The Colorado Food Insecurity Mitigation Program

Food insecurity is a serious issue impacting nearly one in ten Coloradans directly and every Coloradan indirectly through negative impacts on workforce participation, increased physical, mental, and behavioral health costs, decreased community safety, and fiscal and economic repercussions. The financial costs alone of food insecurity to the State of Colorado are estimated to be approximately $3.05 billion annually. The goal of the Colorado Food Insecurity Mitigation Program (CFIMP) is to reduce the current levels of food insecurity in Colorado by 95% within ten years. The CFIMP seeks to achieve this goal through legislative measures including tax credits for producers, manufacturers, donors, and consumers of Colorado-grown and produced food products as well as designating funding for regional grant programs and a statewide data collection department tasked with identifying effective methods to reduce and eradicate food insecurity. These measures aim to make adequate and appropriate nutrition a reality for all Coloradans. Tax credits incentivize the production, purchase, donation, and consumption of food products originating in Colorado while simultaneously stimulating the agricultural sector and local economies. Capital infusions from the grant program provide regional food security collaboratives with the resources necessary to implement programs targeting food insecurity at the regional level. The regional programs feed statewide data collection used to identify best practices and drive evolution of the CFIMP over the ten-year course of the program. The favorable political landscape in Colorado towards social improvement programs paired with the substantial reward-to-risk potential of the CFIMP make the proposed legislation of the program and its ability to positively impact the lives of many Coloradans an appealing cause to support

Carbon Dioxide Embolism during Laparoscopic Surgery

Clinically significant carbon dioxide embolism is a rare but potentially fatal complication of anesthesia administered during laparoscopic surgery. Its most common cause is inadvertent injection of carbon dioxide into a large vein, artery or solid organ. This error usually occurs during or shortly after insufflation of carbon dioxide into the body cavity, but may result from direct intravascular insufflation of carbon dioxide during surgery. Clinical presentation of carbon dioxide embolism ranges from asymptomatic to neurologic injury, cardiovascular collapse or even death, which is dependent on the rate and volume of carbon dioxide entrapment and the patient's condition. We reviewed extensive literature regarding carbon dioxide embolism in detail and set out to describe the complication from background to treatment. We hope that the present work will improve our understanding of carbon dioxide embolism during laparoscopic surgery

Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery

Background: In over 20% of breast conserving operations, postoperative pathological assessment of the excised tissue reveals positive margins, requiring additional surgery. Current techniques for intra-operative assessment of tumor margins are insufficient in accuracy or resolution to reliably detect small tumors. There is a distinct need for a fast technique to accurately identify tumors smaller than 1 mm2 in large tissue surfaces within 30 min. Methods: Multi-modal spectral histopathology (MSH), a multimodal imaging technique combining tissue auto-fluorescence and Raman spectroscopy was used to detect microscopic residual tumor at the surface of the excised breast tissue. New algorithms were developed to optimally utilize auto-fluorescence images to guide Raman measurements and achieve the required detection accuracy over large tissue surfaces (up to 4 × 6.5 cm2). Algorithms were trained on 91 breast tissue samples from 65 patients. Results: Independent tests on 121 samples from 107 patients - including 51 fresh, whole excision specimens - detected breast carcinoma on the tissue surface with 95% sensitivity and 82% specificity. One surface of each uncut excision specimen was measured in 12–24 min. The combination of high spatial-resolution auto-fluorescence with specific diagnosis by Raman spectroscopy allows reliable detection even for invasive carcinoma or ductal carcinoma in situ smaller than 1 mm2. Conclusions: This study provides evidence that this multimodal approach could provide an objective tool for intra-operative assessment of breast conserving surgery margins, reducing the risk for unnecessary second operations