Environmental Public Health Commons^™

Chronic Disease And The Inflammatory Body Burden: Social And Environmental Factors And Implications For Longevity, Catherine L. Zeman, Junu Shrestha, Raihan Khan, Ashley N. Oginz Wilson, Lisa A. Beltz

Department of Health Sciences - Faculty Scholarship

Everyday our body’s immune and detoxification systems are working to protect us from pathogens, cancerous cells, foreign substances, and chemical exposures. Declining trends in per capita longevity in the US suggest that these systems are being stressed beyond their natural resiliency. Several of these trends are discussed in light of funding for preventive vs. illness care. The authors then use a systems and interdisciplinary approach to introduce the immunobiological and biotransformation systems, and the concept of the exposome for those unfamiliar. The science of the immune and detoxification systems is explored considering the idea of chronic low-level inflammation. Additionally, new …

Navigating Car Attitudes: An Analysis Of Transportation Habits, Environmental Views, And Demographics, Caroline J. Jordan, Sydney E. Lucero, Anna L. Imrie

Student Publications

Transportation plays a crucial part in the daily lives of people and society worldwide. Our study examined the transportation habits and environmental attitudes of both Gettysburg College students and individuals across the United States. We conducted a comparative analysis using a sample from students on campus and a national sample collected from the crowdsourcing platform, Amazon’s Mechanical Turk. Additionally, we compared our findings with two similar studies completed by an Environmental Studies capstone nine years ago. We calculated each respondent's environmental score to gauge environmental attitudes, derived explicitly from their answers to five of the 24 survey questions. Next, we …

Roadway Characteristics And Car Accident Trends In Gettysburg, Pa, Max Smith, Jake H. Kennell, Russell H. Canova

Student Publications

This study addresses the rising motor vehicle accident and fatality rates in the United States (Moore, 2023). Focusing on the conditions in the Gettysburg Borough in an attempt to answer the following research questions: Are age of driver, weather conditions of car accidents, and traffic volume contributing to accidents in the Gettysburg Borough? What are the roadway characteristics of accident hot spot areas within the Gettysburg Borough? Utilizing Pennsylvania Department of Transportation (PennDOT) crash data from 2018 to 2022 and PennDot Average Annual Daily Traffic data, this study employs a comprehensive approach. Combining GIS analysis and statistical analysis to determine …

Progress Reimagined: A Generation Z Perspective On Belfast In Relation To The Unsdgs., Lucy Love Haman, Rebecca F. Macleod, Emilee E. Ernster, Camryn Moore, Erin Miller, Daron Baltazar, Ricardo Jackson

Belmont University Research Symposium (BURS)

This research explores a contemporary outsider view of Belfast, through the eyes of Generation Z visiting college students, in relation to how three United Nations Sustainable Development Goals are carried out (Good Health and Well-Being, Climate Action, and Peace, Justice, and Strong Institutions). To learn through firsthand accounts, the researchers utilized ethnographic and phenomenological methods, as interacting with locals to gather community inputs, surveying different groups in the city, Abstract: recording quotes said by citizens and displayed at billboards, and For Peer Review applying personal sensory experiences. It was found that a political deadlock plays a major role in the …

Bisphenol-A And Phthalate Metabolism In Children With Neurodevelopmental Disorders, T Peter Stein, Margaret D Schluter, Robert A Steer, Xue Ming

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: The etiology of autism spectrum (ASD) and Attention Deficit/Hyperactivity (ADHD) disorders are multifactorial. Epidemiological studies have shown associations with environmental pollutants, such as plasticizers. This study focused on two of these compounds, the Bisphenol-A (BPA) and Diethylhexyl Phthalate (DEHP). The major pathway for BPA and DEHP excretion is via glucuronidation. Glucuronidation makes insoluble substances more water-soluble allowing for their subsequent elimination in urine.

HYPOTHESIS: Detoxification of these two plasticizers is compromised in children with ASD and ADHD. Consequently, their tissues are more exposed to these two plasticizers.

METHODS: We measured the efficiency of glucuronidation in three groups of children, …

An Examination Of The Relationships Between The Neighborhood Social Environment, Adiposity, And Cardiometabolic Disease Risk In Adolescence: A Cross-Sectional Study, Kara D. Denstel, Robbie A. Beyl, Denise M. Danos, Maura M. Kepper, Amanda E. Staiano, Katherine T. Theall, Tung Sung Tseng, Stephanie T. Broyles

School of Public Health Faculty Publications

Background: Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years. Methods: This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey …

Neurocognitive Outcomes Of Children Exposed To And Living With Hiv Aged 3–5 Years In Kilifi, Kenya, Esther Chongwo, Catherine Wedderburn, Moses Kachama, Antipa Sigilai, Paul Mwangi, Janet Thoya, Rachel Odhiambo, Katana Ngombo, Charles Newton, Amina Abubakar

Institute for Human Development

Introduction: Globally, 1.7 million children are living with HIV, with the majority of them residing in sub-Saharan Africa. Due to reduced rates of vertical transmission of HIV, there is an increasing population of children born to HIV-infected mothers who remain uninfected. There is a growing concern around the development of these children in the antiretroviral therapy era. This study examined the neurocognitive outcomes of children who are HIV-exposed infected (CHEI), HIV-exposed uninfected (CHEU) and HIV-unexposed uninfected (CHUU) and explored the relationship between child neurocognitive outcomes and child's biomedical and caregivers’ psychosocial factors.

Methods: CHEI, CHUU and CHEU aged 3–5 years …

Low-Cost Pm2.5 Sensors Can Help Identify Driving Factors Of Poor Air Quality And Benefit Communities, Tim Keyes, Rea Domingo, Samantha Dynowski, Royal Graves, Martha Klein, Melissa Leonard, John Pilgrim, Alison Sanchirico, Kate Trinkaus

WCBT Faculty Publications

Air quality is critical for public health. Residents rely chiefly on government agencies such as the Environmental Protection Agency (EPA) in the United States to establish standards for the measurement of harmful contaminants including ozone, sulfur dioxide, carbon monoxide, volatile organic chemicals (VOCs), and fine particulate matter at or below 2.5 μm. According to the California Air Resources Board [1], “short-term PM2.5 exposure (up to 24-h duration) has been associated with premature mortality, increased hospital admissions for heart or lung causes, acute and chronic bronchitis, asthma attacks, emergency room visits, respiratory symptoms, and restricted activity days”. While public agency resources …

Neurotoxicity And Outcomes From Developmental Lead Exposure: Persistent Or Permanent?, Jay S. Schneider

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background:

Childhood lead poisoning remains an important public health issue in the United States, as well as elsewhere in the world. Although primary prevention is a major goal and it is critically important to keep children from getting poisoned, it is also important to explore ways to reduce the neurotoxic effects of lead in those children already poisoned. Whether lead-induced neurotoxicity and its related adverse outcomes are viewed as “permanent” or “persistent” may influence the way in which potential remediation efforts are considered for improving outcomes from childhood lead poisoning.

Objectives:

The objective of this commentary was to discuss the …

Food Insecurity And Risky Sexual Behaviors Among College Students During The Covid-19 Pandemic, Bertille Assoumou, Jennifer Pharr, Courtney Coughenour

Environmental & Occupational Health Faculty Publications

Background

Sexually transmitted infections (STIs) and food insecurity are public health concerns in the United States (US) due to their growing prevalence and incidence among young people, and particularly in college students. Studies have reported that college students are at higher risk of STIs due to the high rates of risky sexual behavior (RSB). Most studies report a food insecurity prevalence of more than 30% among college students, which was more than twice the overall national food insecurity rate of 10.5% in 2020. This study aims to assess the relationship between food insecurity and RSB among college students during the …

Mediation Of Bmi On 25-Hydroxyvitamin D Levels In U.S. Adults With Sugar-Sweetened Beverages Consumption, Wei Ting Lin, Gabrielle V. Gonzalez, Yu Hsiang Kao, Hui Yi Lin, Mirandy S. Li, David W. Seal, Chien Hung Lee, Chih Yang Hu, Lei Shih Chen, Tung Sung Tseng

School of Public Health Faculty Publications

Body mass index (BMI) as well as sugar-sweetened beverages (SSB) has been suggested to independently decrease 25-hydroxyvitamin D (25(OH)D). However, the relationship between SSB, BMI, and 25(OH)D is uncertain. This study aimed to investigate the potential mediating role of BMI in the association between SSB intake and 25(OH)D. A total of 4505 representative U.S. adults aged above 20 years and without liver conditions were selected from the 2013–2014 NHANES. All analyses were performed under survey modules with appropriate sampling weights. The prevalence of 25(OH)D insufficiency and deficiency was 37.8% and 24.1% in U.S. adults, respectively. Compared with non-SSB consumers, an …

Pandemic Response Officers: Integration Between Medical, Public Health, And Higher Education Systems To Expedite Prevention And Response., Anne C Jones, Genevive R Meredith, Donna Leong, Sabine Jamal, Rachel Buckwalter, John D Clarke, Marin Clarkberg, Allan Bishop, Frank Cantone, Claire Espey, Frank Kruppa, Mary George Opperman, Gary A Koretzky

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

CONTEXT: Research and policy studies alike have enumerated population and community health benefits of system integration between medical, public health, and social entities. The emergence of the COVID-19 pandemic revealed the necessity of a well-trained and adequately staffed public health and medical workforce in order to process SARS-CoV-2 cases and prevent subsequent transmission. Higher education systems, in particular, represented defined populations of exposure and transmission. Opportunities existed for collaboration and task sharing between institutions of higher education and local public health departments to limit spread and impacts.

PROGRAM: This article describes the Pandemic Response Officer (PRO) program at Cornell University, …

An Aerobic Exercise Intervention To Improve Metabolic Health Among People Living With Hiv With At-Risk Alcohol Use: The Alive-Ex Research Study Protocol, Liz Simon, Stefany D. Primeaux, Danielle E. Levitt, Brianna Bourgeois, Neil M. Johannsen, Adrianna Peters, Jameel Ahmed, Richard H. Marshall, Alexandra H. Fairchild, Tekeda F. Ferguson, Patricia E. Molina

School of Medicine Faculty Publications

Background: Effective antiretroviral therapy (ART) in people living with HIV (PLWH) has improved life expectancy and increased risk of age-associated cardiometabolic comorbidities. At-risk alcohol use is more frequent among PLWH and increases the risk of health challenges. PLWH with at-risk alcohol use are more likely to meet criteria for prediabetes/diabetes and this is associated with impaired whole-body glucose-insulin dynamics. Methods: The Alcohol & Metabolic Comorbidities in PLWH: Evidence Driven Interventions Study (ALIVE-Ex Study, NCT03299205) is a longitudinal, prospective, interventional study to determine the effects of an aerobic exercise protocol on improving dysglycemia among PLWH with at-risk alcohol use. The intervention …

Small Community Water Systems Have The Highest Prevalence Of Mn In Drinking Water In California, Usa, Miranda Aiken, Samantha C. Ying

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Manganese (Mn) is currently regulated as a secondary contaminant in California, USA; however, recent revisions of the World Health Organization drinking water guidelines have increased regulatory attention of Mn in drinking water due to increasing reports of neurotoxic effects in infants and children. In this study, Mn concentrations reported to California’s Safe Drinking Water Information System were used to estimate the potentially exposed population within California based on system size. We estimate that between 2011 and 2021, over 525,000 users in areas with reported Mn data are potentially exposed to Mn concentrations exceeding the WHO health-based guideline (80 μg L …

The Intersection Of Herbicide Policy, Exposure, And Health At The University Of Connecticut, Katherine Hayward

Honors Scholar Theses

Pesticides play an extremely complicated role in our everyday lives. From the water you use to make your coffee, to the breastmilk your neighbor provides for their child, to the lake your dog swims in, chemical pesticides or their byproducts have been found in nearly every corner of our lives. The chemicals used in synthetic herbicides, a subcategory of pesticides, have far reaching negative impacts on human health, biodiversity, and water quality. Despite there being numerous published studies on the relationships between pesticide exposures and health, there is still ongoing discord and controversy surrounding their role in our lives. After …

Environmental And Social Factors Associated With High Chronic Kidney Disease Mortality Rates In Municipalities Of Guatemala: An Ecological Study Of Municipal-Level Mortality Data, Alejandro Cerón

Anthropology: Faculty Scholarship

The purpose of this study was to determine the association between social and environmental indicators and high mortality rates from chronic kidney disease (CKD) in municipalities of Guatemala. An ecological study of municipal-level factors associated with CKD mortality in Guatemala was conducted. Crude mortality rates were calculated for the 2009–2019 period for each of the country’s 340 municipalities, by gender and age groups. Municipal-level social and environmental indicators were used as independent variables. Linear regression was used for bivariate and multivariate analysis. A total of 28,723 deaths from CKD were documented for the 2009–2019 period. Average crude mortality rate for …

Hepatitis C Virus Screening Strategies To Improve Early Identification And Treatment: ​ A Scoping Review​, Megan Elizabeth Lyons, Rn, Bsn, Ccrn, Thomas Tyler Bennett, Rn, Bsn, Ccrn, Felicia Ann Gray-Hamilton, Rn, Bsn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Hepatitis C virus (HCV) is the most common bloodborne infection in the United States (Ludden et al., 2022). Sadly, over half of the individuals living with chronic HCV are unaware of their condition (Halket et al., 2022). Due to rising numbers, HCV screening guidelines have been updated to recommend that every adult be screened at least once (Patel et al, 2021). Despite these guidelines, screening rates remain low. This scoping review aims to examine current research on HCV screening and strategies to improve early diagnosis and treatment.

Methods

This review began with a literature search using CINAHL and PubMed …

Evaluating Edna Metabarcoding As A Mic-Roe-Scopic Net To Catch Salmon Pathogens, Noah Burby

Honors College

Wild Atlantic salmon in the Gulf of Maine (GOM) is a Distinct Population Segment (DPS) that has been listed since 2000 as endangered by the U.S. Fish and Wildlife Service (USFWS) and the National Oceanic and Atmospheric Administration (NOAA). The current challenge is year-over-year decreases in the number of mature salmon returning to the Penobscot River for reproduction. Early detection of pathogen presence could allow for the identification of infection and the application of corrective measures. Environmental DNA (eDNA) is simply DNA that is collected from environmental samples (e.g., water, air, and soils), which consists of whole microorganisms and genetic …

Adult Asthma Associated With Roadway Density And Housing In Rural Appalachia: The Mountain Air Project (Map)., W Jay Christian, John Flunker, Beverly May, Susan Westneat, Wayne T Sanderson, Nancy Schoenberg, Steven R Browning

UK CARES Faculty Publications

BACKGROUND: Appalachian Kentucky is a rural area with a high prevalence of asthma among adults. The relative contribution of environmental exposures in the etiology of adult asthma in these populations has been understudied.

OBJECTIVE: This manuscript describes the aims, study design, methods, and characteristics of participants for the Mountain Air Project (MAP), and focuses on associations between small area environmental exposures, including roadways and mining operations, and lifetime and current asthma in adults.

METHODS: A cohort of residents, aged 21 and older, in two Kentucky counties, was enrolled in a community-based, cross-sectional study. Stratified cluster sampling was used to select …

The Association Between Time Spent On Screens And Reading With Myopia, Premyopia And Ocular Biometric And Anthropometric Measures In 6- To 7-Year-Old Schoolchildren In Ireland, Síofra Harrington, Veronica O'Dwyer

Articles

Purpose More time spent on near tasks has consistently been associated with the promotion of myopia. The World Health Organization advises limiting daily screentime to less than 2 h for children aged five and over. This study explored the relationship between time spent on screens and reading/writing with refractive status, ocular biometric and anthropometric factors in 6-to 7-year- olds in Ireland.

Methods Participants were 723 schoolchildren (377 boys [51.8%]), mean age 7.08 (0.45) years. The examination included cycloplegic autorefraction (1% cyclopentolate hydrochloride), ocular biometry (Zeiss IOLMaster), height (cm) and weight (kg). Screentime and reading/writing time were reported by parents/legal guardians …

Saliva As A Diagnostic Tool To Measure Polycyclic Aromatic Hydrocarbon Exposure In Dental Patients Exposed To Intimate Partner Violence (Ipv), Aramandla Ramesh, Leslie R. Halpern, Janet H. Southerland, Samuel E. Adunyah, Pandu R. Gangula

School of Dentistry Faculty Publications

Background: Social habits such as tobacco use, alcohol consumption, and chemically contaminated diet contribute to poor oral health. Intimate Partner Violence (IPV) is a global public health epidemic which can exacerbate the prevalence of health conditions affecting a victim's lifespan. This study investigates using saliva as a biomarker for detecting levels of benzo(a)pyrene [B(a)P]; a toxicant present in cigarette smoke and barbecued meat in a population of IPV + female patients. Methods: A cross-sectional IRB-approved study utilized 63 female participants (37 African Americans [AA], and 26 non-African Americans [NAA]), who provided consent for the study. Participants submitted samples of saliva, …

Urban Land-Based Healing: A Northern Intervention Strategy, Nicole Redvers, Melanie Nadeau, Donald Prince

Indigenous Health Faculty Publications

Urban Indigenous populations face significant health and social disparities across Canada. With high rates of homelessness and substance abuse, there are often few options for urban Indigenous Peoples to access land-based healing programs despite the increasingly known and appreciated benefits. In May 2018, the first urban land-based healing camp opened in Yellowknife, Northwest Territories, Canada, one of the first to our knowledge in Canada or the United States. This camp may serve as a potential model for an Indigenous-led and Indigenous-based healing camp in an urban setting. We seek to present preliminary outcome data from the healing camp in a …

Role Of Oxides Of Nitrogen In The Ozone-Cardiorespiratory Visit Association, Xerxes Seposo, Kayo Ueda, Chris Fook Sheng Ng, Lina Madaniyazi, Seiji Sugata, Ayako Yoshino, Akinori Takami

Ateneo School of Medicine and Public Health Publications

Ozone (O3)-induced health effects vary in terms of severity, from deterioration of lung function and hospitalization to death. Several studies have reported a linear increase in health risks after O3 exposure. However, current evidence suggests a non-linear U- and J-shaped concentration-response (C-R) function. The potential increasing risks with decreasing O3 concentrations may seem counterintuitive from the traditional standpoint that decreasing exposure should lead to decreasing health risks. Tus, the question of whether the increasing risks with decreasing concentrations are truly O3-induced or might be from other C-R mechanisms. If these potential risks were not accounted for, this may have contributed …

Strengthening A One Health Approach To Emerging Zoonoses, Samira Mubareka, John Amuasi, Arinjay Banerjee, Hélène Carabin, Joe Copper Jack, Claire Jardine, Bogdan Jaroszewicz, Greg Keefe, Jonathon Kotwa, Susan Kutz, Deborah Mcgregor, Anne Mease, Lily Nicholson, Katarzyna Nowak, Brad Pickering, Maureen Reed, Johanne Saint-Charles, Katarzyna Simonienko, Trevor Smith, J. Scott Weese, E. Jane Parmley

Articles & Book Chapters

Given the enormous global impact of the COVID-19 pandemic, outbreaks of highly pathogenic avian influenza in Canada, and manifold other zoonotic pathogen activity, there is a pressing need for a deeper understanding of the human-animal-environment interface and the intersecting biological, ecological, and societal factors contributing to the emergence, spread, and impact of zoonotic diseases. We aim to apply a One Health approach to pressing issues related to emerging zoonoses, and propose a functional framework of interconnected but distinct groups of recommendations around strategy and governance, technical leadership (operations), equity, education and research for a One Health approach and Action Plan …

Current Topics In Technology-Enabled Stroke Rehabilitation And Reintegration: A Scoping Review And Content Analysis, Katryna Cisek

Articles

Background. There is a worldwide health crisis stemming from the rising incidence of various debilitating chronic diseases, with stroke as a leading contributor. Chronic stroke management encompasses rehabilitation and reintegration, and can require decades of personalized medicine and care. Information technology (IT) tools have the potential to support individuals managing chronic stroke symptoms. Objectives. This scoping review identifies prevalent topics and concepts in research literature on IT technology for stroke rehabilitation and reintegration, utilizing content analysis, based on topic modelling techniques from natural language processing to identify gaps in this literature. Eligibility Criteria. Our methodological search initially identified over 14,000 …

Walkable Neighborhoods: Linkages Between Place, Health, And Happiness In Younger And Older Adults, Kevin M. Leyden, Michael J. Hogan, Lorraine D'Arcy, Brendan Bunting, Sebastiaan Bierema

Articles

Problem, research strategy, and findings: We examined whether living in a walkable neighborhood influenced the happiness of younger and older city residents. The data for this study came from a comprehensive household population survey of 1,064 adults living in 16 neighborhoods in Dublin City (Ireland) and its suburbs. We used multigroup structural equation modeling to analyze the direct and indirect effects of walkability on happiness, mediated by health, trust, and satisfaction with neighborhood appearance. We found living in a walkable neighborhood was directly linked to the happiness of people aged 36 to 45 (p¼.001) and, to a lesser extent, those …

Assessment Of Spatio-Temporal Variations In Pm2.5 And Associated Long-Range Air Mass Transport And Mortality In South Asia, Md Sariful Islam, Shimul Roy, Tanmoy Roy Tusher, Mizanur Rahman, Ryley C. Harris

Political Science & Geography Faculty Publications

Fine particulate matter (PM_2.5) is associated with adverse impacts on ambient air quality and human mortality; the situation is especially dire in developing countries experiencing rapid industrialization and urban development. This study assessed the spatio-temporal variations of PM_2.5 and its health impacts in the South Asian region. Both satellite and station-based data were used to monitor the variations in PM_2.5 over time. Additionally, mortality data associated with ambient particulate matter were used to depict the overall impacts of air pollution in this region. We applied the Mann–Kendall and Sen’s slope trend analysis tool to investigate the …

Behavioral Pathways To Private Well Risk Mitigation: A Structural Equation Modeling Approach, Simon Mooney, Martin Boudou, Jean O'Dwyer, Paul Hynds

Articles

Complex, multi hazard risks such as private groundwater contamination necessitate multiannual risk reduction actions including seasonal, weather-based hazard evaluations. In the Republic of Ireland (ROI), high rural reliance on unregulated private wells renders behavior promotion a vital instrument toward safeguarding household health from waterborne infection. However, to date, pathways between behavioral predictors remain unknown while latent constructs such as extreme weather event (EWE) risk perception and self-efficacy (perceived behavioral competency) have yet to be sufficiently explored. Accordingly, a nationwide survey of 560 Irish private well owners was conducted, with structural equation modeling (SEM) employed to identify underlying relationships determining key …

Novel Therapeutic Approaches To Treat Brain Cancer Combining 3d Cell Culture Models, Cold Atmospheric Plasma And Airborne Acoustic, Janith Wanigasekara

Doctoral

Glioblastoma (GBM), an adult-type diffuse grade 4 glioma (IDH wild type), is the most prevalent, aggressive, fatal, highly vascularized, malignant primary brain tumour in adults with a poor prognosis. Despite existing therapies such as surgical resection, radiation therapy and chemotherapy such as temozolomide (TMZ), patient survival remains largely unchanged over the last three decades. There is an urgent need for novel and effective therapeutic strategies that can overcome drug resistance, cross the blood brain barrier, and minimise off-target side effects that can negatively impact a patient's quality of life. The high failure rate of clinical trials is due to inefficient …

The Effectiveness Of Allen Carr's Method For Smoking Cessation: A Systematic Review, Irene Possenti, Marco Scala, Alessandra Lugo, Luke Clancy, Sheila Keogan, Silvano Gallus

Articles

Introduction: Allen Carr's (AC) method is a pharmacotherapy-free approach to quit smoking that is delivered through seminars, online courses, or in the form of a book. It has gained popularity, but its effectiveness remains controversial due to a lack of scientific evidence. This systematic review aims to provide an updated overview of the current evidence on the effectiveness of the AC method.

Methods: We conducted a systematic literature review of all epidemiological studies evaluating the effectiveness of the AC method for smoking cessation, published in PubMed/MEDLINE and Embase up to March 2023.

Results: Among 34 original studies identified through the …