Correlation between dental care utilization and oral cavity cancer in a large sample of community-based United States residents

Cancer of the oral cavity and pharynx remains one of the ten leading causes of cancer death in the United States (US). Besides smoking and alcohol consumption, there are no well established risk factors. While poor dental care had been implicated, it is unknown if the lack of dental care, implying poor dental hygiene predisposes to oral cavity cancer. This study aimed to assess the relationship between dental care utilization during the past twelve months and the prevalence of oral cavity cancer. A cross-sectional design of the National Health Interview Survey of adult, non-institutionalized US residents (n=30,475) was used to assess the association between dental care utilization and self reported diagnosis of oral cavity cancer. Chi square statistic was used to examine the crude association between the predictor variable, dental care utilization and other covariates, while unconditional logistic regression was used to assess the relationship between oral cavity cancer and dental care utilization. There were statistically significant differences between those who utilized dental care during the past twelve months and those who did not with respect to education, income, age, marital status, and gender (p < 0.05), but not health insurance coverage (p = 0.53). Also, those who utilized dental care relative to those who did not were 65% less likely to present with oral cavity cancer, prevalence odds ratio (POR), 0.35, 95% Confidence Interval (CI), 0.12–0.98. Further, higher income advanced age, people of African heritage, and unmarried status were statistically significantly associated with oral cavity cancer, (p < 0.05), but health insurance coverage, alcohol use and smoking were not, p > 0.05. However, after simultaneously controlling for the relevant covariates, the association between dental care and oral cavity cancer did not attenuate nor persist. Thus, compared with those who did not use dental care, those who did wee 62% less likely to present with oral cavity cancer adjusted POR, 0.38, 95% CI, 0.13-1.10. Among US adults residing in community settings, use of dental care during the past twelve months did not significantly reduce the predisposition to oral cavity cancer. However, due to the nature of the data used in this study, which restricts temporal sequence, a large sample prospective study that may identify modifiable factors associated with oral cancer development namely poor dental care, is needed. ^

HPV vaccine coverage in Texas counties: An application of multilevel, small area estimation

Health departments, research institutions, policy-makers, and healthcare providers are often interested in knowing the health status of their clients/constituents. Without the resources, financially or administratively, to go out into the community and conduct health assessments directly, these entities frequently rely on data from population-based surveys to supply the information they need. Unfortunately, these surveys are ill-equipped for the job due to sample size and privacy concerns. Small area estimation (SAE) techniques have excellent potential in such circumstances, but have been underutilized in public health due to lack of awareness and confidence in applying its methods. The goal of this research is to make model-based SAE accessible to a broad readership using clear, example-based learning. Specifically, we applied the principles of multilevel, unit-level SAE to describe the geographic distribution of HPV vaccine coverage among females aged 11-26 in Texas.^ Multilevel (3 level: individual, county, public health region) random-intercept logit models of HPV vaccination (receipt of ≥ 1 dose Gardasil® ) were fit to data from the 2008 Behavioral Risk Factor Surveillance System (outcome and level 1 covariates) and a number of secondary sources (group-level covariates). Sampling weights were scaled (level 1) or constructed (levels 2 & 3), and incorporated at every level. Using the regression coefficients (and standard errors) from the final models, I simulated 10,000 datasets for each regression coefficient from the normal distribution and applied them to the logit model to estimate HPV vaccine coverage in each county and respective demographic subgroup. For simplicity, I only provide coverage estimates (and 95% confidence intervals) for counties.^ County-level coverage among females aged 11-17 varied from 6.8-29.0%. For females aged 18-26, coverage varied from 1.9%-23.8%. Aggregated to the state level, these values translate to indirect state estimates of 15.5% and 11.4%, respectively; both of which fall within the confidence intervals for the direct estimates of HPV vaccine coverage in Texas (Females 11-17: 17.7%, 95% CI: 13.6, 21.9; Females 18-26: 12.0%, 95% CI: 6.2, 17.7).^ Small area estimation has great potential for informing policy, program development and evaluation, and the provision of health services. Harnessing the flexibility of multilevel, unit-level SAE to estimate HPV vaccine coverage among females aged 11-26 in Texas counties, I have provided (1) practical guidance on how to conceptualize and conduct modelbased SAE, (2) a robust framework that can be applied to other health outcomes or geographic levels of aggregation, and (3) HPV vaccine coverage data that may inform the development of health education programs, the provision of health services, the planning of additional research studies, and the creation of local health policies.^

Nd, Sr and Pb isotopic composition of eolian dust deposited in the central North Pacific

The silicate fractions of recent pelagic sediments in the central north Pacific Ocean are dominated by eolian dust derived from central Asia. An 11 Myr sedimentary record at ODP Sites 885/886 at 44.7°N, 168.3°W allows the evaluation of how such dust and its sources have changed in response to late Cenozoic climate and tectonics. The extracted eolian fraction contains variable amounts (>70%) of clay minerals with subordinate quartz and plagioclase. Uniform Nd isotopic compositions (epsilon-Nd =38.6 to 310.5) and Sm/Nd ratios (0.170-0.192) for most of the 11 Myr record demonstrate a well-mixed provenance in the basins north of the Tibetan Plateau and the Gobi Desert that was a source of dust long before the oldest preserved Asian loess formed. epsilon-Nd values of up to 36.5 for samples 62.9 Ma indicate <=35 wt% admixture of a young, Kamchatka-like volcanic arc component. The coherence of Pb and Nd in the erosional cycle allows us to constrain the Pb isotopic composition of Asian loess devoid of anthropogenic contamination to 206Pb/204Pb =18.97 +/- 0.06, 207Pb/204Pb =15.67 +/- 0.02, 208Pb/204Pb =39.19 +/- 0.11. 87Sr/86Sr (0.711-0.721) and Rb/Sr ratios (0.39-1.1) vary with dust mineralogy and provide an age indication of ~250 Ma. 40Ar/39Ar ages of six dust samples are uniform around 200 Ma and match the K-Ar ages of modern dust deposited on Hawaii. These data reflect the weighted age average of illite formation. Changes from illite- smectite with significant kaolinite to illite- and chlorite-rich, kaolinite-free assemblages since the late Pliocene document changes in the intensity of chemical weathering in the source region. Such weathering evidently did not disturb the K-Ar systematics, and only induced scatter in the Rb-Sr data. We propose that when smectite forms at the expense of illite, K and Ar are quantitatively lost from what becomes smectite, but are quantitatively retained in adjacent illite layers. 40Ar/39Ar age data, therefore, are insensitive to smectite formation during chemical weathering but date the diagenetic growth of illite, the major K-bearing phase in the dust. Over the past 12 Myr, the dust flux to the north Pacific increased by more than an order of magnitude, documenting a substantial drying of central Asia. This climatic change, however, did not alter the ultimate source of the dust, and neoformational products of chemical weathering always remained subordinate to assemblages reworked by mechanical erosion in dust deposited in eastern Asia and the Pacific Ocean.

Grain size percentiles and Mk values of coastal sediments from Schleswig Holstein, western Baltic Sea

In einer Fülle sedimentpetrographischer Arbeiten wird versucht, aus der Korngrößenverteilung und der Mineralzusammensetzung von Sanden Schlüsse auf ihre Herkunft, ihre Transportrichtung oder ihr Ablagerungsmilieu abzuleiten, die für die Lösung geologischer und ebenso auch wasserbaulicher Probleme nötig sind. Diese Literatur steckt noch voller Widersprüche und Fehlschlüsse. In der vorliegenden Arbeit wird daher versucht, den Mechanismus des Sandtransports vom Grundsätzlichen her besser verständlich zu machen. Das geschieht anhand zweier ausgewählter und eingehend untersuchter Beispiele aus dem Küstenbereich der westlichen Ostsee unter Einbeziehung der Erfahrungen an vielen Vergleichsproben aus verschiedensten Sedimentationsräumen. Unentbehrlich für das Verständnis der transportbedingten Veränderungen an den Sanden ist das sog. 'Äquivalenzprinzip' (Abschnitt 2). Es stellt fest, daß es in einem von einer Strömung transportierten Sediment immer Körner zwar verschiedener Korngröße, aber auch entsprechend verschiedener Dichte und/oder Kornform gibt, die miteinander transportiert und abgelagert werden, weil unter den herrschenden hydraulischen Bedingungen diese Eigenschaften einander voll kompensieren. In Abschnitt 3 wird kurz die von Rittenhouse angegebene Methode geschildert, mit der man an natürlichen Sedimenten unter der sehr allgemein gehaltenen 'Äquivalenzbedingung' gleicher Transportierbarkeit bestimmen kann, welches Korngrößenverhältnis ein bestimmtes Verhältnis der Dichten kompensieren kann. Die von Rittenhouse am Beispiel von Flußsanden gefundene Funktion zwischen der Dichte der Körner und ihrem Äquivalenzverhältnis gegen Quarzkörner wird hier als erste Näherung auch für die Transportverhältnisse von Strandsanden zugrunde gelegt. In Abschnitt 6 wird gezeigt, daß das auch gerechtfertigt ist. In Abschnitt 4 wird eine allgemein brauchbare Methode abgeleitet, mit der man nicht nur unter stark vereinfachenden Annahmen, sondern auch an Sanden mit realen, stets komplexen Korn-größenverteilungen die Folgen des Äquivalenzprinzips für die Verteilung von Mineralen verschiedener Dichte berechnen kann. Für jede Serie von Sanden, deren Korngrößenverteilungen entlang des Transportweges eine bestimmte, von den Transportbedingungen abhängige Entwicklung durchmachen, ergibt sich damit eine Kurvenschar, die beschreibt, wie sich die Mengen von Mineralien mit verschiedenen Dichten in den einzelnen Korngrößenklassen dabei ändern müßten, vorausgesetzt, daß sie im gesamten Korngrößenbereich gleich verfügbar wären. Diese Kurvenschar ist die 'Charakteristik' des betreffenden Transportfalles. Durch den Vergleich zwischen den nach der Charakteristik in den einzelnen Klassen zu erwartenden Mineralmengen mit den in dem betrachteten Transportfall tatsächlich gefundenen läßt sich deren relative, d. h. auf die Menge des Quarzes bezogene 'Verfügbarkeit' berechnen. Sie wird durch die sog. 'hydraulischen Verhältnisse' (Rittenhouse) ausgedrückt, die im Gegensatz zu den 'Klassenverhältnissen' von der Korngrößensonderung beim Transport unabhängig und nur von der Zusammensetzung des Ausgangsmaterials bestimmt sind, solange beim Transport allein das Äquivalenzprinzip wirksam ist. In den untersuchten Fällen von Sandtransport an zwei Strandabschnitten der westlichen Ostsee (Abschnitt 5) zeigte dieser Vergleich (Abschnitt 6), daß die beobachtete Verteilung von Schwermineralen nicht allein durch Transportsonderung unter Gültigkeit des Äquivalenzprinzips erklärt werden kann, sondern daß dabei offenbar auch mechanische Zerkleinerung der Körner während des Transports mitgewirkt haben muß. Nur ein solcher, von der Transportsonderung unabhängiger Effekt kann als Transportrichtungs-Kriterium benutzt werden, wenn die Entwicklung der Korngrößenverteilungen allein keine Entscheidung erlaubt. Wie die Beispiele zeigen, läßt sich Klarheit über die bisher noch sehr umstrittene Frage nach dem Ausmaß der transportbedingten mechanischen Zerkleinerung von Sandkörnern nur gewannen, wenn in Zukunft versucht wird, bei der Bearbeitung natürlicher Beispiele den Einfluß der stets vorhandenen Transportsonderung auf Veränderungen des Mineralbestandes unter Anwendung des Äquivalenzprinzips rechnerisch auszuschalten. Über dieses wesentlichste Ergebnis hinaus erlauben die dargestellten Zusammenhänge auch eine kritische Stellungnahme zu den oben erwähnten allgemeinen Problemen und führen zu methodischen und sachlichen Verbesserungsvorschlägen für weitere Untersuchungen an klastischen Sedimenten.

Nitrogen fuelling of the pelagic food web of the Tropical Atlantic

We estimated the relative contribution of atmospheric Nitrogen (N) input (wet and dry deposition and N fixation) to the epipelagic food web by measuring N isotopes of different functional groups of epipelagic zooplankton along 23°W (17°N-4°S) and 18°N (20-24°W) in the Eastern Tropical Atlantic. Results were related to water column observations of nutrient distribution and vertical diffusive flux as well as colony abundance of Trichodesmium obtained with an Underwater Vision Profiler (UVP5). The thickness and depth of the nitracline and phosphocline proved to be significant predictors of zooplankton stable N isotope values. Atmospheric N input was highest (61% of total N) in the strongly stratified and oligotrophic region between 3 and 7°N, which featured very high depth-integrated Trichodesmium abundance (up to 9.4×104 colonies m-2), strong thermohaline stratification and low zooplankton delta15N (~2 per mil). Relative atmospheric N input was lowest south of the equatorial upwelling between 3 and 5°S (27%). Values in the Guinea Dome region and north of Cape Verde ranged between 45 and 50%, respectively. The microstructure-derived estimate of the vertical diffusive N flux in the equatorial region was about one order of magnitude higher than in any other area (approximately 8 mmol m-2 d 1). At the same time, this region received considerable atmospheric N input (35% of total). In general, zooplankton delta15N and Trichodesmium abundance were closely correlated, indicating that N fixation is the major source of atmospheric N input. Although Trichodesmium is not the only N fixing organism, its abundance can be used with high confidence to estimate the relative atmospheric N input in the tropical Atlantic (r2 = 0.95). Estimates of absolute N fixation rates are two- to tenfold higher than incubation-derived rates reported for the same regions. Our approach integrates over large spatial and temporal scales and also quantifies fixed N released as dissolved inorganic and organic N. In a global analysis, it may thus help to close the gap in oceanic N budgets.

Magnetic properties of ODP Site 191-1179 sediments

As reported by Shipboard Scientific Party (2001b, doi:10.2973/odp.proc.ir.191.104.2001) in the Site 1179 chapter of the Initial Reports volume, Leg 191 Site 1179 is located on abyssal seafloor northwest of Shatsky Rise, ~1650 km east of Japan. This part of the Pacific plate was formed during the Early Cretaceous, as shown by northeast-trending M-series magnetic lineations that become younger toward the northwest (Larson and Chase, 1972, doi:10.1130/0016-7606(1972)83[3627:LMEOTW]2.0.CO;2; Sager et al., 1988, doi:10.1029/JB093iB10p11753; Nakanishi et al., 1989, doi:10.1029/1999JB900002). The site is situated on magnetic Anomaly M8 (Nakanishi et al., 1999, doi:10.1029/1999JB900002), corresponding to an age of ~129 Ma and the Hauterivian stage of the Early Cretaceous (Gradstein et al., 1994, doi:10.1029/94JB01889; 1995). The sediments recovered at Site 1179 are split into four lithostratigraphic units based on composition and color (Shipboard Scientific Party, 2001b, doi:10.2973/odp.proc.ir.191.104.2001). Unit I (0-221.52 meters below seafloor [mbsf]) is a dominantly olive-gray clay- and radiolarian-bearing diatom ooze. Unit II (221.52-246.0 mbsf) is a yellowish brown to light brown clay-rich and diatom-bearing radiolarian ooze. Unit III (246.0-283.53 mbsf) is composed of brown pelagic clay. Unit IV (283.53-377.15 mbsf) is composed of chert and some porcellanite; any softer sediments present were washed out of the core barrel by the fluid circulating during the coring process.

Geochemistry of sediment core PS2456-4

Sediment core PS2458 from the Laptev Sea continental margin (983-m water depth) stems from a position close to the paleoriver mouth of Lena and Yana rivers. It was dated by AMS-14C and analyzed in high resolution for oxygen isotopes of planktic foraminifers. Except the uppermost 100 cm and possibly the lowermost meter of the 8-m-long core, the sediments were deposited during the last deglaciation (14.5-8.0 cal-ka). According to 210Pb data, the uppermost 100 cm represents only the last 200 years. Planktic foraminifers are present throughout the dated deglacial interval, with the exception of a short time after ca. 13 cal-ka. Taking into account the global "ice volume effect" on the oxygen isotopic composition of the foraminifers, the isotopic record is considered to reflect salinity changes which were influenced by variable freshwater runoff and a growing marine influence during the postglacial transgression of the Laptev Sea shelf. The most conspicuous feature in the isotopic record is an outstanding peak dated to ca. 13 cal-ka. It is proposed that it represents a rapid outburst of large amounts of freshwater, possibly from an ice-dammed lake in the hinterland. Possible correlations to the onset of the cool Younger Dryas event in the northern hemisphere are discussed.

Regression analysis of ranked segment parameters for optic nerve head classification:a pilot study

Purpose: To determine whether curve-fitting analysis of the ranked segment distributions of topographic optic nerve head (ONH) parameters, derived using the Heidelberg Retina Tomograph (HRT), provide a more effective statistical descriptor to differentiate the normal from the glaucomatous ONH. Methods: The sample comprised of 22 normal control subjects (mean age 66.9 years; S.D. 7.8) and 22 glaucoma patients (mean age 72.1 years; S.D. 6.9) confirmed by reproducible visual field defects on the Humphrey Field Analyser. Three 10°-images of the ONH were obtained using the HRT. The mean topography image was determined and the HRT software was used to calculate the rim volume, rim area to disc area ratio, normalised rim area to disc area ratio and retinal nerve fibre cross-sectional area for each patient at 10°-sectoral intervals. The values were ranked in descending order, and each ranked-segment curve of ordered values was fitted using the least squares method. Results: There was no difference in disc area between the groups. The group mean cup-disc area ratio was significantly lower in the normal group (0.204 ± 0.16) compared with the glaucoma group (0.533 ± 0.083) (p < 0.001). The visual field indices, mean deviation and corrected pattern S.D., were significantly greater (p < 0.001) in the glaucoma group (-9.09 dB ± 3.3 and 7.91 ± 3.4, respectively) compared with the normal group (-0.15 dB ± 0.9 and 0.95 dB ± 0.8, respectively). Univariate linear regression provided the best overall fit to the ranked segment data. The equation parameters of the regression line manually applied to the normalised rim area-disc area and the rim area-disc area ratio data, correctly classified 100% of normal subjects and glaucoma patients. In this study sample, the regression analysis of ranked segment parameters method was more effective than conventional ranked segment analysis, in which glaucoma patients were misclassified in approximately 50% of cases. Further investigation in larger samples will enable the calculation of confidence intervals for normality. These reference standards will then need to be investigated for an independent sample to fully validate the technique. Conclusions: Using a curve-fitting approach to fit ranked segment curves retains information relating to the topographic nature of neural loss. Such methodology appears to overcome some of the deficiencies of conventional ranked segment analysis, and subject to validation in larger scale studies, may potentially be of clinical utility for detecting and monitoring glaucomatous damage. © 2007 The College of Optometrists.