Symptoms of tobacco dependence among middle and high school tobacco users - Data from the 2019-2020 National Youth Tobacco Survey.

INTRODUCTION: Previous studies have indicated that youth who use tobacco products, including cigarettes, cigars, and smokeless tobacco, demonstrate dependence symptoms. However, the tobacco marketplace has expanded dramatically in recent years, and few studies have examined dependence symptoms among youth who use novel products. This study combined 2019-2020 National Youth Tobacco Survey data to report the prevalence and determinants of tobacco dependence symptoms among U.S. middle and high school current (past 30-day) tobacco users. METHODS: Prevalence estimates were calculated to examine dependence outcomes and other covariates by user groups (single product users and multiple product users). Multivariable logistic regression analyses were used to identify independent predictors of tobacco dependence among current users of cigarettes, cigars (regular cigars, cigarillos, and little cigars), e-cigarettes, heated tobacco products, hookah, pipe tobacco, bidis, and smokeless tobacco products (chew, snuff, dip, snus, and dissolvables). RESULTS: Among current tobacco users, 15.7 % (95 % CI: 14.2-17.3) reported wanting to use tobacco within 30 min of waking and 28.3 % (95 % CI: 26.3-30.5) reported strong cravings for tobacco in the past 30 days. Nearly-two-thirds of current users were single product users, of which 80.5 % reported using e-cigarettes. Reporting of dependence symptoms was generally associated with multiple product use, higher frequency of use, earlier initiation age, and use of flavored products. CONCLUSIONS: Among U.S. adolescents, a considerable amount of current tobacco product users, even infrequent users, reported symptoms of dependence. These findings highlight the continued importance of prevention strategies for youth tobacco experimentation and progression to regular use.

Detection of SARS-CoV-2 RNA Using a DNA Aptamer Mimic of Green Fluorescent Protein.

RNA detection is important in diverse diagnostic and analytical applications. RNAs can be rapidly detected using molecular beacons, which fluoresce upon hybridizing to a target RNA but require oligonucleotides with complex fluorescent dye and quencher conjugations. Here, we describe a simplified method for rapid fluorescence detection of a target RNA using simple unmodified DNA oligonucleotides. To detect RNA, we developed Lettuce, a fluorogenic DNA aptamer that binds and activates the fluorescence of DFHBI-1T, an otherwise nonfluorescent molecule that resembles the chromophore found in green fluorescent protein. Lettuce was selected from a randomized DNA library based on binding to DFHBI-agarose. We further show that Lettuce can be split into two separate oligonucleotide components, which are nonfluorescent on their own but become fluorescent when their proximity is induced by a target RNA. We designed several pairs of split Lettuce fragments that contain an additional 15-20 nucleotides that are complementary to adjacent regions of the SARS-CoV-2 RNA, resulting in Lettuce fluorescence only in the presence of the viral RNA. Overall, these studies describe a simplified RNA detection approach using fully unmodified DNA oligonucleotides that reconstitute the Lettuce aptamer templated by RNA.

Community Assessment of Extreme Heat Preparedness in Milwaukee, Wisconsin.

BACKGROUND: This article describes the first Community Assessment for Public Health Emergency Response (CASPER) rapid needs assessment project to be conducted in Wisconsin. The project focused on extreme heat preparedness. METHODS: Fifteen teams conducted household surveys in 30 census blocks in the city of Milwaukee, Wisconsin. RESULTS: Survey results indicated that the majority of households were unaware of the location of a nearby cooling center. Although the vast majority of households reported some form of air conditioning in their house, over half felt too hot inside their home sometimes, most of the time, or always. DISCUSSION: The community partnerships ensured that this project was conducted with local partner input and that the data could be used to inform extreme heat response.

Impact of pharmacological treatment of diabetes mellitus on dementia risk: systematic review and meta-analysis.

BACKGROUND: The association between diabetes mellitus (DM) treatment and dementia is not well understood. OBJECTIVE: To investigate the association between treatment of diabetes, hypoglycemia, and dementia risk. RESEARCH DESIGN AND METHODS: We performed a systematic review and meta-analysis of pharmacological treatment of diabetes and incident or progressive cognitive impairment. We searched Ovid MEDLINE, Embase, Cochrane Central Registry of Controlled Trials, and PsychINFO from inception to 18 October 2017. We included cross-sectional, case-control, cohort, and randomized controlled studies. The study was registered with PROSPERO (ID CRD42017077953). RESULTS: We included 37 studies into our systematic review and 13 into our meta-analysis. Ten studies investigated any antidiabetic treatment compared with no treatment or as add-on therapy to prior care. Treatment with an antidiabetic agent, in general, was not associated with incident dementia (risk ratio (RR) 1.01; 95% CI 0.93 to 1.10). However, we found differential effects across drug classes, with a signal of harm associated with insulin therapy (RR 1.21; 95% CI 1.06 to 1.39), but potentially protective effects with thiazolidinedione exposure (RR 0.71; 95% CI 0.55 to 0.93). Severe hypoglycemic episodes were associated with a nearly twofold increased likelihood of incident dementia (RR 1.77; 95% CI 1.35 to 2.33). Most studies did not account for DM duration or severity. CONCLUSIONS AND LIMITATIONS: The association between treatment for diabetes and dementia is differential according to drug class, which is potentially mediated by hypoglycemic risk. Not accounting for DM duration and/or severity is a major limitation in the available evidence base.

Depression Case Finding in Individuals with Dementia: A Systematic Review and Meta-Analysis.

OBJECTIVES: To compare the diagnostic accuracy of depression case finding tools with a criterion standard in the outpatient setting among adults with dementia. DESIGN: Systematic review and meta-analysis. SETTING: Studies of older outpatients with dementia. PARTICIPANTS: Elderly outpatients (clinic and long-term care) with dementia (N = 3,035). MEASUREMENTS: Prevalence of major depression and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios. RESULTS: From the 11,539 citations, 20 studies were included for qualitative synthesis and 15 for a meta-analysis. Tools included were the Montgomery Åsberg Depression Rating Scale, Cornell Scale for Depression in Dementia (CSDD), Geriatric Depression Scale (GDS), Center for Epidemiologic Studies Depression Scale (CES-D), Hamilton Depression Rating Scale (HDRS), Single Question, Nijmegen Observer-Rated Depression Scale, and Even Briefer Assessment Scale-Depression. The pooled prevalence of depression in individuals with dementia was 30.3% (95% CI = 22.1-38.5). The average age was 75.2 (95% CI = 71.7-78.7), and mean Mini-Mental State Examination scores ranged from 11.2 to 24. The diagnostic accuracy of the individual tools was pooled for the best-reported cutoffs and for each cutoff, if available. The CSDD had a sensitivity of 0.84 (95% CI = 0.73-0.91) and a specificity of 0.80 (95% CI = 0.65-0.90), the 30-item GDS (GDS-30) had a sensitivity of 0.62 (95% CI = 0.45-0.76) and a specificity 0.81 (95% CI = 0.75-0.85), and the HDRS had a sensitivity of 0.86 (95% CI = 0.63-0.96) and a specificity of 0.84 (95% CI = 0.76-0.90). Summary statistics for all tools across best-reported cutoffs had significant heterogeneity. CONCLUSION: There are many validated tools for the detection of depression in individuals with dementia. Tools that incorporate a physician interview with patient and collateral histories, the CSDD and HDRS, have higher sensitivities, which would ensure fewer false-negatives.

Activities associated with injuries in initial entry training.

Previous studies have not reported activities associated with injuries in initial entry training (IET) because these data were seldom available in medical records and not contained in electronic databases. This investigation obtained activities associated with outpatient encounters in IET recorded by primary medical care providers at Fort Leonard Wood, Missouri. Data were entered into a standard database that included fields for diagnosis and activity associated with the injury. Fifty percent of the new injury encounters (i.e., exclusive of follow-ups) were not associated with a specific event but were reported as having a gradual onset. Other activities included physical training (16%), road marching (15%), confidence/obstacle courses (5%), and barracks activities (3%). Risks per unit of training time were estimated at 13, 62, and 97 injuries per hour for physical training, road marching, and the confidence/obstacle courses, respectively. The most frequently recorded diagnoses were joint pain (27%), strains (15%), blisters (14%), sprains (13%), and tendonitis (12%). The types of injuries and their anatomical locations were similar to those reported in other IET investigations, although blister-related encounters were higher. This investigation identifies activities with the highest risk of injury in IET and those that should be targeted for injury prevention efforts.

A systematic review of the effects of physical training on load carriage performance.

Soldiers are often required to carry heavy loads during military operations. This article reports on a systematic literature review examining the influence of physical training on load carriage performance. Several literature databases, reference lists, and other sources were explored to find studies that quantitatively examined the effects of physical training on the time taken for individuals to complete a set distance carrying an external load, with the majority of the load contained in a backpack. Effect sizes (Cohen's d statistic) were used in meta-analyses to examine the changes in load carriage performance after various modes of physical training. Effect sizes quantified training-related changes in terms of SD units. Ten original research studies met the review criteria. Meta-analysis indicated that large training effects (≥0.8SD units) were apparent when progressive resistance training was combined with aerobic training and when that training was conducted at least 3 times per week, over at least 4 weeks. When progressive load-carriage exercise was part of the training program, much larger training effects were evident (summary effect size [SES] = 1.7SD units). Field-based training that combined a wide variety of training modes and included progressive load-carriage exercise was also very effective in improving load carriage performance (SES = 1.1SD units). Aerobic training alone or resistance training alone had smaller and more variable effects, depending on the study. This review indicates that combinations of specific modes of physical training can substantially improve load carriage performance.

Physiological characteristics of elite sport-dancers.

AIM: Dancesport is increasing its popularity and it becomes to be considered as a real sport. Few studies are available about the physiological strain of dancesport competitions: moreover, recent changes in the official rules make it mandatory to revise our knowledge about the specific physiologic demands during competition. The aim of our study was to evaluate physiological parameters in top-level dancers. METHODS: Twelve competitive dancesport couples (12 Latin-American and 12 Standard dancers) composed the study population. The first testing session was aimed at determining physical and physiological characteristics of athletes in laboratory; the second, at establishing physiological responses during simulated competition on field, involving the measurement of O(2) uptake (VO(2)), heart rate and blood lactate (BL). RESULTS: Male dancers showed a peak-VO(2) of 60.9±6.0 and 59.2±7.0 mL/kg/min for Standard and Latin-American dancers, respectively. For females, peak-VO(2) was 53.7±5.0 mL/kg/min in Standard and 52.3±5.0 mL/kg/min in Latin-American dancers. During simulated competition, male dancers reached the 75.7±10.6 and 84.2±11.2% of peak-VO(2) (P<0.05) for Standard and Latin-American sequence, respectively. For females, no difference was observed (70.8±13.8% in Latin-American and 72.5±12.8% in Standard). Peak-BL during simulated Standard competition was 6.50±2.1 and 6.91±2.6 mM in males and females, respectively, and, for Latin-American sequence, 7.95±2.1 mM in males and 6.04±2.5 mM in females. CONCLUSION: Dancesport can be defined as a sport discipline with an alternate physical activity with medium lasting and high energy-demanding (both aerobic and anaerobic) consecutive phases, separated by short recovery periods. These data must be kept into account while planning specific training programs in sportdancers.

[Sport and physical activity]. / Sport e attività fisica.

A regular sport activity involves physical and psychological benefits helping to improve the quality of life at any age. This aspect is even more important in the developing age, when the sport takes on a role of training and education. In this context, instances directed to allow adolescent and young adults with heart disease to practice sports seem justified, and they're becoming more pressing since when the diagnostic and therapeutic advances, especially in cardiac surgery and in interventional hemodynamics, allow an increasing number of patients, previously allocated to physical inactivity, to lead an active lifestyle. However, we have to keep in mind that congenital heart disease population is varied, not only by the nature of the malformation, but also because in the same cardiopathy you can find subjects in "natural history" or after surgery and, between them, subjects treated with several techniques and different outcomes. This justifies the need for a close collaboration between sports doctors, cardiologists and heart surgeons, particularly in the management of the most difficult and delicate problems.

Outcome of newborns with asymptomatic monomorphic ventricular arrhythmia.

BACKGROUND: Frequent premature ventricular contractions (PVCs), couplets (CPLTs) and episodes of ventricular tachycardia are extremely rare in the neonatal population. Limited information is available with regard to clinical relevance and outcome. OBJECTIVES: To evaluate the clinical characteristics and outcomes of a group of newborns with ventricular arrhythmias without heart disease. PATIENTS AND DESIGN: Between January 2000 and January 2003, 16 newborns with ventricular arrhythmias in the absence of heart disease were studied. The newborns were divided into three groups: PVC group (n = 8), CPLT group (n = 4) and ventricular tachycardia group (n = 4). All patients underwent physical examination, electrocardiography, Holter monitoring and echocardiography at diagnosis and at follow-up (1, 3, 6 and 12 months, and yearly thereafter). RESULTS: Mean (standard deviation, SD) age of the patients was 3 (1.19) days in the PVC group, 3.25 (0.95) days in the CPLT group and 6.5 (9.1) days in the ventricular tachycardia group. Median follow-up was 36 months (range 24-48 months). PVCs disappeared during follow-up in all the neonates, in the PVC group, at a mean (SD) age of 2.1 (1.24) months; in the CPLT group, couplets disappeared at a mean (SD) age of 6.5 (1) months. All patients with ventricular tachycardia were treated; ventricular tachycardia disappeared at a mean (SD) age of 1.7 (0.9) months. Neither death nor complications occurred. CONCLUSIONS: Ventricular arrhythmias in newborns without heart disease have a good long-term prognosis. Frequent PVCs and CPLTs do not require treatment. Sustained ventricular tachycardia or high-rate ventricular tachycardia must be treated, but the prognosis is generally favourable.

Does early repolarization in the athlete have analogies with the Brugada syndrome?

AIMS: To re-examine the prevalence and presentation of early repolarization in athletes and to compare it with electrocardiographic abnormalities observed in patients with the Brugada syndrome. METHODS: Electrocardiograms of 155 male athletes and 50 sedentary controls were studied. Early repolarization was considered present if at least two adjacent precordial leads showed elevation of the ST segment > or =1 mm. Amplitude and morphology of ST elevation, the leads where it was present and the lead in which it showed its maximum value were analysed together with QRS duration, the presence of right ventricular activation delay, QT and QTc duration. Data were compared with those obtained by electrocardiograms of 23 patients with the Brugada syndrome. RESULTS: Early repolarization was found in 139 athletes (89%) and 18 controls (36%, P< or =0.025), being limited to right precordial leads in 42 (30%) athletes and 13 (72%) controls (P< or =0.001). Only 12 (8.6%) athletes and one control (5.5%) with early repolarization had an ST elevation 'convex toward the top' in right precordial leads, similar to that seen in the Brugada syndrome. In athletes the maximum ST elevation was greater (2.3+/-0.6 mm) than in the controls (1.2+/-0.8 mm; P< or =0.004) but significantly lower than in patients with the Brugada syndrome (4.4+/-0.7 mm; P< or =0.0001). Patients with the Brugada syndrome also had a greater QRS duration (0.11+/-0.02 s) than athletes (0.090+/-0.011 s; P< or =0.0001) with early repolarization. CONCLUSIONS: Early repolarization is almost always the rule in athletes but it is also frequent in sedentary males. Tracings somewhat simulating the Brugada syndrome were observed in only 8% of athletes without a history of syncope or familial sudden death. Significant differences exist between athletes with early repolarization and patients with the Brugada syndrome as regards the amplitude of ST elevation and QRS duration.