Single, Dual, and Triple Use of Cigarettes, e-Cigarettes, and Snus among Adolescents in the Nordic Countries

New tobacco and nicotine products have emerged on the market in recent years. Most research has concerned only one product at a time, usually e-cigarettes, while little is known about the multiple use of tobacco and nicotine products among adolescents. We examined single, dual, and triple use of cigarettes, e-cigarettes, and snus among Nordic adolescents, using data of 15–16-year-olds (n = 16,125) from the European School Survey Project on Alcohol and other Drugs (ESPAD) collected in 2015 and 2019 from Denmark, Finland, Iceland, Norway, Sweden, and the Faroe Islands. Country-specific lifetime use of any of these products ranged between 40% and 50%, and current use between 17% and 31%. Cigarettes were the most common product in all countries except for Iceland, where e-cigarettes were remarkably more common. The proportion of dual and triple users was unexpectedly high among both experimental (24%–49%) and current users (31–42%). Triple use was less common than dual use. The users’ patterns varied somewhat between the countries, and Iceland differed substantially from the other countries, with a high proportion of single e-cigarette users. More knowledge on the patterns of multiple use of tobacco and nicotine products and on the potential risk and protective factors is needed for targeted intervention and prevention efforts.

Sarcopenia in Hepatocellular Carcinoma: Pathogenesis and Management

Background: Sarcopenia is almost constantly observed in patients with cirrhosis and hepatocellular carcinoma. Summary: Chronic liver disease represents a unique pathophysiological scenario in which sarcopenia develops and all factors involved in the pathogenesis should be taken into account for an appropriate management of the disease. No properly designed intervention studies on this topic are available and, thus, no effective strategies have been developed for clinical practice. Apart from any targeted intervention, treatment and optimization of liver disease is crucial. Key Messages: In patients with cirrhosis and hepatocellular carcinoma, nutritional support to maintain and restore nutrition status, a targeted use of branched-chain amino acids and a guided physical exercise, should all be an integral part of the multidimensional assessment and tailored interventions.

Tuberculous Meningitis in Children: Reducing the Burden of Death and Disability

Tuberculous meningitis disproportionately affects young children. As the most devastating form of tuberculosis, it is associated with unacceptably high rates of mortality and morbidity even if treated. Challenging to diagnose and treat, tuberculous meningitis commonly causes long-term neurodisability in those who do survive. There remains an urgent need for strengthened surveillance, improved rapid diagnostics technology, optimised anti-tuberculosis drug therapy, investigation of new host-directed therapy, and further research on long-term functional and neurodevelopmental outcomes to allow targeted intervention. This review focuses on the neglected field of paediatric tuberculous meningitis and bridges current clinical gaps with research questions to improve outcomes from this crippling disease.

Local Characteristics Related to SARS-CoV-2 Transmissions in the Seoul Metropolitan Area, South Korea

The Seoul metropolitan area is one of the most populated metropolitan areas in the world; hence, Seoul’s COVID-19 cases are highly concentrated. This study identified local demographic and socio-economic characteristics that affected SARS-CoV-2 transmission to provide locally targeted intervention policies. For the effective control of outbreaks, locally targeted intervention policies are required since the SARS-CoV-2 transmission process is heterogeneous over space. To identify the local COVID-19 characteristics, this study applied the geographically weighted lasso (GWL). GWL provides local regression coefficients, which were used to account for the spatial heterogeneity of SARS-CoV-2 outbreaks. In particular, the GWL pinpoints statistically significant regions with specific local characteristics. The applied explanatory variables involving demographic and socio-economic characteristics that were associated with higher SARS-CoV-2 transmission in the Seoul metropolitan area were as follows: young adults (19~34 years), older population, Christian population, foreign-born population, low-income households, and subway commuters. The COVID-19 case data were classified into three periods: the first period (from January 2020 to July 2021), the second period (from August to November 2020), and the third period (from December 2020 to February 2021), and the GWL was fitted for the entire period (from January 2020 to February 2021). The result showed that young adults, the Christian population, and subway commuters were the most significant local characteristics that influenced SARS-CoV-2 transmissions in the Seoul metropolitan area.

SARS-CoV-2 transmission across age groups in France and implications for control

The shielding of older individuals has been proposed to limit COVID-19 hospitalizations while relaxing general social distancing in the absence of vaccines. Evaluating such approaches requires a deep understanding of transmission dynamics across ages. Here, we use detailed age-specific case and hospitalization data to model the rebound in the French epidemic in summer 2020, characterize age-specific transmission dynamics and critically evaluate different age-targeted intervention measures in the absence of vaccines. We find that while the rebound started in young adults, it reached individuals aged ≥80 y.o. after 4 weeks, despite substantial contact reductions, indicating substantial transmission flows across ages. We derive the contribution of each age group to transmission. While shielding older individuals reduces mortality, it is insufficient to allow major relaxations of social distancing. When the epidemic remains manageable (R close to 1), targeting those most contributing to transmission is better than shielding at-risk individuals. Pandemic control requires an effort from all age groups.

Dismissing “Don’t Know” Responses to Perceived Risk Survey Items Threatens the Validity of Theoretical and Empirical Behavior-Change Research

Since the middle of the 20th century, perceptions of risk have been critical to understanding engagement in volitional behavior change. However, theoretical and empirical risk perception research seldom considers the possibility that risk perceptions do not simply exist: They must be formed. Thus, some people may not have formulated a perception of risk for a hazard at the time a researcher asks them, or they may not be confident in the extent to which their perception matches reality. We describe a decade-long research program that investigates the possibility that some people may genuinely not know their risk of even well-publicized hazards. We demonstrate that indications of not knowing (i.e., “don’t know” responses) are prevalent in the U.S. population, are systematically more likely to occur among marginalized sociodemographic groups, and are associated with less engagement in protective health behaviors. “Don’t know” responses are likely indications of genuinely limited knowledge and therefore may indicate populations in need of targeted intervention. This body of research suggests that not allowing participants to indicate their uncertainty may threaten the validity and generalizability of behavior-change research. We provide concrete recommendations for scientists to allow participants to express uncertainty and to analyze the resulting data.

The Genetic, Environmental, and Immunopathological Complexity of Autoantibody-Negative Rheumatoid Arthritis

Differences in clinical presentation, response to treatment, and long-term outcomes between autoantibody-positive and -negative rheumatoid arthritis (RA) highlight the need for a better comprehension of the immunopathogenic events underlying the two disease subtypes. Whilst the drivers and perpetuators of autoimmunity in autoantibody-positive RA have started to be disclosed, autoantibody-negative RA remains puzzling, also due its wide phenotypic heterogeneity and its possible misdiagnosis. Genetic susceptibility appears to mostly rely on class I HLA genes and a number of yet unidentified non-HLA loci. On the background of such variable genetic predisposition, multiple exogeneous, endogenous, and stochastic factors, some of which are not shared with autoantibody-positive RA, contribute to the onset of the inflammatory cascade. In a proportion of the patients, the immunopathology of synovitis, at least in the initial stages, appears largely myeloid driven, with abundant production of proinflammatory cytokines and only minor involvement of cells of the adaptive immune system. Better understanding of the complexity of autoantibody-negative RA is still needed in order to open new avenues for targeted intervention and improve clinical outcomes.

Advances in RNA Epigenetic Modifications in Hepatocellular Carcinoma and Potential Targeted Intervention Strategies

The current interventions for hepatocellular carcinoma (HCC) are not satisfactory, and more precise targets and promising strategies need to be explored. Recent research has demonstrated the non-negligible roles of RNA epigenetic modifications such as N6-methyladenosine (m6A) and 5-methylcytosine (m5C) in various cancers, including HCC. However, the specific targeting mechanisms are not well elucidated. In this review, we focus on the occurrence and detailed physiopathological roles of multiple RNA modifications on diverse RNAs closely related to the HCC process. In particular, we highlight fresh insights into the impact mechanisms of these posttranscriptional modifications on the whole progression of HCC. Furthermore, we analyzed the possibilities and significance of these modifications and regulators as potential therapeutic targets in HCC treatment, which provides the foundation for exploring targeted intervention strategies. This review will propel the identification of promising therapeutic targets and novel strategies that can be translated into clinical applications for HCC treatment.