Effect of a Fruit and Vegetable Prescription Program on Children's Fruit and Vegetable Consumption.

IntroductionMost children in families with low income do not meet dietary guidance on fruit and vegetable consumption. Fruit and vegetable prescription programs improve access to and affordability of health-supporting foods for adults, but their effect on dietary behavior among children is not known. The objective of this study was to describe the extent to which exposure to a fruit and vegetable prescription program was associated with changes in consumption among participants aged 2 to 18.MethodsWe used data from a modified National Cancer Institute screener to calculate fruit and vegetable intake among 883 children who were overweight or had obesity and participated in a 4- to 6-month fruit and vegetable prescription program at federally qualified health centers during 4 years (2012-2015). Secondary analyses in 2017 included paired t tests to compare change in fruit and vegetable consumption (cups/day) between first and last visits and multivariable linear regressions, including propensity dose-adjusted models, to model this change as a function of sociodemographic and program-specific covariates, such as number of clinical visits and value of prescription redemption.ResultsWe found a dose propensity-adjusted increase of 0.32 cups (95% confidence interval, 0.19-0.45 cups) for each additional visit while holding constant the predicted number of visits and site. An equal portion of the change-score increase was attributed to vegetable consumption and fruit consumption (β = 0.16 for each).ConclusionFruit and vegetable prescription programs in clinical settings may increase fruit and vegetable consumption among children in low-income households. Future research should use a comparison group and consider including qualitative analysis of site-specific barriers and facilitators to success

Social Determinants of Health: Underreported Heterogeneity in Systematic Reviews of Caregiver Interventions.

BACKGROUND AND OBJECTIVES:Although most people have some experience as caregivers, the nature and context of care are highly variable. Caregiving, socioeconomic factors, and health are all interrelated. For these reasons, caregiver interventions must consider these factors. This review examines the degree to which caregiver intervention research has reported and considered social determinants of health. RESEARCH DESIGN AND METHODS:We examined published systematic reviews and meta-analyses of interventions for older adults with age-related chronic conditions using the PRISMA and AMSTAR 2 checklists. From 2,707 papers meeting search criteria, we identified 197 potentially relevant systematic reviews, and selected 33 for the final analysis. RESULTS:We found scant information on the inclusion of social determinants; the papers lacked specificity regarding race/ethnicity, gender, sexual identity, socioeconomic status, and geographic location. The majority of studies focused on dementia, with other conditions common in later life vastly underrepresented. DISCUSSION AND IMPLICATIONS:Significant gaps in evidence persist, particularly for interventions targeting diverse conditions and populations. To advance health equity and improve the effectiveness of interventions, research should address caregiver heterogeneity and improve assessment, support, and instruction for diverse populations. Research must identify aspects of heterogeneity that matter in intervention design, while recognizing opportunities for common elements and strategies

Multispectral Imaging from Mars PATHFINDER

The Imager for Mars Pathfinder (IMP) was a mast-mounted instrument on the Mars Pathfinder lander which landed on Mars Ares Vallis floodplain on July 4, 1997. During the 83 sols of Mars Pathfinders landed operations, the IMP collected over 16,600 images. Multispectral images were collected using twelve narrowband filters at wavelengths between 400 and 1000 nm in the visible and near infrared (VNIR) range. The IMP provided VNIR spectra of the materials surrounding the lander including rocks, bright soils, dark soils, and atmospheric observations. During the primary mission, only a single primary rock spectral class, Gray Rock, was recognized; since then, Black Rock, has been identified. The Black Rock spectra have a stronger absorption at longer wavelengths than do Gray Rock spectra. A number of coated rocks have also been described, the Red and Maroon Rock classes, and perhaps indurated soils in the form of the Pink Rock class. A number of different soil types were also recognized with the primary ones being Bright Red Drift, Dark Soil, Brown Soil, and Disturbed Soil. Examination of spectral parameter plots indicated two trends which were interpreted as representing alteration products formed in at least two different environmental epochs of the Ares Vallis area. Subsequent analysis of the data and comparison with terrestrial analogs have supported the interpretation that the rock coatings provide evidence of earlier martian environments. However, the presence of relatively uncoated examples of the Gray and Black rock classes indicate that relatively unweathered materials can persist on the martian surface

Social Determinants of Health: Underreported Heterogeneity in Systematic Reviews of Caregiver Interventions

Background and Objectives: Although most people have some experience as caregivers, the nature and context of care are highly variable. Caregiving, socioeconomic factors, and health are all interrelated. For these reasons, caregiver interventions must consider these factors. This review examines the degree to which caregiver intervention research has reported and considered social determinants of health. Research Design and Methods: We examined published systematic reviews and meta-analyses of interventions for older adults with age-related chronic conditions using the PRISMA and AMSTAR 2 checklists. From 2,707 papers meeting search criteria, we identified 197 potentially relevant systematic reviews, and selected 33 for the final analysis. Results: We found scant information on the inclusion of social determinants; the papers lacked specificity regarding race/ethnicity, gender, sexual identity, socioeconomic status, and geographic location. The majority of studies focused on dementia, with other conditions common in later life vastly underrepresented. Discussion and Implications: Significant gaps in evidence persist, particularly for interventions targeting diverse conditions and populations. To advance health equity and improve the effectiveness of interventions, research should address caregiver heterogeneity and improve assessment, support, and instruction for diverse populations. Research must identify aspects of heterogeneity that matter in intervention design, while recognizing opportunities for common elements and strategies

Emission-Line Galaxy Surveys as Probes of the Spatial Distribution of Dwarf Galaxies. I. The University of Michigan Survey

Objective-prism surveys which select galaxies on the basis of line-emission are extremely effective at detecting low-luminosity galaxies and constitute some of the deepest available samples of dwarfs. In this study, we confirm that emission-line galaxies (ELGs) in the University of Michigan (UM) objective-prism survey (MacAlpine et al. 1977-1981) are reliable tracers of large-scale structure, and utilize the depth of the samples to examine the spatial distribution of low-luminosity (M$_{B} >$ -18.0) dwarfs relative to higher luminosity giant galaxies (M$_{B} \leq$ -18.0) in the Updated Zwicky Catalogue (Falco et al. 1999). New spectroscopic data are presented for 26 UM survey objects. We analyze the relative clustering properties of the overall starbursting ELG and normal galaxy populations, using nearest neighbor and correlation function statistics. This allows us to determine whether the activity in ELGs is primarily caused by gravitational interactions. We conclude that galaxy-galaxy encounters are not the sole cause of activity in ELGs since ELGs tend to be more isolated and are more often found in the voids when compared to their normal galaxy counterparts. Furthermore, statistical analyses performed on low-luminosity dwarf ELGs show that the dwarfs are less clustered when compared to their non-active giant neighbors. The UM dwarf samples have greater percentages of nearest neighbor separations at large values and lower correlation function amplitudes relative to the UZC giant galaxy samples. These results are consistent with the expectations of galaxy biasing.Comment: 17 pages, 4 tables, 10 figures. Accepted for publication in the Ap

Modeling the Effects of Star Formation Histories on Halpha and Ultra-Violet Fluxes in Nearby Dwarf Galaxies

We consider the effects of non-constant star formation histories (SFHs) on Halpha and GALEX far ultra-violet (FUV) star formation rate (SFR) indicators. Under the assumption of a fully populated Chabrier IMF, we compare the distribution of Halpha-to-FUV flux ratios from ~ 1500 simple, periodic model SFHs with observations of 185 galaxies from the Spitzer Local Volume Legacy survey. We find a set of SFH models that are well matched to the data, such that more massive galaxies are best characterized by nearly constant SFHs, while low mass systems experience bursts amplitudes of ~ 30 (i.e., an increase in the SFR by a factor of 30 over the SFR during the inter-burst period), burst durations of tens of Myr, and periods of ~ 250 Myr; these SFHs are broadly consistent with the increased stochastic star formation expected in systems with lower SFRs. We analyze the predicted temporal evolution of galaxy stellar mass, R-band surface brightness, Halpha-derived SFR, and blue luminosity, and find that they provide a reasonable match to observed flux distributions. We find that our model SFHs are generally able to reproduce both the observed systematic decline and increased scatter in Halpha-to-FUV ratios toward low mass systems, without invoking other physical mechanisms. We also compare our predictions with those from the Integrated Galactic IMF theory with a constant SFR. We find that while both predict a systematic decline in the observed ratios, only the time variable SFH models are capable of producing the observed population of low mass galaxies ($M_{*}$ < 10$^{7}$ Msun) with normal Halpha-to-FUV ratios. These results demonstrate that a variable IMF alone has difficulty explaining the observed scatter in the Halpha-to-FUV ratios. We conclude by considering the limitations of the model SFHs, and discuss the use of additional empirical constraints to improve future SFH modeling efforts.Comment: 15 pages, 11 Figures. Accepted for publication in Ap

SDSS-III: Massive Spectroscopic Surveys of the Distant Universe, the Milky Way Galaxy, and Extra-Solar Planetary Systems

Building on the legacy of the Sloan Digital Sky Survey (SDSS-I and II), SDSS-III is a program of four spectroscopic surveys on three scientific themes: dark energy and cosmological parameters, the history and structure of the Milky Way, and the population of giant planets around other stars. In keeping with SDSS tradition, SDSS-III will provide regular public releases of all its data, beginning with SDSS DR8 (which occurred in Jan 2011). This paper presents an overview of the four SDSS-III surveys. BOSS will measure redshifts of 1.5 million massive galaxies and Lya forest spectra of 150,000 quasars, using the BAO feature of large scale structure to obtain percent-level determinations of the distance scale and Hubble expansion rate at z<0.7 and at z~2.5. SEGUE-2, which is now completed, measured medium-resolution (R=1800) optical spectra of 118,000 stars in a variety of target categories, probing chemical evolution, stellar kinematics and substructure, and the mass profile of the dark matter halo from the solar neighborhood to distances of 100 kpc. APOGEE will obtain high-resolution (R~30,000), high signal-to-noise (S/N>100 per resolution element), H-band (1.51-1.70 micron) spectra of 10^5 evolved, late-type stars, measuring separate abundances for ~15 elements per star and creating the first high-precision spectroscopic survey of all Galactic stellar populations (bulge, bar, disks, halo) with a uniform set of stellar tracers and spectral diagnostics. MARVELS will monitor radial velocities of more than 8000 FGK stars with the sensitivity and cadence (10-40 m/s, ~24 visits per star) needed to detect giant planets with periods up to two years, providing an unprecedented data set for understanding the formation and dynamical evolution of giant planet systems. (Abridged)Comment: Revised to version published in The Astronomical Journa

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival