools for boys, siblings’ smoking for girls, and the urge to smoke for both genders. Predictors of waterpipe smoking progression were enrollment in public schools, frequent physical activity, and low refusal self-efficacy for boys, ever smoking cigarettes, friends’ and siblings’ waterpipe smoking for girls. Awareness of harms of waterpipe among boys and seeing warning labels on the tobacco packs by girls were protective against waterpipe smoking progression. In Conclusion, waterpipe can serve as a gateway to cigarette smoking initiation among adolescents. Waterpipe and cigarette smoking progressions among initiators were solely family-related among girls, and mainly peer-related among boys. The unique gender differences for both cigarette and waterpipe smoking among Jordanian adolescents in Irbid call for cultural and gender-specific smoking prevention interventions to prevent the progression of smoking among initiators

General Control Nonderepressible 2 and ATF4 Direct Liver Genes during Asparaginase Treatment in Mice

Asparaginase (ASNase) treatment results in the synthesis of some factors such as ATF4. The eIF2-ATF4 pathway is essential for cell survival during amino acid starvation conditions. Activation of the AAR in the liver requires the eIF2 kinase called general control nonderepressible 2 kinase (GCN2). To what extent activation of the GCN2-eIF2-AAR is mediated by ATF4 is unknown. Our objective and hypothesis are addressed in our aim to describe the liver response to ASNase in mice deleted for Atf4. RNA sequencing alongside complementary biochemical approaches was performed in the livers of mice treated with eight daily injections of ASNase or saline excipient. Cellular pathways examined in detail included the AAR. We discovered that global hepatic gene expression patterns in Atf4 knockout mice overlapped with Gcn2 knockout mice. Shared hepatic pathways or processes altered during ASNase included mTOR signaling, and xenobiotic metabolism. On the other hand, loss of Atf4 during ASNase uniquely altered gene expression signatures reflecting signaling via eIF2 and ER stress. This research provides insight into the importance of genetic background of patients in choosing ASNase as a treatmen

Predictors of Cigarette Smoking Progression Among a School-Based Sample of Adolescents in Irbid, Jordan: A Longitudinal Study (2008–2011)

INTRODUCTION: Little evidence regarding longitudinal predictors of cigarette smoking progression is available from developing countries. This study aimed to identify gender-specific individual and social predictors of cigarette smoking progression among a school-based sample of adolescents in Irbid, Jordan. METHODS: A total of 1781 seventh graders (participation rate 95%) were enrolled and completed an annual self-administered questionnaire from 2008 through 2011. Students who reported ever-smoking a cigarette at baseline or in the subsequent follow-up but not being heavy daily smokers (\u3e10 cigarettes per day) were eligible for this analysis (N = 669). Grouped-time survival analyses were used to identify predictors of cigarette smoking progression in boys and girls. RESULTS: Among the study sample, 38.3% of students increased the frequency and /or amount of cigarette smoking during the 3 years of follow-up. Among individual factors, the urge to smoke in the morning predicted smoking progression for boys and girls. The independent predictors of cigarette smoking progression were friends\u27 smoking and attending public schools in boys, and siblings\u27 smoking in girls. Discussing the dangers of smoking with family members was protective for girls. CONCLUSION: Boys and girls progressed similarly in cigarette smoking once they initiated the habit. Progression among girls was solely family-related, while it was peer-related for boys

Waterpipe a gateway to cigarette smoking initiation among adolescents in Irbid, Jordan: a longitudinal study

SETTING: According to anecdotal evidence, waterpipe smoking may lead to the initiation of cigarette smoking among young people. This hypothesis is yet to be examined using an appropriate study design and a theoretical model for behavioral change. OBJECTIVE: To compare the risk of cigarette smoking initiation among waterpipe-only smokers and never smokers in a school-based sample of adolescents from Irbid, Jordan. METHODS: A total of 1454 cigarette-naïve participants were drawn from a longitudinal study on smoking behavior conducted in Irbid among 1781 seventh graders who were enrolled at baseline (2008) and completed the study questionnaire on smoking behavior annually until 2011. Grouped time-survival analysis was used to compare the risk of subsequent initiation of cigarette smoking between waterpipe smokers (n = 298) and never smokers (n = 1156) using adjusted hazard ratios (aHRs) and 95% confidence intervals (95%CI). RESULTS: Risk of initiation of cigarette smoking among waterpipe smokers was significantly higher than among never smokers after adjusting for potential confounders (aHR 1.67, 95%CI 1.46–1.92). The association between waterpipe and cigarette smoking initiation was dose-dependent. The risk of initiating cigarette smoking increased with increase in the frequency of waterpipe smoking (P for linear trend < 0.001). CONCLUSIONS: Waterpipe smoking led to the initiation of cigarette smoking among this cohort of Jordanian adolescents; the effect was dose-dependent

Predictors of waterpipe smoking progression among youth in Irbid, Jordan: A Longitudinal Study (2008-2011)

BACKGROUND: The predictors of waterpipe smoking progression are yet to be examined using a longitudinal study that is guided by a theoretical model of behavioral change. This study identifies the gender-specific predictors of waterpipe smoking progression among adolescents in Irbid, Jordan. METHODS: This study uses data from a school longitudinal study of smoking behavior in Irbid, Jordan. A random sample of 19 schools was selected by probability proportionate to size. A total of 1781 seventh graders were enrolled at baseline, and completed a questionnaire annually from 2008 through 2011. Students who reported ever smoking waterpipe (N = 864) at any time point were assessed for progression (escalation in the frequency of waterpipe smoking) in the subsequent follow-up. Grouped-time survival analysis was used to identify the risk of progression. RESULTS: During the three years of follow-up, 29.6% of students progressed in waterpipe smoking. Predictors of waterpipe smoking progression were higher mother's education, enrollment in public school, frequent physical activity, and low refusal self-efficacy among boys, having ever smoked cigarettes, and having friends and siblings who smoke waterpipe among girls. Awareness of harms of waterpipe was protective among boys and seeing warning labels on the tobacco packs was protective among girls. CONCLUSIONS: Even at this early stage, about a third of waterpipe smokers progressed in their habit during the 3 year follow up. Factors predicting progression of use differed by gender, which calls for gender-specific approaches to waterpipe interventions among Jordanian youth

Nephroprotective roles of local licorice, peppermint extracts and their mixture on gentamicin-induced renal insufficiency in Wistar albino rats

Aminoglycosides (AGs) such as gentamicin (gen) are considered as the optimum therapy for many infections and diseases. Unfortunately, AGs treatment has been linked to acute kidney injury that is also referred to as nephrotoxicity. In the current study, we sought to explore the protective roles of peppermint (pep) and licorice (Lic) extracts as well as their mixture on gen-induced nephrotoxicity. Forty male and female Wistar albino rats were divided into 5 experimental groups: C- was administered with 2 ml of normal saline as a single daily dose intraperitoneally (i.p.) for 14 d. C+ was administered with once-daily i.p. injections of 100 mg/kg BW gen for 8 d. T1 group was administered once-daily i.p. of gen (100mg/kg BW) for 8 d. and Lic ethanolic extract (EE) (100mg/kg BW) every 12 hr for 14 d. T2 was administered once-daily i.p. of gen for 8 d. and pep EE (100mg/kg BW) every 12 hr for 14 d. T3 was administered once-daily i.p. of gen for 8 d. in addition to lic and pep EE mixture (100mg/kg BW) every 12 hr for 14 d. At the end of the study, all rats were anesthetized and trunk blood collected to study renal injury parameters. Those include serum enzymes such as AST, ALT, and ALP; kidney damage markers including urea, creatinine, and total protein; serum electrolytes including Cl, K, and Na levels as well as other renal function markers such as Glutathione peroxidase (GSH) and superoxide dismutase (SOD). All the parameters that indicated the nephrotoxicity occurrence in the C+ group in response to gen were found to be highly improved in most of the studied aspects in T1, T2, and T3. We found that Lic and pep extracts improve renal injury, kidney damage, and renal function markers opposed to gentamicin treatment. In conclusion, our study suggests prescribing those remedies to AGs receiving patients

Further investigation on the degree of deacetylation of chitosan determined by potentiometric titration

The degree of deacetylation (DDA) of various low molecular weight chitosan (LMWC) species as the hydrochloride and free base (amine form) was determined by direct and back potentiometric titration, respectively. The DDA values obtained for the chitosan hydrochloride by direct titration were greater than 93% for all oligomers tested (Molecular weight (Mwt) between about 1.3 to 30.0 kDa). However, the DDA values obtained for chitosan amine oligomers using back titration were significantly lower, especially for the relatively high molecular weight (30.0 kDa) chitosan amine oligomers. Furthermore, after using the back titration method, greater DDA values were obtained for the same samples of chitosan amine after the chitosan solution had been heated to 60EC before titration. In addition, the DDA values showed a significant decrease with increased concentration for a given chitosan oligomer. Although the effects of hydration time, ionic strength and method specific behavior were not explicitly studied and therefore cannot be entirely ruled out, the results from this study might be attributed to the conformation of changes of chitosan in solution that lead to more inter/intra attractive forces in the case of chitosan amine. The DDA values obtained by the potentiometric method were also compared with those obtained by the FDUV and IR spectroscopic methods. Thus, subject to the caveats mentioned above, DDA values obtained for chitosan amine by the back titration method should be used with caution since the results are significantly lower than those obtained by direct titration, FDUV spectroscopy or FTIR

A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.

BACKGROUND: Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. METHODS AND FINDINGS: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia;$39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and$1,3000,000,000 and 378439 LYG in Turkey. CONCLUSION: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives