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    Additional file 2 of The association between risk perceptions, anxiety, and self-reported changes in tobacco and nicotine product use due to COVID-19 in May-June 2020 in Israel

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    Additional file 2. Reported use of combustible cigarettes (CCs), Nargila, and E-cigarettes/IQOS before COVID-19, by Population Group and gender: Descriptive statistics (Weighted data)

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    The association between risk perceptions, anxiety, and self-reported changes in tobacco and nicotine product use due to COVID-19 in May-June 2020 in Israel

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    Abstract Background Early in the COVID-19 pandemic, reports about a possible protective effect of nicotine on COVID-19 conflicted with messaging by public health organizations about increased risks of COVID-19 due to smoking. The ambiguous information the public received, combined with COVID-19-induced anxiety, may have led to changes in tobacco or other nicotine product use. This study examined changes in use of combustible cigarettes (CCs), nargila (hookah/waterpipe), e-cigarettes, and IQOS and home-smoking behaviors. We also assessed COVID-19 related anxiety and perceptions regarding changes in risk of COVID-19 severity due to smoking. Methods We used cross-sectional data from a population telephone survey that was conducted in Israel in the early phase of the COVID-19 pandemic (May–June 2020) and included 420 adult (age 18+) individuals who reported having ever used CCs (n = 391), nargila (n = 193), and/or electronic cigarettes (e-cigarettes)/heated tobacco products (e.g., IQOS) (n = 52). Respondents were asked about the effect that COVID-19 had on their nicotine product use (quit/reduced use, no change, increased use). We assessed changes in product use, risk perceptions, and anxiety using adjusted multinomial logistic regression analyses. Results Most respondents did not change their frequency of product use (CCs: 81.0%, nargila: 88.2%, e-cigarettes/IQOS: 96.8%). A small percentage either decreased use (CCs: 7.2%, nargila: 3.2%, e-cigarettes/IQOS:2.4%) or increased use (CCs:11.8%, nargila:8.6%, e-cigarettes/IQOS:+ 0.9%). 55.6% of respondents used a product in the home prior to COVID-19; but during the first lockdown COVID-19 period, a greater percentage increased (12.6%) than decreased (4.0%) their home use. Higher levels of anxiety due to COVID-19 were associated with increased home smoking (aOR = 1.59, 95% CI:1.04–2.42, p = 0.02). Many respondents believed that increased severity of COVID-19 illness was associated with CCs (62.0%) and e-cigarettes/vaping (45.3%), with uncertainty about the association being lower for CCs (20.5%) than for vaping (41.3%). Conclusions While many respondents believed that nicotine product use (particularly CCs and e-cigarettes) was associated with increased risk of COVID-19 disease severity, the majority of users did not change their tobacco/nicotine use. The confusion about the relationship between tobacco use and COVID-19 calls for clear evidence-based messaging from governments. The association between home smoking and increased COVID-19-related stress suggests the need for campaigns and resources to prevent smoking in the home, particularly during times of stress

    Pancreatic Adenocarcinoma: Real World Evidence of Care Delivery in AccessHope Data

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    Background: Pancreatic adenocarcinoma is an aggressive disease and the delivery of comprehensive care to individuals with this cancer is critical to achieve appropriate outcomes. The identification of gaps in care delivery facilitates the design of interventions to optimize care delivery and improve outcomes in this population. Methods: AccessHope™ is a growing organization that connects oncology subspecialists with treating providers through contracts with self-insured employers. Data from 94 pancreatic adenocarcinoma cases (August 2019–December 2022) in the AccessHope dataset were used to describe gaps in care delivery. Results: In all but 6% of cases, the subspecialist provided guideline-concordant recommendations anticipated to improve outcomes. Gaps in care were more pronounced in patients with non-metastatic pancreatic cancer. There was a significant deficiency in germline testing regardless of the stage, with only 59% of cases having completed testing. Only 20% of cases were receiving palliative care or other allied support services. There was no difference in observed care gaps between patients receiving care in the community setting vs. those receiving care in the academic setting. Conclusions: There are significant gaps in the care delivered to patients with pancreatic adenocarcinoma. A concurrent subspecialist review has the opportunity to identify and address these gaps in a timely manner

    Deer or Horses with Antlers? Wooden Figures Adorning Herders in the Altai

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    Among the burials of horse herders who lived in the 4th–3rd centuries BCE Altai Mountains of South Siberia were some that contained small wooden figures of four-legged hoofed animals that represent horses, deer, or hybrid creatures. They decorated headgear buried with select commoners of the Pazyryk Culture. Although the people, material possessions, and horses of the elites were frequently ornamented with imagery often associated with the so-called Scytho-Siberian animal style, these figurines are generally more realistic and less stylized representations of natural creatures, either cervids or horses. There is, however, ambiguity in these representations; in some cases, figures that are horses have inset recesses on the tops of their heads, in addition to holes for ear inserts. This recalls the elaborate headdresses on some horses outfitted with large displays of antlers or horns made of wood, leather, and felt buried with the Pazyryk leaders. The implication of this ambiguity is explored here. Horses were “cultural capital and tokens of clout” (see Andreeva Introduction, this volume) in the Pazyryk Culture, as well as the base of the economy. Deer were foundational to older belief systems in Siberia. The commingling of horse, mountain goat/ibex, and deer features in Pazyryk Culture imagery has inspired this study

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