Social Disadvantage and Multimorbidity Including Oral Conditions in the United States.

Existing studies on multimorbidity have largely excluded oral diseases in multimorbidity prevalence estimates. The reason behind this is somewhat unclear, as chronic oral conditions are highly prevalent, affecting over half the global population. To address this gap, we examined the relationship between social disadvantage and multimorbidity, stratifying by the inclusion and exclusion of oral conditions. For participants aged 30 y and over (n = 3,693), cross-sectional analysis was carried out using the US National Health and Nutrition Survey (2013-2014). Multimorbidity was defined as having 2 or more chronic conditions. Five medical conditions were examined: diabetes, asthma, arthritis, cardiovascular disease, and depression, as well as 4 oral health conditions: caries, periodontal disease, number of teeth, and edentulousness. Education and income poverty ratio were selected as measures of social disadvantage. Multimorbidity prevalence estimates according to social disadvantage were analyzed on an absolute and relative scale using inverse probability treatment weighting (IPTW), adjusting for age, sex, and ethnicity. The inclusion of oral health conditions in the assessment of multimorbidity increased the overall prevalence of multimorbidity from 20.8% to 53.4%. Findings from IPTW analysis demonstrated clear social gradients for multimorbidity estimates stratified by the exclusion of oral conditions. Upon inclusion of oral conditions, the prevalence of multimorbidity was higher across all social groups for both education and income. Stratifying by the inclusion of oral conditions, the mean probability of multimorbidity was 27% (95% confidence interval [CI], 23%-30%) higher in the low-education group compared to the high-education group. Similarly, the mean probability of multimorbidity was 44% (95% CI, 40%-48%) higher in the low-income group. On a relative scale, low education was associated with a 1.52 times (95% CI, 1.44-1.61) higher prevalence of multimorbidity compared to high education. Low income was associated with a 2.18 (95% CI, 1.99-2.39) higher prevalence of multimorbidity. This novel study strongly supports the impact of chronic oral conditions on multimorbidity prevalence estimates.

Correction: Synthesis and characterisation of brannerite compositions (U0.9Ce0.1)1-x M x Ti2O6 (M = Gd3+, Ca2+) for the immobilisation of MOX residues.

[This corrects the article DOI: 10.1039/C7RA11742F.].

Synthesis and characterization of iodovanadinite using PdI2, an iodine source for the immobilisation of radioiodine.

The synthesis of a palladium-containing iodovanadinite derivative, hypothetically "PdPb9(VO4)6I2", was attempted using PdI2 as a source of iodine in searching for a novel waste form for radioiodine. Stoichiometric amounts of Pb3(VO4)2 and PdI2 were batched and reacted at elevated temperatures in sealed vessels. Batched material was also subjected to high-energy ball-milling (HEBM) in order to reduce reaction time and the potential for iodine volatilization during subsequent reaction at 200-500 °C. The resulting products were characterized using X-ray diffraction, scanning electron microscopy, energy-dispersive X-ray analysis, IR spectroscopy, thermal analysis and Pd K XANES. Results showed that PdI2 can function as a sacrificial iodine source for the formation of iodovanadinite, prototypically Pb10(VO4)6I2, however, the incorporation of Pd into this phase was not definitively observed. The sacrificial reaction mechanism involved the decomposition of PdI2 to Pd metal and nascent I2, with the latter incorporated into the iodovanadinite Pb10(VO4)6I2 phase. In comparison to processing using standard solid state reaction techniques, the use of HEBM prior to high temperature reaction generates a more homogeneous end-product with better iodine retention for this system. Overall, the key novelty and importance of this work is in demonstrating a method for direct immobilisation of undissolved PdI2 from nuclear fuel reprocessing, in a composite wasteform in which I-129 is immobilised within a durable iodovandinite ceramic, encapsulating Pd metal.

A synchrotron X-ray spectroscopy study of titanium co-ordination in explosive melt glass derived from the trinity nuclear test.

The speciation of Ti in trinitite, the explosive melt glass derived from the Trinity Test of 16th of July 1945, was investigated by X-ray absorption spectroscopy (XAS). Ti K-edge XANES showed that Ti was present in the Ti(iv) oxidation state for all samples. Fitting of pre-edge features by Gaussian functions and comparison with standards of known Ti coordination revealed significant variation in Ti coordination environment between samples. The variation of Ti coordination may be attributed to several factors including specific local chemistry and thermal histories of samples, in keeping with the highly heterogeneous microstructure of trinitite and the arkosic sand source material.

Synthesis and characterisation of brannerite compositions (U0.9Ce0.1)1-x M x Ti2O6 (M = Gd3+, Ca2+) for the immobilisation of MOX residues.

A suite of uranium brannerites for the disposal of MOX residues, formulated (U0.9Ce0.1)1-x M x Ti2O6 (M = Ca2+ and/or Gd3+), were prepared using a mixed oxide route under oxidising, inert and reducing atmospheres (air, argon and H2/N2). Gd3+ was added to act as a neutron absorber in the final Pu bearing wasteform and Ce added to function as a structural analogue for Pu. X-ray powder diffraction of the synthesised specimens found that phase distribution was strongly affected by the processing atmosphere and Gd content. In all cases prototypical brannerite was formed, accompanied by different secondary phases dependent on processing atmosphere. Microstructural analysis (SEM) of the sintered samples confirmed the results of the X-ray powder diffraction. Bulk XANES found that Ti remained in the Ti4+ oxidation state whereas Ce was uniformly reduced to the Ce3+ oxidation state regardless of processing conditions or stoichiometry. Micro-focus XANES was used to determine U oxidation in the brannerite phase and showed that U oxidised to higher U oxidation states to charge compensate. It was concluded that the charge balance mechanism was a combination of U oxidation and A-site vacancies.

Ovarian Dermoid Cyst Causing Distal Ureteral Obstruction.

A case of a 45-year old woman with an ovarian dermoid cyst causing ureteric colic secondary to distal ureteral obstruction is reported. The dermoid cyst was observed on computed tomography to be adjacent to and compressing the distal left ureter and this was confirmed at surgical exploration. Following oophorectomy, the patient's symptoms completely resolved and the excised ovarian cyst was confirmed on pathological evaluation to be a dermoid cyst. This appears to be the first reported case of ureteral obstruction caused by an ovarian dermoid cyst in the English medical literature.

The pathology of breast cancer in Jamaica: the National Public Health Laboratory study.

OBJECTIVE: To document the pathologic features of breast cancer in Jamaica. METHODS: The pathology reports and slides of all patients diagnosed with breast cancer at the National Public Health Laboratory between January 1999 and December 2002 were reviewed. Patient age and gender side involved, number of tumours identified, tumour size, histologic type, histologic grade, degree of lymph node involvement and parish of origin of the specimens were documented. RESULTS: There were 772 patients, 762 females and 10 males; age range 21 to 96 (mean 57.9 +/- 15.9) years. There were 778 specimens (6 bilateral cases), the majority of whom originated from Kingston and St Andrew (34.7%). Manchester (22.9%), St Catherine (13.9%) and St Ann (7.3%) were the next most common sources. The left breast was involved in 50.5% of cases. Gross tumour was identified in 641 (82.4%) specimens, the number of tumours ranging from 1 - 6 (mean 1.1 +/- 0.6). The maximum gross tumour dimension ranged from 0.3 to 15 cm (mean 4.1 +/- 2.7 cm). Infiltrating duct carcinoma was the predominant histologic type (69.3 %); 13.3%, 49.5% and 37.2 % of all infiltrating tumours were well, moderately and poorly differentiated respectively. In-situ lesions (7.1% of tumours) were all of the ductal phenotype. Axillary lymph nodes were submitted in 296 (38.1%) cases; metastatic disease was identified in 224 (75.7%) of these. The total number of nodes submitted ranged from 1 - 34 (mean 10.8 +/- 6.7) with an average of 6.1 (+/- 5.8) being positive for metastases (range 1 - 29). CONCLUSIONS: The pathologic features of breast cancer documented in this series including average tumour size, histologic types and grade and the degree of lymph node involvement are consistent with patient presentation at relatively advanced stages of disease and highlight the urgent need for public health intervention including a national screening programme.