A body map of somatic mutagenesis in morphologically normal human tissues.

Somatic mutations that accumulate in normal tissues are associated with ageing and disease1,2. Here we performed a comprehensive genomic analysis of 1,737 morphologically normal tissue biopsies of 9 organs from 5 donors. We found that somatic mutation accumulations and clonal expansions were widespread, although to variable extents, in morphologically normal human tissues. Somatic copy number alterations were rarely detected, except for in tissues from the oesophagus and cardia. Endogenous mutational processes with the SBS1 and SBS5 mutational signatures are ubiquitous among normal tissues, although they exhibit different relative activities. Exogenous mutational processes operate in multiple tissues from the same donor. We reconstructed the spatial somatic clonal architecture with sub-millimetre resolution. In the oesophagus and cardia, macroscopic somatic clones that expanded to hundreds of micrometres were frequently seen, whereas in tissues such as the colon, rectum and duodenum, somatic clones were microscopic in size and evolved independently, possibly restricted by local tissue microstructures. Our study depicts a body map of somatic mutations and clonal expansions from the same individual.

Factors associated with prior completion of colorectal cancer and hepatitis C virus screenings among community health center patients: a cross-sectional study to inform a multi-behavioral educational intervention.

BACKGROUND: Colorectal cancer (CRC) and liver cancer are two of the leading causes of cancer death in the United States and persistent disparities in CRC and liver cancer incidence and outcomes exist. Chronic hepatitis C virus (HCV) infection is one of the main contributors to liver cancer. Effective screening for both CRC and HCV exist and are recommended for individuals based upon age, regardless of gender or sex assigned at birth. Recommendations for both screening behaviors have been recently updated. However, screening rates for both CRC and HCV are suboptimal. Targeting adoption of multiple screening behaviors has the potential to reduce cancer mortality and disparities. OBJECTIVE: To examine psychosocial factors associated with completion of CRC and HCV screenings in order to inform a multi-behavioral educational intervention that pairs CRC and HCV screening information. METHODS: A cross-sectional survey was conducted with participants (N = 50) recruited at two community health centers in Florida (United States). Kruskal-Wallis and Fisher's exact tests were used to examine associations between completion of both CRC and HCV screening, CRC and HCV knowledge, Preventive Health Model constructs (e.g., salience and coherence, response efficacy, social influence), and sociodemographic variables. RESULTS: Most participants were White (84%), female (56%), insured (80%), and reported a household income of $25,000 or less (53%). 30% reported ever previously completing both CRC and HCV screenings. Prior completion of both screening behaviors was associated with higher educational attainment (p = .014), having health insurance (p = .022), being U.S.-born (p = .043), and higher salience and coherence scores for CRC (p = .040) and HCV (p = .004). CONCLUSIONS: Findings demonstrate limited uptake of both CRC and HCV screenings among adults born between 1945 and 1965. Uptake was associated with multiple sociodemographic factors and health beliefs related to salience and coherence. Salience and coherence are modifiable factors associated with completion of both screening tests, suggesting the importance of incorporating these health beliefs in a multi-behavioral cancer education intervention. Additionally, health providers could simultaneously recommend and order CRC and HCV screening to improve uptake among this age cohort.

Household Dependence on Forest Resources in the Luki Biosphere Reserve, Democratic Republic of CONGO.

This study was aimed at examining the contribution of forest products to rural livelihoods and the socio-economic factors that influence household forest dependence in the Luki Biosphere Reserve. A structured questionnaire poll of 193 households randomly chosen from two enclaves in the Luki Biosphere Reserve, and focus group discussions were used to gather the data. For data analysis, a binary logistic regression model was used. The study revealed a substantial contribution of forest products to household livelihood based on household wealth strata and the gender of the household head. The contribution of forest income has been found to be higher for poor households than to other wealth categories, although their mean income from forest was low. However, the present research further revealed that household forest dependence was significantly determined by socioeconomic factors such as length of residency, age, sex, education, employment and household size. Compared to their elderly counterparts, the youth were probably more dependent on forest products. Therefore, there should be increased capacity-building efforts among the young people to enable them enlighten the local communities about the need for sustainable forest management. Meanwhile, highly educated people were observed to be less dependent on forests. The findings of this research provides empirical evidence from the Mayombe tropical forest, thus contributing to the growth of knowledge on the impact of socioeconomic factors on the household dependence on forest resources, especially in the tropical forest of the Democratic Republic of Congo where the complexity of the relationship between local communities and their environment is still being studied.

Delineation of clinical course, outcomes, and prognostic factors in patients with T-cell prolymphocytic leukemia.

T-cell prolymphocytic leukemia (T-PLL) is a rare, post-thymic T-cell neoplasm with a diverse clinical course. T-PLL is typically associated with a poor prognosis; however, a subset of patients have inactive disease on initial presentation. There is a lack of accurate delineation of the disease based on initial clinical presentation and pathological assessment, hindering clinical decision-making. To characterize and delineate disease subtypes based on initial clinical presentation and pathologic assessment, we retrospectively reviewed 81 patients with T-PLL treated at our institution. We compared patients with T-PLL who initially presented with a relatively indolent or stable disease course to those with an aggressive disease course. Clinicopathologic characteristics, overall survival (OS), and prognostic factors were analyzed. Patients with inactive disease had a significantly longer OS than patients with active disease. At diagnosis, presence of B symptoms, low hemoglobin, low platelet count, lymphocyte doubling time of fewer than 3 months, and abnormal cytogenetics were associated with shorter OS. Cell morphology, immunophenotype, absolute lymphocyte count, lactate dehydrogenase levels, involvement of liver, spleen, skin or central nervous system, presence of TCL1 rearrangement or inv (14)/t(14;14), presence of chromosome 8 abnormalities, and presence of deletion of 11q were not associated with significant OS difference among the patients. Receiving alemtuzumab as first-line treatment and consolidation with allogeneic hematopoietic stem cell transplant were associated with better outcomes. T-PLL inactive and active disease subtypes can exhibit overlapping yet different clinical and pathological features. We describe several prognostic factors at diagnosis that can be used for risk stratification and aid in guiding treatment decisions.

Sociocultural factors associated with physical activity in Black prostate cancer survivors.

PURPOSE: Prostate cancer disproportionately affects Black men. Physical activity protects long-term health and quality of life outcomes in prostate cancer survivors. This study aimed to identify sociocultural factors related to physical activity among Black prostate cancer survivors to inform culturally tailored intervention development. METHODS: This secondary analysis included data from 257 men who identified as Black or African American and were diagnosed with prostate cancer between 2013 and 2018. Participants completed validated self-report measures of perceived history of racial discrimination, religiosity, fatalism, sociodemographic (e.g., age, ethnicity, income) and clinical characteristics (e.g., years since diagnosis, comorbidity burden), and leisure-time physical activity. Regression analyses were conducted to examine the associations between sociocultural factors and mild, moderate, and vigorous physical activity. RESULTS: Participants were on average 68.7 years old (SD = 7.7), and most were non-Hispanic (97.3%), married (68.9%), reported an annual household income above $50,000 (57.1%), received at least some college education (74.1%), and were overweight or had obesity (78.5%). Participants reported on average 88.1 (SD = 208.6) min of weekly mild physical activity, and most did not meet guidelines for weekly moderate (80.5%) or vigorous (73.0%) physical activity. After adjusting for covariates, older age and greater religiosity were associated with mild physical activity (ps ≤ 0.05). Higher levels of fatalism were associated with lower odds of meeting guidelines for moderate physical activity (OR = 0.87, 95% CI = 0.77-0.99). CONCLUSIONS: Sociocultural factors such as religiosity and fatalism may be associated with some forms of physical activity in Black prostate cancer survivors. These findings suggest that incorporating faith-based practices into health behavior interventions may be appropriate for this population.

Safety outcomes of pembrolizumab with platinum agent chemotherapy combined with 5-fluorouracil or taxane derivative in head and neck cancer.

INTRODUCTION: For patients with metastatic head and neck squamous cell cancer (HNSCC), the outcomes of pembrolizumab in combination with a platinum agent and taxane as first-line therapy remain unknown. The purpose of this study is to characterize the impact of substituting the 5-fluorouracil (5-FU) backbone for a taxane in this chemoimmunotherapy regimen on safety/tolerability and survival outcomes. METHODS: This was an IRB-approved, single-center, retrospective, active comparator, new-user design study in adult patients with HNSCC treated between January 2018 and September 2021. The primary objective was to assess safety and tolerability of pembrolizumab in combination with a platinum agent and taxane against an active comparator arm of pembrolizumab in combination with a platinum agent and 5-FU. Safety and tolerability were evaluated by assessing differences in overall toxicities, with further secondary analysis evaluating differences in hematologic toxicities and pre-defined non-hematologic toxicities. RESULTS: There was no statistical difference demonstrated with the primary endpoint between the cohorts. Reduced toxicity rates were found in the taxane arm for mucositis and creatinine levels. No grade 4 non-hematologic toxicities were reported. Patients receiving 5-FU were more likely to have dose reductions upfront, discontinue treatment due to intolerances and had significantly higher mucositis. CONCLUSIONS: This study helps to characterize the safety profile and activity of pembrolizumab in combination with a platinum agent and taxane derivative in HNSCC patients. Within our study, substitution of 5-FU with a taxane did not show an increased risk of toxicities, worsened survival, or decreased odds of achieving a response. Mucositis and elevated creatinine rates were significantly reduced within the taxane arm.

Patient-caregiver dyads in pancreatic cancer: identification of patient and caregiver factors associated with caregiver well-being.

We aimed to examine the psychosocial well-being in the pancreas cancer patient-caregiver dyad, and determine patient and caregiver characteristics that predict caregiver distress. This was a cross-sectional, observational study. Demographics and caregiving characteristics were gathered from patients and caregivers. Caregivers completed validated instruments investigating anxiety, depression, perceived stress and caregiver burden. Over a period of eleven months, 128 patient-caregiver dyads were enrolled. Patient and caregiver distress scores were not associated with patient clinical disease burden. Patient distress was a significant predictor of concurrent caregiver distress, anxiety, depression, and perceived burden. Younger caregivers were also associated with higher caregiver anxiety and perceived burden. Additionally, number of caregiving activities and caregiver overall health status were predictors of concurrent caregiver depression and perceived stress. Certain pancreatic cancer patient and caregiver variables may negatively impact the well-being of caregivers. Future efforts should focus on development and implementation of comprehensive caregiver support programs for those at risk for psychosocial distress.

Sequential acquisition of human papillomavirus infection between genital and oral anatomic sites in males.

Oral human papillomavirus (HPV) is associated with increasing rates of HPV-associated oropharyngeal cancer (OPC) in men. Sequential infection from one site to another has been demonstrated at the cervix and anus. Thus, risk of an oral HPV infection after a genital infection of the same type in the HPV infection in men study was investigated. Samples from 3140 men enrolled in a longitudinal cohort were assessed for sequential genital to oral infection with one of nine HPV types (HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58); and then also sequential, same-type oral to genital infection. Incidence rate ratios (IRRs) compared rates of oral HPV among men with and without prior genital infection of the same type. Risk of sequential HPV infections were assessed using Cox proportional hazards model. Incidence of an oral HPV infection was significantly higher among men with a prior genital infection of the same type for any of the 9 HPV types (IRR: 2.3; 95% CI: 1.7-3.0). Hazard ratio of a sequential genital to oral HPV infection was 2.3 (95% CI: 1.7-3.1) and 3.5 (95% CI: 1.9-6.4) for oral to genital infection. Both changed minimally after adjustment for age, country, circumcision, alcohol use, lifetime sexual partners and recent oral sex partners. HPV infections at one site could elevate risk of a subsequent genital or oral HPV infection of the same type in men, emphasizing the importance of vaccination to prevent all HPV infections.

The Effect of Synergistic Approaches of Features and Ensemble Learning Algorith on Aboveground Biomass Estimation of Natural Secondary Forests Based on ALS and Landsat 8.

Although the combination of Airborne Laser Scanning (ALS) data and optical imagery and machine learning algorithms were proved to improve the estimation of aboveground biomass (AGB), the synergistic approaches of different data and ensemble learning algorithms have not been fully investigated, especially for natural secondary forests (NSFs) with complex structures. This study aimed to explore the effects of the two factors on AGB estimation of NSFs based on ALS data and Landsat 8 imagery. The synergistic method of extracting novel features (i.e., COLI1 and COLI2) using optimal Landsat 8 features and the best-performing ALS feature (i.e., elevation mean) yielded higher accuracy of AGB estimation than either optical-only or ALS-only features. However, both of them failed to improve the accuracy compared to the simple combination of the untransformed features that generated them. The convolutional neural networks (CNN) model was much superior to other classic machine learning algorithms no matter of features. The stacked generalization (SG) algorithms, a kind of ensemble learning algorithms, greatly improved the accuracies compared to the corresponding base model, and the SG with the CNN meta-model performed best. This study provides technical support for a wall-to-wall AGB mapping of NSFs of northeastern China using efficient features and algorithms.

Modified photochemical reflectance index to estimate leaf maximum rate of carboxylation based on spectral analysis.

The maximum rate of carboxylation in leaves (Vcmax) is an important parameter used to determine the photosynthetic rate. An accurate estimation of Vcmax is important for evaluating the photosynthetic capacity of vegetation productivity and the carbon budget of forest ecosystems. In this study, we measured the light use efficiency (LUE) and Vcmax of leaves and their corresponding spectral characteristics. Spectral analysis was used to find a modified photochemical reflectance index (PRI) of leaves to estimate LUE and thereby estimate leaf Vcmax. The results showed that the precision with which the modified ratio PRI index estimated LUE was significantly increased. The R2 of the estimation model was 0.69, and the root mean square error (RMSE) was 0.0024. The R2 of the model for estimating leaf Vcmax based on the LUE was 0.72, and the RMSE was 8.439 µmol/m2/s. The Vcmax values of conifer trees (Scots pine, Korean pine, and larch) were higher than those of broadleaf trees (white birch, Manchurian walnut, Siberian elm, Manchurian ash, Mongolian oak, Korean aspen, and Amur linden). This method avoids problem that conventional PRI is not sensitive to high leaf LUE values and provides important parameter data for the quantitative estimation of the gross primary productivity of forest ecosystems.

Forest age mapping based on multiple-resource remote sensing data.

Forest age is an important stand description factor and plays an important role in the carbon cycle of forest ecosystems. However, forest age data are typically lacking or are difficult to acquire at large spatial scale. Thus, it is important to develop a method of spatial forest age mapping. In this study, a method of forest age estimation based on multiple-resource remote sensing data was developed. Forest age was estimated by using average tree height estimated from the ICESat/GLAS and MODIS BRDF products. The results showed that forest age was significantly related to average tree height with a correlation coefficient of 0.752. Then, the average tree height was inversed using a waveform parameter extracted from ICESat/GLAS and was extended to continuous space with the help of the MODIS BRDF product. Thus, forest age mapping was realized. Lastly, the structure of forest age in the study area was evaluated. The results indicated that this method can be used to estimate forest age at the local scale and at large scale and can facilitate understandings of the real forest age structure features of a research area.

Stigma Among Chinese Medical Students Toward Individuals With Mental Illness.

The current study aimed to examine medical students' attitudes toward individuals with mental illness. Stratified cluster sampling was used to survey 735 Chinese medical students from three medical universities in Shandong, China. Participants completed the Perceived Devaluation and Discrimination Scale (PDD). Scores on the devaluation subscale items (mean = 2.80, SD = 0.59) were lower than the midpoint score (i.e., 3) (p < 0.001), and scores on the discrimination subscale items (mean = 3.20, SD = 0.52) were higher than the midpoint score (p < 0.001). Higher scores indicated more negative attitudes toward individuals with mental illness. Significant gender differences were found in the discrimination subscale scores and total PDD scores, with lower scores in men compared with women. Compared with medical students in other years, students in their senior year of medical school had the lowest scores on the discrimination subscale. Students may benefit from increased education regarding psychology and psychiatry and by having more contact with individuals with mental illness. [Journal of Psychosocial Nursing and Mental Health Services, 58(2), 27-31.].

Oral administration of a select mixture of Bacillus probiotics generates Tr1 cells in weaned F4ab/acR- pigs challenged with an F4+ ETEC/VTEC/EPEC strain.

Although breeding of F4 receptor - negative (F4R(-)) pigs may prevent post-weaning diarrhea, the underlying immunity is poorly understood. Here, various doses of a Bacillus licheniformis and Bacillus subtilis mixture (BLS-mix) were orally administered to F4ab/acR(-) pigs for 1 week before F4 (K88) - positive ETEC/VTEC/EPEC challenge. Administration of BLS-mix increased the percentage of Foxp3(-)IL-10(+) T cells but not of Foxp3(+)IL-10(+) regulatory T (Treg) cells among peripheral blood CD4(+) T cells. A low dose of BLS-mix feeding resulted in increased the expression of IL-6, TNF-α, IL-10, and the transcription factors Foxp3 and T-bet mRNAs in the jejunum. Administration of either a low or high dose BLS-mix also led to an increase in the percentage of CD4(+)Foxp3(+) Treg cells among intraepithelial lymphocytes and CD4(+)IL-10(+) T cells in the small intestinal Peyer's patches and the lamina propria of F4ab/acR(-) pigs following F4(+) ETEC/VTEC/EPEC challenge. The increased number of IL-10-producing CD4(+) T cells was attributed to an increase in the proportion of Foxp3(-)IL-10(+) Treg cells rather than Foxp3(+)IL-10(+) Treg cells. Our data indicate that oral administration of BLS-mix to newly weaned F4ab/acR(-) pigs ameliorates enteritis in an F4(+) ETEC/VTEC/EPEC model; however, induction of IL-10-producing Foxp3(-) Treg cells by BLS-mix administration cannot account for the protection of newly weaned F4ab/acR(-) pigs from F4(+) ETEC/VTEC/EPEC infection, and that excessive generation of CD4(+)IL-10(+) T cells following consumption of BLS-mix during episodes of intestinal inflammation that is caused by enteric pathogens might prohibit clearance of the pathogen. Select probiotic mixtures may allow for tailoring strategies to prevent infectious diseases.

Chlorophyll content retrieval from hyperspectral remote sensing imagery.

Chlorophyll content is the essential parameter in the photosynthetic process determining leaf spectral variation in visible bands. Therefore, the accurate estimation of the forest canopy chlorophyll content is a significant foundation in assessing forest growth and stress affected by diseases. Hyperspectral remote sensing with high spatial resolution can be used for estimating chlorophyll content. In this study, the chlorophyll content was retrieved step by step using Hyperion imagery. Firstly, the spectral curve of the leaf was analyzed, 25 spectral characteristic parameters were identified through the correlation coefficient matrix, and a leaf chlorophyll content inversion model was established using a stepwise regression method. Secondly, the pixel reflectance was converted into leaf reflectance by a geometrical-optical model (4-scale). The three most important parameters of reflectance conversion, including the multiple scattering factor (M 0 ), and the probability of viewing the sunlit tree crown (P T ) and the background (P G ), were estimated by leaf area index (LAI), respectively. The results indicated that M 0 , P T , and P G could be described as a logarithmic function of LAI, with all R (2) values above 0.9. Finally, leaf chlorophyll content was retrieved with RMSE = 7.3574 µg/cm(2), and canopy chlorophyll content per unit ground surface area was estimated based on leaf chlorophyll content and LAI. Chlorophyll content mapping can be useful for the assessment of forest growth stage and diseases.

The influence of stress on mental health among Chinese college students: The moderating role of psychological suzhi.

Depending on its duration, stress can be divided into chronic and acute stress, both of which can be detrimental to an individual's mental health. Psychological suzhi may act as a protective factor that buffers the adverse effects of stress. This study aimed to explore the moderating role of psychological suzhi in the relationship between these two types of stress and mental health based on a dual-factor model of mental health. Study 1 explored the moderating role of psychological suzhi on the relationship between chronic stress and mental health using the Adolescent Self-Rating Life Events Check List, College Student Psychological Suzhi Scale Brief Mental Health Version, Satisfaction With Life Scale, and 12-item General Health Questionnaire to investigate 919 Chinese college students. A hierarchical regression model was used to examine the moderating effects. Study 2 examined the moderating role of psychological suzhi on the relationship between acute stress and mental health. Participants (N = 56) were classified into high (N = 30) and low (N = 26) psychological suzhi groups based on the Psychological Suzhi Scale. They completed the Trier Social Stress Test for Groups and a specific control condition, and their state anxiety and happiness levels were assessed. Data were analyzed using a mixed-design repeated-measures ANOVA. The results of Study 1 revealed that psychological suzhi moderated the influence of chronic stress on the negative indicator of mental health (psychological symptoms) (ß = -0.18, t = -6.90, p < 0.001). The results of Study 2 showed that psychological suzhi moderated the effect of acute stress on the negative indicator of mental health (state anxiety) [F (1, 54) = 4.79, p < 0.05, η2 = 0.08]. Psychological suzhi can moderate the influence of both chronic and acute stress on the negative indicators of college students' mental health but cannot moderate the influence on the positive indicators of mental health.

Monomodular and multifunctional processive endocellulases: implications for swine nutrition and gut microbiome.

Poor efficiency of dietary fibre utilization not only limits global pork production profit margin but also adversely affects utilization of various dietary nutrients. Poor efficiency of dietary nutrient utilization further leads to excessive excretion of swine manure nutrients and results in environmental impacts of emission of major greenhouse gases (GHG), odor, nitrate leaching and surface-water eutrophication. Emission of the major GHG from intensive pork production contributes to global warming and deteriorates heat stress to pigs in tropical and sub-tropical swine production. Exogenous fibre enzymes of various microbial cellulases, hemicellulases and pectinases have been well studied and used in swine production as the non-nutritive gut modifier feed enzyme additives in the past over two decades. These research efforts have aimed to improve growth performance, nutrient utilization, intestinal fermentation as well as gut physiology, microbiome and health via complementing the porcine gut symbiotic microbial fibrolytic activities towards dietary fibre degradation. The widely reported exogenous fibre enzymes include the singular use of respective cellulases, hemicellulases and pectinases as well as their multienzyme cocktails. The currently applied exogenous fibre enzymes are largely limited by their inconsistent in vivo efficacy likely due to their less defined enzyme stability and limited biochemical property. More recently characterized monomodular, multifunctional and processive endoglucanases have the potential to be more efficaciously used as the next-generation designer fibre biocatalysts. These newly emerging multifunctional and processive endoglucanases have the potential to unleash dietary fibre sugar constituents as metabolic fuels and prebiotics, to optimize gut microbiome, to maintain gut permeability and to enhance performance in pigs under a challenged environment as well as to parallelly unlock biomass to manufacture biofuels and biomaterials.

Prevalence and influencing factors of post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic: a systematic review and meta-analysis.

Background: Post-traumatic stress disorder is an important psychological problem affecting the physical mental health of Chinese healthcare workers during the COVID-19 pandemic. Aims: To estimate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among Chinese healthcare workers during COVID-19. Methods: Search of Chinese and English literature in PubMed, EMbase, Web of Science, Medline, Elsevier, SpringerLink, China Biomedical Literature Database, CNKI, Wan-fang, and CQVIP for the period from December 2019 to August 2023. Stata 14.0 software was used for data analysis. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the Random-effects model. Publication bias was evaluated using Egger's test and Begg's test. Results: Twenty-one studies included 11841 Chinese healthcare workers in this review. First, the overall prevalence of Post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic was 29.2% (95% CI: 20.7% to 33.7%). Twelve factors included in the meta-analysis were found to be protective against PTSD among Chinese healthcare workers: female, nurse, married, front-line work, less work experience, family or friend diagnosed with COVID-19, history of chronic disease and fear of COVID-19. Conversely, outside Hubei, higher education, social support and psychological resilience are protective factors. Conclusion: These recent findings increase our understanding of the psychological status of Chinese healthcare workers and encourage that long-term monitoring and long-term interventions should be implemented to improve the mental health of Chinese healthcare workers in the aftermath of the COVID-19.

Multinational epidemiological analysis of oral human papillomavirus incidence in 3,137 men.

Oral human papillomavirus (HPV) is associated with oropharyngeal cancer (OPC). Although OPC incidence is increasing globally, knowledge of oral HPV infection rates is limited. Here we carried out an observational epidemiological analysis of oral HPV incidence in 3,137 men enrolled from the United States, Mexico and Brazil between 2005 and 2009. Individuals were followed for new HPV infection for a median of 57 months. Cumulative incidence and factors associated with acquisition were also assessed. The incidence rate of oral oncogenic HPV was 2.4 per 1,000 person-months, did not vary with age and was constant throughout the study period. Risk of oral HPV acquisition was significantly associated with alcohol consumption, having male sexual partners, more lifetime female sexual partners, more oral sex given and higher educational attainment. These data indicate that men are at risk of acquiring oral HPV throughout their lifetime, suggesting that catch-up vaccination may reduce new infection incidence.