Improving Access to Food in Low-Income Communities: An Investigation of Three Bay Area Neighborhoods

This report seeks to describe and analyze that dysfunction as it manifests itself in three low-income neighborhoods in San Francisco and Oakland. It does not examine the causes nor scope of poverty in those communities nor does it intend to estimate or describe the prevalence of hunger. These measures are amply documented in a 1995 report on hunger and the problem of food insecurity commissioned by the California Senate Office of Research and, in 1993 and 1994, reports on hunger from the Alameda County Community Food Bank and San Francisco Food Bank, respectively. Rather, this report treats poverty, hunger and a lack of nutritious, affordable food in low-income neighborhoods as givens and seeks to answer the following three questions: what and how people in low-income communities eat; what obstacles they experience in accessing nutritious food at reasonable prices; and what potential solutions there are to overcome these barriers

Segment-specific associations between local haemodynamic and imaging markers of early atherosclerosis at the carotid artery: an in vivo human study

Low and oscillatory wall shear stress (WSS) has long been hypothesized as a risk factor for atherosclerosis; however, evidence has been inferred primarily from model and post-mortem studies, or clinical studies of patients with already-developed plaques. This study aimed to identify associations between local haemodynamic and imaging markers of early atherosclerosis. Comprehensive magnetic resonance imaging allowed quantification of contrast enhancement (CE) (a marker of endothelial dysfunction) and vessel wall thickness at two distinct segments: the internal carotid artery bulb and the common carotid artery (CCA). Strict criteria were applied to a large dataset to exclude inward remodelling, resulting in 41 cases for which personalized computational fluid dynamic simulations were performed. After controlling for cardiovascular risk factors, bulb wall thickening was found to be weakly, but not significantly, associated with oscillatory WSS. CE at the bulb was significantly associated with low WSS (p < 0.001) and low flow helicity (p < 0.05). No significant associations were found for the CCA segment. Local haemodynamics at the bulb were significantly correlated with blood flow rates and heart rates, but not carotid bifurcation geometry (flare and curvature). Therefore low, but not oscillatory, WSS is an early independent marker of atherosclerotic changes preceding intimal thickening at the carotid bulb

Joint analysis of stressors and ecosystem services to enhance restoration effectiveness

With increasing pressure placed on natural systems by growing human populations, both scientists and resource managers need a better understanding of the relationships between cumulative stress from human activities and valued ecosystem services. Societies often seek to mitigate threats to these services through large-scale, costly restoration projects, such as the over one billion dollar Great Lakes Restoration Initiative currently underway. To help inform these efforts, we merged high-resolution spatial analyses of environmental stressors with mapping of ecosystem services for all five Great Lakes. Cumulative ecosystem stress is highest in near-shore habitats, but also extends offshore in Lakes Erie, Ontario, and Michigan. Variation in cumulative stress is driven largely by spatial concordance among multiple stressors, indicating the importance of considering all stressors when planning restoration activities. In addition, highly stressed areas reflect numerous different combinations of stressors rather than a single suite of problems, suggesting that a detailed understanding of the stressors needing alleviation could improve restoration planning. We also find that many important areas for fisheries and recreation are subject to high stress, indicating that ecosystem degradation could be threatening key services. Current restoration efforts have targeted high-stress sites almost exclusively, but generally without knowledge of the full range of stressors affecting these locations or differences among sites in service provisioning. Our results demonstrate that joint spatial analysis of stressors and ecosystem services can provide a critical foundation for maximizing social and ecological benefits from restoration investments. www.pnas.org/lookup/suppl/doi:10.1073/pnas.1213841110/-/DCSupplementa

Clinician Knowledge and Beliefs after Statewide Program to Promote Appropriate Antimicrobial Drug Use

In 1999, Wisconsin initiated an educational campaign for primary care clinicians and the public to promote judicious antimicrobial drug use. We evaluated its impact on clinician knowledge and beliefs; Minnesota served as a control state. Results of pre- (1999) and post- (2002) campaign questionnaires indicated that Wisconsin clinicians perceived a significant decline in the proportion of patients requesting antimicrobial drugs (50% in 1999 to 30% in 2002; p<0.001) and in antimicrobial drug requests from parents for children (25% in 1999 to 20% in 2002; p = 0.004). Wisconsin clinicians were less influenced by nonpredictive clinical findings (purulent nasal discharge [p = 0.044], productive cough [p = 0.010]) in terms of antimicrobial drug prescribing. In 2002, clinicians from both states were less likely to recommend antimicrobial agent treatment for the adult case scenarios of viral respiratory illness. For the comparable pediatric case scenarios, only Wisconsin clinicians improved significantly from 1999 to 2002. Although clinicians in both states improved on several survey responses, greater overall improvement occurred in Wisconsin

Rating impacts in a multi‐stressor world: a quantitative assessment of 50 stressors affecting the Great Lakes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/116318/1/eap2015253717.pd

Demand for Prophylaxis after Bioterrorism-Related Anthrax Cases, 2001

In 1991, most physicians in Minnesota and Wisconsin managed patients concerns about anthrax without dispensing prophylactic antimicrobial agents

Naive tumor-specific CD4+ T cells differentiated in vivo eradicate established melanoma

In vitro differentiated CD8+ T cells have been the primary focus of immunotherapy of cancer with little focus on CD4+ T cells. Immunotherapy involving in vitro differentiated T cells given after lymphodepleting regimens significantly augments antitumor immunity in animals and human patients with cancer. However, the mechanisms by which lymphopenia augments adoptive cell therapy and the means of properly differentiating T cells in vitro are still emerging. We demonstrate that naive tumor/self-specific CD4+ T cells naturally differentiated into T helper type 1 cytotoxic T cells in vivo and caused the regression of established tumors and depigmentation in lymphopenic hosts. Therapy was independent of vaccination, exogenous cytokine support, CD8+, B, natural killer (NK), and NKT cells. Proper activation of CD4+ T cells in vivo was important for tumor clearance, as naive tumor-specific CD4+ T cells could not completely treat tumor in lymphopenic common gamma chain (γc)–deficient hosts. γc signaling in the tumor-bearing host was important for survival and proper differentiation of adoptively transferred tumor-specific CD4+ T cells. Thus, these data provide a platform for designing immunotherapies that incorporate tumor/self-reactive CD4+ T cells

A Progressively Wetter Early through Middle Holocene Climate in the Eastern Lowlands of Guatemala

Climate records from Central America and the Caribbean region reveal considerable spatiotemporal complexity in precipitation variability, with multiple hypotheses explaining the likely ocean-atmosphere processes influencing precipitation in the region. Here we report on findings from a 760-cm long sediment core from Lake Izabal, eastern Guatemala that affords insight on regional hydroclimate change over the last ∼9,500 years. We utilized a radiocarbon-based age-depth model integrated with lithological, XRF elemental abundances, and principal component analyses to infer changes in erosion/precipitation, lake productivity, and lake water chemistry. Abundance of elements commonly associated with terrigenous sources increase from the early to the latest mid-Holocene, from ca. 9,500 to ca. 4,800 calibrated years before present (cal yr BP), suggesting a progressive increase in erosion/precipitation. This is followed by relatively stable and high erosion/precipitation conditions until ca. 1,200 cal yr BP, with an abrupt decrease in erosion/precipitation ∼1,200 years ago. Comparison of the Izabal record with other paleoclimate records from Central America and the Caribbean region indicates substantial heterogeneity in hydroclimate, even across relatively short distances, likely due to a combination of topographic complexity and the combined influences of Atlantic and Pacific basin ocean-atmosphere dynamics. Our results suggest that the progressive increase in boreal autumn insolation throughout the middle and late Holocene may have driven an increase in Caribbean sea-surface temperatures (SST) during the late wet season, leading to increased moisture availability through enhanced evaporation and greater precipitation amounts associated with zonal convergence and orographic uplift along the eastern coast of Central America. However, other nearby records demonstrate hydroclimate changes that are at least partially at odds with the Izabal record, indicating that the modern SST relationships with atmospheric circulation, including Intertropical Convergence Zone dynamics, and precipitation alone cannot be used as a framework for explaining hydroclimate variability across Central America during the Holocene