Northern Mariana Islands Research Articles

Island hopping the lauxaniid-way, Poecilominettia sexseriata Hendel, 1932 (Diptera: Lauxaniidae), new to Guam with additional records of Lauxaniidae and Chamaemyiidae (Diptera) from Guam and the Commonwealth of the Northern Mariana Islands

Island hopping the lauxaniid-way, Poecilominettia sexseriata Hendel, 1932 (Diptera: Lauxaniidae), new to Guam with additional records of Lauxaniidae and Chamaemyiidae (Diptera) from Guam and the Commonwealth of the Northern Mariana Islands

What Lies Behind the Increasing Chinese Tourism Presence in the Northern Mariana Islands?

ABSTRACT The Chinese presence in the Commonwealth of the Northern Mariana Islands (CNMI) has increased dramatically in the past two decades. Fuelled by a combination of Beijing’s 2004 agreement on ‘Approved Destination Status’ and relaxed US border policy, Chinese arrivals boomed from the second half of the first decade of the new millennium. This article analyses CNMI’s economic engagement with China in the tourism industry. I argue that US federalization policies forced the CNMI to look for sources of revenue beyond the USA at the same time that China was expanding its outbound tourism. Yet, like the garment industry that preceded it, the Chinese tourism industry remains precarious and could easily fall victim to heightened geo-strategic rivalry in the 21st century.

New species and genus of Columbellidae (Gastropoda: Buccinoidea) from the Western Pacific

Ten new species and one new genus of Columbellidae from several Pacific Islands are introduced as new to science. The following species originating from Saipan, Northern Marianas are described: Ascalista saipanensis sp. nov., Mitrella harryleei sp. nov., Mitropsis noduliferus sp. nov., Retizafra praefulgida sp. nov. and Zafra spadicea sp. nov. Euspiralta okinawaensis sp. nov. originates from Okinawa, Japan. Zafra fijiensis sp. nov. originates from Fiji. From Wake Atoll the species Mokumea gracilicostata sp. nov., Speirazafra wakensis gen. nov. et sp. nov. and Zafra thaanumi sp. nov..

First report of Erwinia papayae associated with papaya mushy canker disease in Guam.

Carica papaya (papaya) in Guam, USA may experience soft rot symptoms, often referred to as mushy canker disease. Disease symptoms first appear as expanding water-soaked dark-green stem lesions or leaf spotting with chlorotic halos. Defoliation at petiole-stem junctions and crown necrosis leads to plant death. Papaya diseases caused by Erwinia spp. are documented in nearby tropic regions such as the Northern Mariana Islands (Trujillo and Schroth 1982), the Philippines (Dela Cueva et al. 2017), Japan (Hanagasaki et al. 2020), and Indonesia (Suharjo et al., 2021). The pathogen was isolated from symptomatic papaya stem sections (cv. Red Lady) from a nursery at the University of Guam Agriculture and Life Sciences building in April 2023. Approximately 20% of seedlings collapsed from stem soft rot, with nearly all plants showing varying degrees of water-soaked lesions on leaves or stems. Stem tissue from lesion margins was excised, surface sterilized with 70% EtOH, and macerated in sterile water. Macerate was plated onto nutrient agar (NA) and incubated at 28°C, yielding colonies that were clear to white in color, smooth, circular and mucoid on NA plates for five suspect isolates (JGD231-235). Strains produced blue diffusible pigment on King's B (KB) media, were Gram-negative rods, and exhibited swimming motility on semi-solid (0.5% agar) NA plates. Crown stab inoculation of ten papaya plants (cv. Red Lady) with isolates resulted in mushy canker symptoms within seven days, while negative control plants stabbed with a sterile probe remained asymptomatic. Koch's postulates were fulfilled by drench-inoculating spontaneous rifampicin-resistant (100µg/ml) mutants, JGD233r and JGD235r, onto ten papaya plants (cv. Solo Sunrise). Nine days post-inoculation, bacterial strains were recovered from symptomatic stem tissue macerate plated on rifampicin (100µg/ml) NA and incubated at 28°C. No symptoms or bacterial cells were recovered from the tissue of negative control plants. Cell morphology, culture phenotypes, and disease symptoms suggested the isolates were Erwinia spp., and blue pigment production on KB further suggested E. papayae (Gardan et al. 2004). Partial 16S rDNA sequences of Guam strains JGD231-235 (sequenced using PCR forward primer 5' - AGAGTTTGATCMTGGCTCAG - 3' and reverse primer 5' - GGTTACCTTGTTACGACTT - 3', GENEWIZ (South Plainfield, NJ)) were deposited into GenBank (OR577627- 631). Highest NCBI BLAST results for all strains showed a 16S rDNA sequence identity of 98.17-98.91% with those of Erwinia sp. I-leaf (LC590218) and E. mallotivora BT-MARDI (HQ456230). A maximum likelihood phylogenetic tree based on concatenated partial atpD, infB, and rpoB sequences of strains JGD232 (PP669340, PP669346, PP669343), JGD233 (PP669341, PP669347, PP669344), and JGD235 (PP669342, PP669348, PP669345) (Brady et al. 2008) constructed using MEGA11 (Tamura et al. 2021) showed all strains formed a monophyletic group with Erwinia sp. I-leaf (Hanagasaki et al. 2020) and E. papayae NCPPB 4294T (Gardan et al. 2004), supported with 98% bootstrap. This note documents the first occurrence of E. papayae as a papaya pathogen in Guam. Papaya cultivation supports sustainable food security for Guam (Bevacqua and Sayama 2023), and Erwinia spp. pathogens threaten papaya on other Pacific islands like Hawaii. These findings convey the need for effective quarantine practices, local disease management, and further research on this pathogen.

White-eyed, red-handed: Novel observations of nest material kleptoparasitism by Bridled White-eye (Zosterops conspicillatus) on Tinian Island, Northern Mariana Islands

White-eyed, red-handed: Novel observations of nest material kleptoparasitism by Bridled White-eye (Zosterops conspicillatus) on Tinian Island, Northern Mariana Islands

Human Papillomavirus Vaccination Coverage Among Adolescent Girls Aged 13-17 Years - U.S.-Affiliated Pacific Islands, 2013-2023.

Worldwide, cervical cancer is the fourth most common cancer among women, and the World Health Organization (WHO) Western Pacific Region, where the U.S.-affiliated Pacific Islands (USAPI) are located, accounts for one quarter of all estimated cases. Human papillomavirus (HPV) vaccines are recommended at age 11-12 years to prevent most cervical cancers. HPV vaccines were introduced across USAPI during 2007-2016, predominantly provided through school-located vaccination programs. Retrospective analysis using data from jurisdictional immunization information systems was used to estimate vaccination coverage among adolescent girls as of the last day of each calendar year during 2013-2023. This analysis measured progress toward the WHO 2030 vaccination coverage goal of ≥90% completion of the HPV vaccination series among girls by age 15 years. As of December 2023, initiation of the HPV vaccination series among adolescent girls aged 13-17 years ranged from 58.0% in Palau to 97.2% in the Northern Mariana Islands, and HPV vaccination series completion coverage ranged from 43.4% in Palau to 91.8% in the Northern Mariana Islands. HPV vaccination series completion coverage is >90% in the Northern Mariana Islands and is on track to meet WHO goals by 2030 in American Samoa. Assessment of adolescent vaccination coverage can help immunization programs monitor progress toward regional goals and identify populations and areas with low coverage. Implementing evidence-based strategies to increase vaccine access and coverage would benefit jurisdictions with lagging coverage.

News Literacy and Critical Thinking in the Pacific: Evidence from Guam and the Northern Mariana Islands

ABSTRACT This study analyzes data from surveys conducted in two Pacific Island communities—Guam and the Commonwealth of the Northern Mariana Islands—to assess relationships among news literacy, news literacy efficacy, critical thinking about content, and news credibility. Results, on the one hand, show that news literacy is positively associated with both critical thinking about content and news literacy efficacy. On the other hand, news literacy is negatively related to news credibility. Also, the positive association between news literacy and critical thinking about content is mediated by news literacy efficacy. Results support the role of news literacy in facilitating critical thinking about news messages across the two sociocultural settings. We discuss theoretical implications of findings.

“Smoking weed it gets you over the hump”: Cannabis co-use as a facilitator of decreased opioid use among people who inject drugs in Los Angeles, California

IntroductionOpioid overdose mortality rates have surged dramatically in the last decade due largely to fentanyl in the illicit US drug supply. As of June 2024, 38 states, three territories, namely US Virgin Islands, Guam and the Northern Mariana Islands, and the District of Columbia, allow the medical use of cannabis products. However, there remains limited qualitative community-based evidence on the role of cannabis co-use among opioid using and injecting populations. In this study, we present data from people who inject drugs (PWID)’s co-use of cannabis-opioid. MethodsWe conducted 30 one-on-one semi-structured interviews with PWID from July 2021 to April 2022 at two community sites in Los Angeles, CA, near a syringe service program and a methadone clinic. Interviews were recorded and transcribed. We used constructivist grounded theory methods for identifying and comparing the emerging themes that appeared across transcripts to construct a conceptual explanation of how PWID co-used cannabis and opioids. Participant inclusion criteria included injection drug use, opioid and cannabis use, English fluency, and age 18+ years. ResultsPWID described that cannabis co-use assisted in developing patterns of reduced opioid use in a number of ways: 1) maintain opioid cessation and/or adhere to opioid use disorder treatment by managing cessation-specific symptoms, 2) manage symptoms of opioid withdrawal episodically and, 3) decrease opioid use due to low barrier accessibility of cannabis. DiscussionParticipants reported myriad benefits of opioid and cannabis co-use for reducing patterns of opioid use. These findings have two major harm reduction implications for PWID: 1) the distribution of cannabis via low threshold peer programming and interventions can facilitate changes in opioid use patterns and 2) access to cannabis co-use, potentially alongside existing Medication for Opioid Use Disorder, in treatment settings may improve efficacy of uptake and treatment outcomes and goals for individual PWID.

EDITORIAL: Gaza, genocide and media: Will journalism survive?

30th Anniversary Edition of Pacific Journalism Review: When editor Philip Cass and I, as founding editor, started planning for this 30th anniversary edition of Pacific Journalism Review, we wanted a theme that would fit such an important milestone. At the time when we celebrated the second decade of the journal’s critical inquiry at Auckland University of Technology with a conference in 2014, our theme was ‘Political journalism in the Asia Pacific’, and our mood about the mediascape in the region was far more positive than it is today (Duffield, 2015). Three years later, we marked the 10th anniversary of the Pacific Media Centre, with a conference and a rather gloomier ‘Journalism under duress’ slogan. The PJR cover then featured a gruesome corpse at the height of Rodrigo Duterte’s callous and bloodthirsty ‘war on drugs’—and on media—in the Philippines. Three years later again the PMC itself had been closed in spite of its success. EDITORIAL NOTE: After the editorial of Pacific Journalism Review and the lead article in this edition (Vol 30, No 1&2) about the fate of WikiLeaks founder Julian Assange were printed, the Australian journalist was set free and he arrived back in Australia after a plea bargain. The winner of his country’s Walkley Award for journalism excellence, Assange was freed by a US federal court in Saipan, Northern Mariana Islands, on 26 June 2024 after a plea bargain to plead guilty to one charge of violating the US Espionage Act and the judge sentenced him to 62 months, jail time already served in the UK on remand. His 14-year struggle for freedom was over, but his lawyers say they will press for a full US presidential pardon.

War on Palestine: How the fates of Gaza and Julian Assange are sealed together

Commentary: Were they being properly reported, two critically important court hearings in February 2024, in London and The Hague, would expose the US ‘rules-based order’ as a hollow sham. Both posed globe-spanning threats to our most basic freedoms. Neither received more than perfunctory coverage in Western establishment media such as the BBC. One was a week-long hearing by the International Court of Justice (ICJ) over a United Nations General Assembly request for an advisory opinion over Israel’s illegal occupation of the Palestinian territories and the other was a last-ditch appeal of WikiLeaks founder Julian Assange against efforts by the United States to extradite him so that he can be locked away for the rest of his life. EDITORIAL NOTE: After the editorial of Pacific Journalism Review and the lead article in this edition (Vol 30, No 1&2) about the fate of WikiLeaks founder Julian Assange were printed, the Australian journalist was set free and he arrived back in Australia after a plea bargain. The winner of his country’s Walkley Award for journalism excellence, Assange was freed by a US federal court in Saipan, Northern Mariana Islands, on 26 June 2024 after a plea bargain to plead guilty to one charge of violating the US Espionage Act and the judge sentenced him to 62 months, jail time already served in the UK on remand. His 14-year struggle for freedom was over, but his lawyers say they will press for a full US presidential pardon.

War on Palestine: How the fates of Gaza and Julian Assange are sealed together

Commentary: Were they being properly reported, two critically important court hearings in February 2024, in London and The Hague, would expose the US ‘rules-based order’ as a hollow sham. Both posed globe-spanning threats to our most basic freedoms. Neither received more than perfunctory coverage in Western establishment media such as the BBC. One was a week-long hearing by the International Court of Justice (ICJ) over a United Nations General Assembly request for an advisory opinion over Israel’s illegal occupation of the Palestinian territories and the other was a last-ditch appeal of WikiLeaks founder Julian Assange against efforts by the United States to extradite him so that he can be locked away for the rest of his life. EDITORIAL NOTE: After the editorial of Pacific Journalism Review and the lead article in this edition (Vol 30, No 1&2) about the fate of WikiLeaks founder Julian Assange were printed, the Australian journalist was set free and he arrived back in Australia after a plea bargain. The winner of his country’s Walkley Award for journalism excellence, Assange was freed by a US federal court in Saipan, Northern Mariana Islands, on 26 June 2024 after a plea bargain to plead guilty to one charge of violating the US Espionage Act and the judge sentenced him to 62 months, jail time already served in the UK on remand. His 14-year struggle for freedom was over, but his lawyers say they will press for a full US presidential pardon.

97 BUILD EXITO: a successful collaborative training program for STEM undergraduates to improve workforce diversity

OBJECTIVES/GOALS: To truly improve health equity and accessibility, we must develop a diverse and inclusive workforce. The BUILD EXITO program developed as a collaboration between a network of undergraduate programs and a CTSA hub and now has become a sustainable resource that will outlive NIH funding. We will disseminate our successful model. METHODS/STUDY POPULATION: The BUILD EXITO program has completed 10 years of NIH funding, a partnership between OCTRI and Portland State University (PSU), to create a new model of research training for underrepresented and disadvantaged students. This model provides an opportunity to learn about clinical and translational research academic careers; participate in a research enhancement and professional development curriculum;have a long-term authentic research experience; and receive enhanced mentorship. BUILD EXITO includes PSU, and local and 3 US Pacific territory 2-year colleges. We have developed a sustainable plan that includes these core elements after NIH support for the program ends. We have tracked long-term student outcomes for entry into graduate programs and the research workforce. RESULTS/ANTICIPATED RESULTS: We will describe the experimental model and the network of university and community colleges in BUILD EXITO, including PSU, U of Alaska, and colleges in US territories of Guam, Northern Mariana Islands, and American Samoa. All these universities and colleges have high proportions of underrepresented and disadvantaged students. We will present data on characteristics of the >600 students who have participated in BUILD EXITO to demonstrate the diversity of the cohort. We will also describe 4-year degree completion, engagement in the research workforce, and entry into graduate or professional programs. We will show how this has positively affected faculty inclusion of students in research, institutional policies at the 2-year and 4-year programs, and how this model has become sustainable. DISCUSSION/SIGNIFICANCE: The BUILD EXITO program developed as a collaboration of the CTSA hub at OHSU and a highly diverse undergraduate programs. We have developed a successful model for training a diverse research workforce and will disseminate this sustainable model.

Social determinants of health literacy among parents and caregivers in the US-Affiliated Pacific.

Health literacy is understudied in the US-Affiliated Pacific (USAP), where local populations have historically experienced social marginalization and disproportionate health inequities caused by the social determinants of health (SDOH). This cross-sectional study analyzed several SDOH indicators-acculturation, use of food assistance programs and demographic characteristics (race and ethnicity, household income, primary language spoken at home and educational attainment)-and their relationship to health literacy among 1305 parents/caregivers of young children ages 2-8 years old who participated in the Children's Healthy Living (CHL) program in Alaska, American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, and Hawai'i. Significantly increased odds of low health literacy were found among parents/caregivers with households where a language other than English was the primary language compared to English-only households (OR = 1.86, 95% CI = 1.22, 2.82), household income of <$35 000 compared to ≥$35 000 (OR = 2.15, 95% CI = 1.13, 4.07), parents/caregivers of Asian children compared to parents/caregivers of White children (OR = 2.68, 95% CI = 1.05, 6.84), parent/caregivers with less than or some high school education compared to high school completion (1st- to 8th-grade OR = 4.46, 95% CI = 2.09, 9.52; 9th- to 11th-grade OR 1.87, 95% CI = 1.06, 3.30) and parent/caregivers with acculturation status defined as marginalized as compared to integrated (OR = 2.31, 95% CI = 1.09, 4.86). This study indicates that some USAP parents/caregivers may lack the capacity to acquire health information, utilize health resources, and navigate health decision making. Future efforts to understand and improve health literacy in the USAP should be population specific, thoroughly assess personal and organizational health literacy, and inventory community health care capacity.

Cumulative trophic curves elucidate tropical coral reef ecosystems

There are few generalizable patterns in ecology, with widespread observations and predictability. One possible generalizable pattern is the cumulative trophic theory, which consistently exhibits S-curves of cumulative biomass over trophic level (TL) for over 200 different marine ecosystems. But whether those cumulative biomass patterns persist in some of the more distinct marine ecosystems, coral reefs, is unclear. Coral reefs are unique among marine ecosystems, representing global biodiversity hotspots and providing crucial ecosystem services. They are subject to many pressures, including both global (e.g., climate and ocean changes, warming, acidification) and local (e.g., overexploitation/overfishing, increase in turbidity, bleaching, habitat destruction, invasive species) stressors. The analysis of emergent ecosystem features, such as cumulative biomass S-curves, could represent a useful and new analytical option that can also be implemented for coral reefs. The cumulative biomass approach was applied to 42 U.S. Pacific islands (Guam and the Commonwealth of Northern Mariana Islands, American Samoa, the Pacific Remote Islands Areas, and the Northwestern and Main Hawaiian Islands), using data collected from fish surveys. Results show that coral reef ecosystems do indeed follow the S-curve patterns expected from cumulative trophic theory, which is not trivial for tropical reef systems that tend to be less widely examined and strongly dominated by structuring organisms like corals. The curve parameters results are also consistent with both fish assemblage diversity indexes and the benthic substrate ratio, which suggests this measure could serve as a useful ecosystem indicator to measure the ecological status of reefs. Moreover, the curve shape was consistent with what one would expect for different levels of perturbation, with the areas more densely inhabited showing less pronounced S-curves, in contrast to those observed in low human population density islands. All this is reflected in the curve parameters, particularly inflection point of the TL and steepness, generally showing a negative response to both natural and anthropogenic disturbances. Cross-archipelago differences have also been detected with the Hawaiian Island chain tending to have lower inflection points for biomass and TL than other regions. Collectively our findings demonstrate the potential application of the cumulative biomass approach to evaluate coral reef ecosystems.

Re-opening the Royal Road: The Unquiet War Dead of the Northern Marianas Islands

This article explores intersecting experiences of landscapes of death in the Northern Marianas islands, in the shadow of brutal battles during World War II. My discussion builds upon prior work on how the human body registers personal and historical trauma. I emphasize that in East Asian and Pacific contexts, “the body” is often best understood as extending into the immediate spatial environs, to include topography, air and water flows, and floral and faunal entities. Ritual process of healing this traumatized somatized land-person continuum revolve around reworking the body-landscape matrix, reconfiguring the ontological status of those who perished under horrific circumstances.

The global incidence, mortality, and burden of uterine cancer in 2019 and correlation with SDI, tobacco, dietary risks, and metabolic risk factors: An ecological study.

Endometrial cancer (EC) is the sixth most common cancer among women worldwide. Since global studies are based on awareness of the incidence trend, mortality, geographical diversity, and level of social development and income of countries, this study was conducted to investigate the trend of uterine cancer (UC) in the world in 2019. Age-standardized rates (ASR) of incidence, deaths, prevalence, and disability-adjusted life years (DALYs) of UC, as well as targeted risk factors, were extracted from the Global Burden of Disease (GBD) online database 2019. Pearson correlation coefficient and SPSS 16 were used to calculate the correlation between risk factors and ASR of epidemiological indicators. Statistical significance was considered as p < 0.05. In 2019, the age-specific incidence and death rate of UC was peaking at 60-64 and 65-69 years, respectively. The highest age-standardized incidence rate per 100,000 people for UC has been reported in the Northern Mariana Islands, high sociodemographic index (SDI) countries, World Bank High-Income category, Europe continent and among World Health Organization (WHO) regions were found in the European Region. The highest age-standardized death rateper 100,000 people for UC has been reported in Grenada, high SDI countries, the World Bank High-Income category, Europe continent, and among WHO regions found in the European Region. In 2019, the age-standardized DALYs rate was 53.54 per 100,000 inhabitants, of which 48.49 cases were related to years of life lost (YLLs) and 5.05 cases were related to years lived with disability. According to GBD-2019, the highest incidence, mortality, and DALY of UC are in Europe. The evidence and traces of diversity can be seen in the inequalities of UC. Race, ethnicity, economic status, level of education and awareness, co-morbidities, access, grade, and histological type of tumor are the most important causes of this inequality.

Abstract C007: Disparities in occurrence and outcome of male reproductive cancers in the United States Pacific Islander community

Abstract Data from the National Cancer Database indicates prostate cancer (CPa) prevalence in the Pacific Islander (PI) community to be nearly 1.6 times higher than the national standard. Recent data suggests that prostate cancer rates seen in United States PI men are comparable to that of African American men, the community with the longstanding recognition as having the highest rates of the disease in the US. PIs are defined as those originating from or being indigenous to the islands of Polynesia, Melanesia, and Micronesia including the US governed Hawaiian islands, Guam, Northern Marianas Islands, and American Samoa. PIs make up a grossly underrepresented minority group, often being overshadowed by their mainland Asian counterparts when aggregated together as a group defined as “AANHPI” in sociological and epidemiological data sets and studies. In addition, Pacific Islanders, at least in the mainland US, are considered a “new” minority population, and with the exception of those indigenous to US territories, the vast majority of the population are post 1970 first or second generation immigrants. Research into health disparities in the PI community is thus unsurprisingly sparse, and there is great work to be done to explore these alarming trends. The purposes of this study are threefold: further explore the data pertaining to prostate cancer prevalence in the pacific islander community; disaggregate the data between ethnic lines; and provide a foundation for future research that can further elucidate the causes and outcomes of this disease in the Pacific Islander community. Data was taken from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS). The NHPI NHIS is a national survey administered by the CDC-NCHS to collect disease data including health condition and characteristics, health care access and service utilization but specific to the national NHPI population. Among 2588 participants, 4% indicated ever having been diagnosed with cancer among which prostate cancer was the second most commonly diagnosed. This study relies heavily on large-scale national questionnaires, thus future research should incorporate additional qualitative exploratory research, including targeted and ethnicity-specific canvassing and interviews in order to better understand the real life manifestations of the disease. The preliminary findings highlight an ever growing concern for the health outcomes of this community, and provide compelling evidence in support for both disaggregation of the community from Asian Americans, as well as interethnic disaggregation in data sets. A common thread of distancing between PI communities and the healthcare system was particularly evident, raising the concern that PIs are not being screened early enough and are not seeking life saving medical attention until advanced disease progression. A hopeful outcome of this study is a recognition that more outreach and community work must be done to bridge the gap between PIs and the Western healthcare system in order to mitigate the observed disparities. Citation Format: Nicholas A. Sowizral. Disparities in occurrence and outcome of male reproductive cancers in the United States Pacific Islander community [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C007.

Diet Quality of Young Children in the US-Affiliated Pacific's Children's Healthy Living (CHL) Program.

Childhood diet can impact health outcomes over the life course. Few studies have assessed dietary quality among infants and children in the US-Affiliated Pacific (USAP) region. The aim of this study was to examine the differences in diet quality among Pacific children in the Children's Healthy Living (CHL) program by Pacific jurisdiction and by their World Bank Income Group (WBIG) level. This cross-sectional study used dietary records collected from 2012 to2015. Data were collected on 2- to 8-year-old children (n= 3,529) enrolled in the Children's Healthy Living Program for Remote Underserved Minority Populations in the Pacific region, conducted in the USAP jurisdictions of Alaska, Hawai'i, American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, Federated States of Micronesia (FSM islands include Chuuk, Kosrae, Pohnpei, Yap), Republic of the Marshall Islands (RMI), and Republic of Palau. Diet quality was assessed using the Healthy Eating Index-2005 (HEI-2005). This HEI version was commensurate with the time of dietary data collection for the CHL project and previous studies, thus allowing cross-study comparisons. Means of total HEI-2005 scores between jurisdictions and their WBIG level were compared using linear models, with and without adjustment for age, sex, and dietary energy. Differences in mean HEI-2005 scores among children were found between jurisdictions and their WBIG level. Alaska had the highest adjusted mean score (63.3). RMI had the lowest adjusted mean score (50.1). By WBIG, lower-middle income jurisdictions had the lowest adjusted mean HEI-2005 score (56.0), whereas high income jurisdictions had the highest adjusted mean HEI-2005 score (60.5). Variation in children's diet quality was found between USAP jurisdictions, notably between jurisdictions of different WBIG levels. Future research is needed to deepen understanding of these differences in diet quality by WBIG level, such as whether differences may be attributable to the jurisdictions' varying food systems, and possibly explained by the nutrition transition. Understanding childhood diet quality in this region can inform approaches for nutrition programs in the Pacific region.

The worldwide epidemiology of lip and oral cavity cancer attributable to smoking based on the Global Burden of Disease Study 2019

Abstract Aim To analyze the worldwide epidemiology of lip and oral cavity cancer attributable to smoking. Methods The worldwide epidemiology of lip and oral cavity cancer attributable to smoking and its spatial distribution differences were analyzed using the age-standardized mortality rate, age-standardized disability-adjusted life years (DALYs) rate, and estimated annual percent change (EAPC) according to information from the Global Burden of Disease Study 2019. Results The number of deaths and DALYs associated with lip and oral cavity cancer attributable to smoking globally showed upward trends from 1990 to 2019, but the age-standardized mortality and DALYs rates decreased. The age-standardized mortality rate gradually increased with age. The age-standardized mortality and DALYs rates were markedly higher in low-middle social development index (SDI) regions than in other regions. The age-standardized mortality and DALYs rates showed slight increasing trends (EAPC = 0.16 and 0.07, respectively) in middle-SDI regions and the greatest decrease (EAPC = –1.60 and –1.74, respectively) in high-SDI regions. The three regions with the highest age-standardized mortality and DALYs rates were South Asia (1.59; 39.68), Eastern Europe (1.33; 40.59), and Central Europe (1.30; 37.67), but the largest increases were observed in East Asia (EAPC = 2.32, EAPC = 2.30), the Northern Mariana Islands (EAPC = 3.79, EAPC = 3.67), and Cabo Verde (EAPC = 2.84; DALY, EAPC = 3.38). Conclusion The overall disease burden attributable to smoking is decreasing, but the number of deaths and DALYs are still increasing. Moreover, there are regional and national differences, and high-risk regions and countries should implement targeted interventions to reduce the burden.

Ecological and environmental predictors of juvenile coral density across the central and western Pacific

The persistence of Pacific coral reefs is threatened by large-scale mortality resulting from heat stress, storms, overfishing, disease, and land-based pollution. While reefs have demonstrated the ability to recover from these disturbances, recovery potential is highly variable; in part driven by the high spatial variability in the abundance of coral juveniles. However, our understanding of the patterns and predictors of juvenile coral density is hampered by the limited geographic scope of previous studies. Our objectives in this study were to: (1) explore the spatial and temporal patterns of juvenile (1- &amp;lt; 5cm in diameter) colony density across the U.S.-affiliated Pacific islands and atolls; and (2) identify the potential role of ecological and environmental factors which may influence coral juvenile abundance. Juvenile density was quantified as part of NOAA’s National Coral Reef Monitoring Program between 2013 and 2019 using a stratified sampling design across 1,405 forereef sites on 34 islands and atolls. Regional mean juvenile density varied from 1.4 to 10.5 colonies m-2 with the highest densities observed in the northern Mariana Islands, Northwestern Hawaiian Islands, and southern Mariana Islands. Juvenile density significantly increased between sampling periods in the Main Hawaiian Islands, Line Islands and northern Mariana Islands. Survey-weighted generalized linear modeling demonstrated that juvenile density was best predicted by the interaction between time since a heat stress event and heat stress severity, depth, site and sector-level percent coral cover, human density, percent unconsolidated substrate, macroalgal cover, herbivore biomass, and the interaction of sector coral cover area and heat stress, and the interaction of wave power (combination of wave height and period) and heat stress. With the unique scale and gradients across the U.S. Pacific, our study found that the high latitude regions have enhanced juvenile density compared to their lower latitude counterparts. Our results also suggest density is most dependent on the timing and severity of heat stress, depth, stock-recruitment with an open adult population, availability of suitable habitat at the site-scale, and the number of humans in the system.