Background: Observational studies have found an association between attention-deficit/hyperactivity disorder (ADHD) and ischemic stroke. Aims: The purpose of this study was to investigate whether genetic liability to ADHD has a causal effect on ischemic stroke and its subtypes. Methods: In this two-sample Mendelian randomization (MR) study, genetic variants (nine single-nucleotide polymorphisms; P < 5 × 10-8) using as instrumental variables for the analysis was obtained from a genome-wide association study of ADHD with 19,099 cases and 34,194 controls. The outcome datasets for stroke and its subtypes were obtained from the MEGASTROKE consortium, with 40,585 cases and 406,111 controls. MR inverse variance-weighted method was conducted to investigate the effect of genetic liability to ADHD on ischemic stroke and its subtypes. Sensitivity analyses (median-based methods, MR-Egger, MR-robust adjusted profile scores, MR-pleiotropy residual sum and outlier) were also utilized to assess horizontal pleiotropy and remove outliers. Multivariable MR (MVMR) analyses were conducted to explore potential mediators. Results: Genetically determined ADHD (per 1 SD) was significantly associated with a higher risk of any ischemic stroke (AIS) (odds ratio (OR) = 1.15, 95% confidence interval (CI) = 1.05–1.25, P = 0.002) and large-artery atherosclerotic stroke (LAS) (OR = 1.40, 95% CI = 1.10–1.76, P = 0.005). The significant association was also found in sensitivity analyses and MVMR analyses. Conclusions: Genetic liability to ADHD was significantly associated with an increased risk of AIS, especially LAS. The association between ADHD and LAS was independent of age of smoking initiation but mediated by coronary artery disease.

BackgroundChronic exposure to particulate matter air pollution (PM2.5) is associated with chronic rhinosinusitis (CRS). Elevated ambient temperature may increase PM2.5 levels and thereby exacerbate sinonasal symptoms. This study investigates the association between high ambient temperature and the risk of CRS diagnosis.MethodsPatients with CRS were diagnosed at Johns Hopkins hospitals from May to October 2013–2022, and controls were matched patients without CRS meanwhile. A total of 4752 patients (2376 cases and 2376 controls) were identified with a mean (SD) age of 51.8 (16.8) years. The effect of maximum ambient temperature on symptoms was estimated with a distributed lag nonlinear model (DLNM). Extreme heat was defined as 35.0°C (95th percentile of the maximum temperature distribution). Conditional logistic regression models estimated the association between extreme heat and the risk of CRS diagnosis.ResultsExposure to extreme heat was associated with increased odds of exacerbation of CRS symptoms (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03–1.19). The cumulative effect of extreme heat during 0–21 lag days was significant (OR 2.37, 95% CI 1.60–3.50) compared with the minimum morbidity temperature (MMT) at 25.3°C. Associations were more pronounced among young and middle‐aged patients and patients with abnormal weight.ConclusionsWe found that short‐term exposure to high ambient temperature is associated with increased CRS diagnosis, suggesting a cascading effect of meteorological phenomena. These results highlight climate change's potentially deleterious health effects on upper airway diseases, which could have a significant public health impact.

Background COVID-19 vaccines are in short supply worldwide. China was among the first countries to pledge supplies of the COVID-19 vaccine as a global public product, and to date, the country has provided more than 600 million vaccines to more than 200 countries and regions with low COVID-19 vaccination rates. Understanding the public’s attitude in China toward the global distribution of COVID-19 vaccines could inform global and national decisions, policies, and debates. Objective The aim of this study was to determine the attitudes of adults living in China regarding the global allocation of COVID-19 vaccines developed in China and how these attitudes vary across provinces and by sociodemographic characteristics. Methods We conducted a cross-sectional online survey among adults registered with the survey company KuRunData. The survey asked participants 31 questions about their attitudes regarding the global allocation of COVID-19 vaccines developed in China. We disaggregated responses by province and sociodemographic characteristics. All analyses used survey sampling weights. Results A total of 10,000 participants completed the questionnaire. Participants generally favored providing COVID-19 vaccines to foreign countries before fulfilling domestic needs (75.6%, 95% CI 74.6%-76.5%). Women (3778/4921, 76.8%; odds ratio 1.18, 95% CI 1.07-1.32; P=.002) and those living in rural areas (3123/4065, 76.8%; odds ratio 1.13, 95% CI 1.01-1.27; P=.03) were especially likely to hold this opinion. Most respondents preferred providing financial support through international platforms rather than directly offering support to individual countries (72.1%, 95% CI 71%-73.1%), while for vaccine products they preferred direct provision to relevant countries instead of via a delivery platform such as COVAX (77.3%, 95% CI 76.3%-78.2%). Conclusions Among our survey sample, we found that adults are generally supportive of the international distribution of COVID-19 vaccines, which may encourage policy makers to support and implement the distribution of COVID-19 vaccines developed in China worldwide. Conducting similar surveys in other countries could help align policy makers’ actions on COVID-19 vaccine distribution with the preferences of their constituencies.

BACKGROUND COVID-19 vaccines are in short supply globally. China was among the first countries to pledge supplies of the COVID-19 vaccine as a global public product, and to date the country has provided more than 600 million vaccines to more than 200 countries and regions with low COVID-19 vaccination rates. To date, however, no research has determined public attitudes within China regarding global vaccine assistance, although such perspectives could inform global and national decisions, policies and debates. OBJECTIVE The aim of this study was to learn the attitudes of adults living in China regarding global allocation of Chinese COVID-19 vaccines, and to determine variation in attitudes across provinces and by sociodemographic characteristics within China. METHODS A cross-sectional online survey were conducted in China where participants were asked 31 questions on their attitudes regarding global allocation of ChineseCOVID-19 vaccines. We disaggregated responses by sociodemographic characteristics. All analyses used survey sampling weights. RESULTS A total of 10,000 participants completed the questionnaire. Participants generally favored providing COVID-19 vaccines to foreign countries before fully fulfilling domestic needs (75.6%, 95% CI: 74.6%-76.5%), and of the participants, this was applied especially to those who were female, in the youngest age group, and living in a rural area. Most respondents preferred providing financial support through international platforms rather than directly offering support to individual countries (72.1%, 95% CI: 71.0%-73.1%), providing vaccine products directly to relevant countries instead of via a delivery platform such as COVAX (77.3%, 95% CI: 76.3%-78.2%). CONCLUSIONS This finding has important policy implications for current global COVID-19 vaccine delivery and allocation work. This research provides evidence for global policy makers such as the WHO to encourage and call on more countries to provide vaccine assistance in the name of public support. Meanwhile, similar surveys should be conducted in more countries. If the public supports the international assistance or export of COVID-19 vaccines, politicians may feel encouraged to stop stockpiling vaccines.