Incense Use and Cardiovascular Mortality among Chinese in Singapore: The Singapore Chinese Health Study

Background: Incense burning is common in many parts of the world. Although it is perceived that particulate matter from incense smoke is deleterious to health, there is no epidemiologic evidence linking domestic exposure to cardiovascular mortality.Objective: We examined the association between exposure to incense burning and cardiovascular mortality in the Singapore Chinese Health Study.Methods: We enrolled a total of 63,257 Singapore Chinese 45–74 years of age during 1993–1998. All participants were interviewed in person to collect information about lifestyle behaviors, including the practice of burning incense at home. We identified cardiovascular deaths via record linkage with the nationwide death registry through 31 December 2011.Results: In this cohort, 76.9% were current incense users, and most of the current users (89.9%) had burned incense daily for ≥ 20 years. Relative to noncurrent users, current users had a 12% higher risk of cardiovascular mortality [multivariable adjusted hazard ratio (HR) = 1.12; 95% CI: 1.04, 1.20]. The HR was 1.19 (95% CI: 1.03, 1.37) for mortality due to stroke and 1.10 (95% CI: 1.00, 1.21) for mortality due to coronary heart disease. The association between current incense use and cardiovascular mortality appeared to be limited to participants without a history of cardiovascular disease at baseline (HR = 1.16; 95% CI: 1.07, 1.26) but not linked to those with a history (HR = 1.00; 95% CI: 0.86, 1.17). In addition, the association was stronger in never-smokers (HR = 1.12; 95% CI: 1.02, 1.23) and former smokers (HR = 1.19; 95% CI: 1.00, 1.42) than in current smokers (HR = 1.05; 95% CI: 0.91, 1.22).Conclusions: Long-term exposure to incense burning in the home environment was associated with an increased risk of cardiovascular mortality in the study population.Citation: Pan A, Clark ML, Ang LW, Yu MC, Yuan JM, Koh WP. 2014. Incense use and cardiovascular mortality among Chinese in Singapore: The Singapore Chinese Health Study. Environ Health Perspect 122:1279–1284; http://dx.doi.org/10.1289/ehp.1307662     

Deficits in motor performance after pedunculopontine lesions in rats – impairment depends on demands of task

Anatomically and functionally located between basal ganglia and brainstem circuitry, the pedunculopontine tegmental nucleus (PPTg) is in a pivotal position to contribute to motor behavior. Studies in primates have reported akinesia and postural instability following destruction of the PPTg. In humans, the PPTg partially degenerates in Parkinson's disease and stimulation of this region is under investigation as a possible therapeutic. Studies in rats report no crude motor impairment following PPTg lesion, although a detailed assessment of the role of the PPTg in rat motor function has not been reported. Our studies applied motor tests generally used in rodent models of Parkinson's disease to rats bearing either excitotoxic damage to all neuronal populations within PPTg, or selective destruction of the cholinergic subpopulation created with the toxin Dtx‐UII. Neither lesion type altered baseline locomotion. On the rotarod, excitotoxic lesions produced a persistent impairment on the accelerating, but not fixed speed, conditions. In the vermicelli handling task (a quantitative measure of fine motor control and effective behavioral sequencing) excitotoxic lesions produced no single impairment, but globally increased the number of normal and abnormal behaviors. In contrast, depletion of cholinergic PPTg neurons produced impairment on the accelerating rotarod but no changes in vermicelli handling. Together, these results show that while PPTg lesions produce no impairment in the execution of individual motor actions, impairments emerge when the demands of the task increase. Results are discussed in terms of PPTg acting as part of a rapid action selection system, which integrates sensory information into motor output.     

Outcomes of Single‐Stage Compared to Two‐Stage Basilic Vein Transposition Fistulae

Basilic vein transposition (BVT) fistulae are increasing in prevalence in the United States. We examined outcomes of BVT fistulae created in a single stage compared to those created in two stages. Prospective QA databases identified a consecutive cohort of 144 patients with BVT fistulae. Of these, 42% were created in one stage and 58% in two stages. Fistula maturation rates, mean time to fistula use and intensity of percutaneous interventions were compared; patency rates were compared from time of first intervention. Maturation rates (including assisted maturation) were 90% among 1‐stage and 75% among 2‐stage BVT (p = 0.02). Mean time to initiation of fistula use was 142 days (1‐stage) and 146 days (2‐stage) (p = 0.92). Intensity of percutaneous interventions was 1.84/patient‐year of dialysis (PYD) (1‐stage) and 2.15/PYD (2‐stage) (p = 0.57). Secondary patency at 1, 2, 3, and 4 years for 1‐stage BVT was 86%, 75%, 69%, and 57%; secondary patency at 1, 2, 3, and 4 years for 2‐stage BVT was 76%, 71%, 49%, and 25%, respectively (p = 0.12). BVT creation in two stages confers only a modest reduction in maturation rates and secondary patency and therefore should be considered over a synthetic graft in patients with basilic veins deemed inadequate for 1‐stage BVT.