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Climate change is one of the most complex challenges facing South Africa as the country designs plans and policies for future economic growth and development. Higher temperatures and more variable rainfall are already affecting the economy and are expected to continue for decades. The degree to which climate change affects different regions in South Africa is likely to vary significantly, characterized by wide ranges in the direction and magnitude of change in key climate variables, especially precipitation. These uncertainties interact with South Africa’s growth and development challenges and complicate planning and policy formation in support national development objectives. This chapter presents key research on changes in climate experienced in South Africa in recent years, along with projected changes in years to come. It illustrates the uncertainties related to climate change and the key channels through which climate change affects the economy. The economic and developmental impacts of such changes are presented along with the lessons for adaptation policy. As energy will be a key focus area for mitigation efforts in the country, this chapter also outlines the implications of such a transition and the factors that need to be accounted for in limiting the impacts on vulnerable populations.

We present results from large ensembles of projected twenty-first century changes in seasonal precipitation and near-surface air temperature for the nation of South Africa. These ensembles are a result of combining Monte Carlo projections from a human-Earth system model of intermediate complexity with pattern-scaled responses from climate models of the Coupled Model Intercomparison Project Phase 5 (CMIP5). These future ensemble scenarios consider a range of global actions to abate emissions through the twenty-first century. We evaluate distributions of surface-air temperature and precipitation change over three sub-national regions: western, central, and eastern South Africa. In all regions, we find that without any emissions or climate targets in place, there is a greater than 50% likelihood that mid-century temperatures will increase threefold over the current climate’s two-standard deviation range of variability. However, scenarios that consider more aggressive climate targets all but eliminate the risk of these salient temperature increases. A preponderance of risk toward decreased precipitation (3 to 4 times higher than increased) exists for western and central South Africa. Strong climate targets abate evolving regional hydroclimatic risks. Under a target to limit global climate warming to 1.5 °C by 2100, the risk of precipitation changes within South Africa toward the end of this century (2065–2074) is commensurate to the risk during the 2030s without any global climate target. Thus, these regional hydroclimate risks over South Africa could be delayed by 30 years and, in doing so, provide invaluable lead-time for national efforts to prepare, fortify, and/or adapt.

IntroductionDiet, shown to impact colorectal cancer (CRC) risk, is a modifiable environmental factor. Fibre foods fermented by gut microbiota produce metabolites that not only provide food for the colonic epithelium but also exert regulatory effects on colonic mucosal inflammation and proliferation. We describe methods used in a double-blinded, randomised, controlled trial with Alaska Native (AN) people to determine if dietary fibre supplementation can substantially reduce CRC risk among people with the highest reported CRC incidence worldwide.Methods and analysesEligible patients undergoing routine screening colonoscopy consent to baseline assessments and specimen/data collection (blood, urine, stool, saliva, breath and colon mucosal biopsies) at the time of colonoscopy. Following an 8-week stabilisation period to re-establish normal gut microbiota post colonoscopy, study personnel randomise participants to either a high fibre supplement (resistant starch, n=30) or placebo (digestible starch, n=30) condition, repeating stool sample collection. During the 28-day supplement trial, each participant consumes their usual diet plus their supplement under direct observation. On day 29, participants undergo a flexible sigmoidoscopy to obtain mucosal biopsy samples to measure the effect of the supplement on inflammatory and proliferative biomarkers of cancer risk, with follow-up assessments and data/specimen collection similar to baseline. Secondary outcome measures include the impact of a high fibre supplement on the oral and colonic microbiome and biofluid metabolome.Ethics and disseminationApprovals were obtained from the Alaska Area and University of Pittsburgh Institutional Review Boards and Alaska Native Tribal Health Consortium and Southcentral Foundation research review bodies. A data safety monitoring board, material transfer agreements and weekly study team meetings provide regular oversight throughout the study. Study findings will first be shared with AN tribal leaders, health administrators, providers and community members. Peer-reviewed journal articles and conference presentations will be forthcoming once approved by tribal review bodies.Trial registration numberNCT03028831.

Food security in Bangladesh has improved in recent years, but the country is now facing a double burden of malnutrition while also being highly vulnerable to climate change. Little is known about how this may affect food supply to different sectors of the population. To inform this, we used a national dietary survey of 800 rural households to define dietary patterns using latent class analysis. Nutrient adequacy of dietary patterns and their potential vulnerability to climate shocks (based on diversity of calorie sources) were assessed. We fitted mixed effects logistic regression models to identify factors associated with dietary patterns. Four dietary patterns were identified: rice and low diversity, wheat and high diversity, pulses and vegetables, meat and fish. The wheat and high diversity and meat and fish patterns tended to be consumed by households with higher levels of wealth and education, while the rice and low diversity pattern was consumed by households with lower levels of wealth and education. The pulses and vegetables pattern was consumed by households of intermediate socio-economic status. While energy intake was high, fat and protein intake were suboptimal for all patterns except for the wheat and high diversity pattern. All patterns had fruit and vegetable intake below the WHO recommendation. The wheat and high diversity pattern was least vulnerable to shocks, while the rice and low diversity pattern was the most vulnerable, relying mainly on single cereal staples. The diets showed “double vulnerability” where the nutrient inadequate patterns were also those most vulnerable to shocks.

The deep learning techniques namely Long Short Term Memory (LSTM) network and Bi-directional Gated Recurrent Unit (BGRU) network turn to be de facto to build an optimal assembly line for neural network models. The prevailing state-of-the-art approaches require a substantial amount of labeled data detailed to an unambiguous event in the training phase. In this paper, embedded bi-directional GRU and LSTM learning models is applied for disaster event prediction that uses deep learning techniques to categorize the tweets. The performance of the proposed neural network model is evaluated on CrisisLexT26 benchmarking dataset. The resulting validation accuracy is estimated by comparing LSTM and bi-directional GRU with and without word embeddings. The experiments demonstrate the model selector choose the deep learning techniques to predict the disaster event with reasonably high accuracy.

Social media provides an effective tool to reach, engage, and connect smokers in cessation efforts. Our team developed a Facebook group, CAN Quit (Connecting Alaska Native People to Quit smoking), to promote use of evidence-based smoking cessation resources for Alaska Native people living in Alaska, which are underused despite their effectiveness. Often separated by geography and climate, Alaska Native people prefer group-based approaches for tobacco cessation that support their culture and values. Such preferences make Alaska Native people candidates for social media–based interventions that promote connection. This viewpoint discusses the steps involved and lessons learned in building and beta-testing our Facebook group prototype, which will then be evaluated in a pilot randomized controlled trial. We describe the process of training moderators to facilitate group engagement and foster community, and we describe how we developed and tested our intervention prototype and Facebook group. All parts of the prototype were designed to facilitate use of evidence-based cessation treatments. We include recommendations for best practices with the hope that lessons learned from the CAN Quit prototype could provide a model for others to create similar platforms that benefit Alaska Native and American Indian people in the context of smoking cessation.

UNSTRUCTURED Social media provides an effective tool to reach, engage, and connect smokers in cessation efforts. Our team developed a Facebook group, CAN Quit (Connecting Alaska Native People to Quit smoking), to promote use of evidence-based smoking cessation resources for Alaska Native people living in Alaska, which are underused despite their effectiveness. Often separated by geography and climate, Alaska Native people prefer group-based approaches for tobacco cessation that support their culture and values. Such preferences make Alaska Native people candidates for social media–based interventions that promote connection. This viewpoint discusses the steps involved and lessons learned in building and beta-testing our Facebook group prototype, which will then be evaluated in a pilot randomized controlled trial. We describe the process of training moderators to facilitate group engagement and foster community, and we describe how we developed and tested our intervention prototype and Facebook group. All parts of the prototype were designed to facilitate use of evidence-based cessation treatments. We include recommendations for best practices with the hope that lessons learned from the CAN Quit prototype could provide a model for others to create similar platforms that benefit Alaska Native and American Indian people in the context of smoking cessation.

The importance of a resilient agriculture sector in providing food security, livelihoods, and household income was highlighted in many countries by the recent pandemic, as was the capacity of the sector to cushion the negative impacts of the subsequent economic slowdown. This has been the case in Egypt, where agriculture has been resilient to the health crisis in comparison with the service and industry sectors (Breisinger et al. 2020). However, the sector’s resiliency is gradually being corroded by climate change, with lasting, harmful effects for agriculture and food systems.

Low intake of fruits and vegetables and high intake of sugar-sweetened beverages persists as a public health concern in rural remote Alaska Native (AN) communities. Conducting key informant interviews with 22 storekeepers in 12 communities in the Yukon-Kuskokwim region of Alaska, we explored potential factors impeding or facilitating dietary change towards healthier food choices. We selected these sites as part of a multi-level intervention aimed at introducing more traditional AN subsistence foods, increasing fruit and vegetable intake, and decreasing SSB consumption among young children enrolled in Head Start (preschool) programmes (Clinicaltrials.gov #NCT03601299). Storekeepers in these communities agreed that seasonality and flight schedules were primary factors determining commercial foods’ availability. Several storekeepers noted that federal food assistance programmes that specify which food items may be purchased with funds received from the programme and community policies that set limits on less healthy items promote customer purchases of healthier products. The fact that storekeepers are comfortable enforcing government assistance programme guidelines, company policies, and tribal resolutions suggests an important role storekeepers play in improving nutritional intake in their communities.

Background Face-to-face tobacco cessation has had limited reach and efficacy in Alaska Native (AN) communities. We describe our two-phased approach to develop content for Connecting Alaska Native People to Quit Smoking, a Facebook group intervention to reduce barriers to evidence-based smoking cessation treatment for AN people in Alaska. Methods Phase 1 included semi-structured telephone interviews with 30 AN people who smoke and ten stakeholders. They provided feedback on existing content from the Centers for Disease Control and Prevention Tips campaign and AN digital stories. Phase 2 included an online survey with a new group of 40 AN smokers who provided feedback on existing content via a measure of perceived effectiveness and cultural relevance. Results Phase I results revealed participants evaluated content based upon story strength, relevance to AN culture, emotional appeal, relatability to AN people, and favorite video. No single posting was rated highly across all themes. All perceived effectiveness (PE) and cultural relevance median scores fell between 3.5 and 4.4 (range 1–5). PE scores varied across participant demographic groups. Conclusions Content embodying characteristics perceived to be most appealing, effective, and culturally relevant were selected for the private Facebook group content library with refinements made to incorporate images of AN people engaged in AN activities. PE scores indicate a need for a wide variety of content that moderators could pull from when conducting the intervention. Implications Social media content targeting specific population sectors, such as American Indian/AN people for tobacco cessation needs to be culturally tailored. Our approach provides a model others can follow to determine what is appealing, relevant, and effective messaging. Clinical Trial Registration NCT 03645941.

Objectives Previous surveys have demonstrated high rates of early childhood caries (ECC) in the Alaska Native (AN) population of western Alaska. There are many challenges to providing dental care in this road-less Yukon-Kuskokwim Delta region. The regional Tribal Health Organization implemented an electronic dental record (EDR) system in the late 1990s. We explored use of the EDR to establish an oral health surveillance system in children. Methods We contracted with EDR software developers to implement calculation of a summary count of decayed (d), missing (m) or filled (f) primary (dmft) score for each individual. We calculated the yearly average dmft scores for 2011-2019 for children aged 3 and 5 years with a comprehensive exam in a given year. We also assessed the number of children undergoing full mouth dental rehabilitation (FMDR). We used US census data population estimates for these age groups to calculate rates. Results Over the 9-year period, 2,427 3-year-old children (47 percent of all 3-year olds over this period), received a comprehensive exam; increasing from 24 percent in 2011 to 62 percent in 2019. Their average dmft score over the 9-years was 6.4 with a significant annual decline over this period. Seventy percent of AN children who turned 6 between 2015 and 2019 had received at least one FMDR. Conclusions An oral health surveillance system has been established in western Alaska using the Electronic Dental Record. High rates of ECC and FMDR were observed. This surveillance system will allow assessments of ECC prevalence and impact of dental interventions.

Casing collapse under external pressure is a complex phenomenon and is one of the governing factors in the tubular design of oil and gas wells. Collapse strength of a casing depends on its outer diameter to wall thickness ratio (i.e. D/t), material Young's modulus, yield stress, shape of stress-strain curve, temperature, ovality, wall eccentricity, circumferential residual stress, as well as combined loadings. This paper studies the quantitative effects of two geometric impefections, namely (i) wear on the inside diameter (ID) of casing and (ii) wall eccentricity angle; as well as two combined loading scenarios: (iii) dogleg bending and (iv) axial compression. Although these scenarios are not covered in the industry Standards, such as API TR 5C3 (June 2018 edition) [1], they are important factors that must be considered in the tubular design of oil and gas wells. In order to quantify the effects of the four scenarios listed above, nonlinear parametric collapse Finite Element Analysis (FEA) studies were performed. Modified Riks method was utilized to predict the casing on-site collapse pressure as well as the unstable post-collapse response. Both material and geometric nonlinearities were taken into account. Elastic-plastic material property with strain hardening was incorporated in the collapse FEA models. Based on the results of the parametric FEA simulations, some important observations and conclusions can be made: (i) for the scenario of casing ID wear, reduction in worn casing collapse resistance is nearly proportional to the reduction in minimum worn thickness regardless of the casing dimensiosns and material grade; (ii) for the case of wall eccentricity irregularity, as the circumferential location of maximum wall thickness moves closer to the minimum wall thickness location, the casing collapse resistance decreases; (iii) casing collapse resistance decreases as the dogleg severity (DLS) increases. Moreover, the effect of dogleg bending on collapse resistance has a strong dependence on casing dimensions and material grade; (iv) in contrast to the effect of axial tension, dependence of collapse resistance on axial compression is quite nonlinear and non-monotonic. In other words, as axial compression increases, collapse resistance increases until the axial compression reaches approximately 50% to 60% (primarily depending on D/t ratio) of yield strength, and then decreases as axial compression increases further.

For ungulates and other long-lived species, life-history theory predicts that nutritional reserves are allocated to reproduction in a state-dependent manner because survival is highly conserved. Further, as per capita food abundance and nutritional reserves decline (i.e., density dependence intensifies), reproduction and recruitment become increasingly sensitive to weather. Thus, the degree to which weather influences vital rates should be associated with proximity to nutritional carrying capacity-a notion that we refer to as the Nutritional Buffer Hypothesis. We tested the Nutritional Buffer Hypothesis using six moose (Alces alces) populations that varied in calf recruitment (33-69 calves/100 cows). We predicted that populations with high calf recruitment were nutritionally buffered against the effects of unfavorable weather, and thus were below nutritional carrying capacity. We applied a suite of tools to quantify habitat and nutritional condition of each population and found that increased browse condition, forage quality, and body fat were associated with increased pregnancy and calf recruitment, thereby providing multiple lines of evidence that declines in calf recruitment were underpinned by resource limitation. From 2001 to 2015, recruitment was more sensitive to interannual variation in weather (e.g., winter severity, drought) and plant phenology (e.g., duration of spring) for populations with reduced browse condition, forage quality, and body fat, suggesting these populations lacked the nutritional reserves necessary to buffer demographic performance against the effects of unfavorable weather. Further, average within-population calf recruitment was determined by regional climatic variation, suggesting that the pattern of reduced recruitment near the southern range boundary of moose stems from an interaction between climate and resource limitation. When coupled with information on habitat, nutrition, weather, and climate, life-history theory provides a framework to estimate nutritional limitation, proximity to nutritional carrying capacity, and impacts of climate change for ungulates. Wyoming Game and Fish Department, Wyoming Wildlife Published version We thank Aimee Hurt, Ngaio Richards, Wicket, and Orbee from Working Dogs for Conservation for their assistance with locating moose feces, B. Davitt and the staff of the Washington State Wildlife Habitat Lab for estimating fecal N and NDF, J. Brown and the Center for Species Survival at the Smithsonian Conservation Biology Institute for quantifying fecal progestogen concentrations, J. Branen and the staff of BioTracking LLC for conducting the BioPryn Wild ELISA assays, the Matson Laboratory for analyzing tooth age, Jerod Merkle for assistance with quantifying plant phenology from NDVI data, and Melanie Murphy for providing laboratory space and guidance in fecal DNA analysis. This work was supported by grants from the Wyoming Game and Fish Department, Wyoming Wildlife Public domain – authored by a U.S. government employee

Keywords: Forest Landscape Restoration1, Land Degradation2, Bonn Challenge3, Food Security4, Climate Change5.Existing approaches and methodologies that investigate effects of land degradation on food security vary greatly. Although a relatively rich body of literature that investigates localized experiences, geophysical and socioeconomic drivers of land degradation, and the costs and benefits of avoiding land degradation already exists, less rigorously explored are the global effects of restoring degraded landscapes for the health of the land, the climate, and world food security global effects of restoring degraded landscapes. The current scale of land degradation is such that the problem can be meaningfully addressed only if local successes are upscaled and a large number of landowners and land managers implement restoration activities. Significant global efforts to address degradation exist, but studies that evaluate the global benefits of these efforts generally do not account for global market forces and the complex web of relationships that determine the effects of wide-scale restoration on production and food security. This paper provides important insights into how a full integration of crop production in restoration efforts could impact food production levels, food availability, forest carbon stocks and Greenhouse gas emissions.

Chevron experienced four casing leaks in subsea deepwater environments with an estimated cost of $80 million to remediate the wells. A similar incident at BHP resulted in parted casing and cost the company an estimated $21 million. This paper describes the investigative techniques which led to the conclusion of heat checking as the likely root cause of the casing leaks and the development of a 3D static FEA model which predicts downhole casing temperature. The model was validated by historical data analysis of more than 20 deepwater wells and found strong correlations between predicted downhole casing temperature and casing leak incidents. The results provided confidence for the implementation of a drilling parameter window and real-time temperature prediction algorithm to monitor and mitigate the potential for heat checking. The intent of this paper is to share with industry the recent realization and understanding of heat checking as a casing failure mode and mitigation measures put in place to manage a known but not necessarily widely monitored risk.

This review summarizes the key results of recently published studies on the effects of dietary change and nutritional intervention on the human microbiome from around the world, focusing on the USA, Canada, Europe, Asia, and Africa. It first explores mechanisms that might explain the ability of fiber-rich foods to suppress the incidence and mortality from westernized diseases, notably cancers of the colon, breast, liver, cardiovascular, infectious, and respiratory diseases, diabetes, and obesity (O’Keefe in Lancet Gastroenterol Hepatol 4(12):984–996, 2019; Am J Clin Nutr 110:265–266, 2019). It summarizes studies from Africa which suggest that disturbance of the colonic microbiome may exacerbate chronic malnutrition and growth failure in impoverished communities and highlights the importance of breast feeding. The American section discusses the role of the microbiome in the swelling population of patients with obesity and type 2 diabetes and examines the effects of race, ethnicity, geography, and climate on microbial diversity and metabolism. The studies from Europe and Asia extoll the benefits of whole foods and plant-based diets. The Asian studies examine the worrying changes from low-fat, high-carbohydrate diets to high-fat, low-carbohydrate ones and the increasing appearance of westernized diseases as in Africa and documents the ability of high-fiber traditional Chinese diets to reverse type 2 diabetes and control weight loss. In conclusion, most of the studies reviewed demonstrate clear changes in microbe abundances and in the production of fermentation products, such as short-chain fatty acids and phytochemicals following dietary change, but the significance of the microbiota changes to human health, with the possible exception of the stimulation of butyrogenic taxa by fiber-rich foods, is generally implied and not measured. Further studies are needed to determine how these changes in microbiota composition and metabolism can improve our health and be used to prevent and treat disease.

Agri-food production remains vital to the economies in Latin America and the Caribbean (LAC). Food systems are rapidly changing and are driven by income growth, (urban) population growth, shifts in dietary preferences, and agricultural productivity growth. Food systems are also under threat from disrupters like climate change and distorting policies (including trade wars). This paper makes two quantitative, forward-looking assessments for the future of food and agriculture in the LAC region. The first focuses on the long-term prospects - given projected pathways for the main drivers and under the threat of climate change. The second focuses on current vulnerability of LACs agri-food system to short-term disrupters with special reference to impacts of global trade wars and the prospects for reducing that vulnerability. The implications are not uniform across the countries in the region, but vary greatly depending on economic and demographic size, contribution of the agricultural sector to national GDP, natural resource endowments, ecological and climatic characteristics, level of sophistication of rural and agrarian institutions, available technology, farm-size distribution and tenure systems. Policy interventions to address the challenges will need to consider those differences in initial conditions. The foresight assessments are built on IFPRI’s core global model frameworks, IMPACT and MIRAGRODEP. They allow to capture the complexity of agri-food system development and the scenario analysis helps quantify the relative importance of the drivers and disruptors of food system change, which in turn should be of essential to policymakers in setting priorities for steering towards sustainable and stable food systems capable of meeting twenty-first century challenges.

Chapter 4, “Climate Change Impacts on Crop Yields,†presents results of model simulations of crop yields in Ethiopia through 2085. The analysis draws on climate outcomes from 32 global climate models and an agronomic crop model to estimate effects of expected higher temperatures and, for most of Ethiopia, increased rainfall. The simulation results suggest that climate change will likely have only relatively small effects on average yields of maize, wheat, and sorghum in Ethiopia up to 2055, as agronomic conditions for cultivation of these crops may actually improve in large parts of the country. Nonetheless, crop yields will need to increase over time to enable cereal production to keep pace with expected demand growth due to increases in population and per capita incomes. Moreover, even if future changes in climate have only moderate impacts on average crop yields in Ethiopia, weather outcomes and consequent crop yields are likely to become more variable in the future.

BACKGROUND: Alaska Native (AN) people have the world's highest recorded incidence of sporadic colorectal cancer (CRC) (∼91:100,000), whereas rural African (RA) people have the lowest risk (

Summary of Problem Alaska Native (AN) people experience higher incidence of, and mortality from, gastric cancer compared to other U.S. populations1, 2. Compared to the general U.S. population, gastric cancer in AN people occurs at a younger age, is diagnosed at later stages, is more evenly distributed between the sexes, and is more frequently signet-ring or diffuse histology3. It is known that the prevalence of Helicobacter pylori (Hp) infection, a risk factor for gastric cancer, is high in AN people4; however, high antimicrobial resistance combined with high reinfection rates in Alaska make treatment at the population level complex5. In addition, health issues in AN people are uniquely challenging due to the extremely remote locations of many residents. A multiagency workgroup hosted a symposium in Anchorage that brought internationally-recognized experts and local leaders together to evaluate issues around gastric cancer in the AN population. The overall goal of this symposium was to identify the best strategies to combat gastric cancer in the AN population through prevention and early diagnosis.

To review recent data on the role and interactions of fiber and fat as dietary risk factors associated with colorectal cancer (CRC) risk in humans. Fiber intake shows convincing and linear dose-response negative correlation with CRC risk. Dietary fiber stimulates butyrogenic activity of the gut microbiota, providing high amounts of butyrate that shows extensive anti-neoplastic effects. A high-fat diet promotes CRC risk through stimulated bile acid metabolism, facilitating bile acid conversion by the gut microbiota to tumor-promoting deoxycholic acid. Comprehensive interactions of these microbial metabolites are likely to underlie mechanisms driving diet-dependent CRC risk in different populations, but require further experimental investigation. Dietary fiber and fat shape the composition and metabolic function of the gut microbiota, resulting in altered amounts of butyrate and deoxycholic acid in the colon. Fiber supplementation and restriction of fat intake represent promising strategies to reduce CRC risk in healthy individuals.

Transfer Learning is a technique that reduces the time taken for training and improves performance by reusing the weights of a previously trained source neural network. This poses a question of how the source network must be chosen, which is still an unsolved problem. In this work, we have built a framework that automatically performs transfer learning by selecting the source neural network based on an estimate of dataset classification difficulty. The framework designates the neural network of the dataset that is closest in difficulty as the source. The framework is evaluated on 7 datasets namely SVHN, Cifar10, Cifar100, GTSRB, MNIST, Flowers and Linnaeus5, and experimental results suggest that in most cases this type of source selection gives the highest improvement in accuracy. The framework provides an average improvement in accuracy of 6.7% for ResNet than when training from scratch, and achieves it within the first 10 epochs in some cases.

To improve the accuracy and efficiency of trace element analysis in ruby and sapphire, standards sets containing matrix-matched corundum with targeted levels of beryllium, magnesium, silicon, titanium, vanadium, chromium, iron, and gallium were created. Ultra-high-purity corundum was also incorporated as a “true matrix zero.” To our knowledge, these sets contain the most accurate standards for the key trace elements in corundum today. The standards were designed to cover the optimal range of the main trace elements typically characterized in natural ruby and sapphire. Additionally, we were able to accurately quantify silicon in corundum by successfully resolving the ^(28)Si^+ peak from the ^(27)Al^1H^+ peak using the superior mass resolving power of secondary ion mass spectrometry (SIMS) as compared to laser ablation–inductively coupled plasma–quadrupole mass spectrometry (LA-ICP-QMS).

Forty-two communities in rural Alaska are considered unserved or underserved with water and sewer infrastructure. Many challenges exist to provide centralized piped water and sewer infrastructure to the homes, and they are exacerbated by decreasing capital funding. Unserved communities in rural Alaska experience higher rates of disease, supporting the recommendation that sanitation infrastructure should be provided. Organizations are pursuing alternative solutions to conventional piped water and sewer in order to maximize water use and reuse for public health. This paper reviews initiatives led by the State of Alaska, the Alaska Native Tribal Health Consortium, and the Yukon Kuskokwim Health Corporation to identify and develop potential long-term solutions appropriate and acceptable to rural communities. Future developments will likely evolve based on the lessons learned from the initiatives. Recommendations include Alaska-specific research needs, increased end-user participation in the design process, and integrated monitoring, evaluation, and information dissemination in future efforts.

Success of antiretroviral therapy depends on adherence to effective treatment. We evaluated four adherence methods and their correlation with immunological and virologic response among women receiving PMTCT. Univariable and multivariable analyses were used to assess how adherence by pill count (n = 463), self-report (n = 463), MEMS (n = 129) and plasma drug level (n = 89) was associated with viral load suppression within a 6 months period. Longitudinal analysis was performed to determine the correlation of CD4 cell count with each measure of adherence. For all measures of adherence, sustained viral suppression was less likely for participants in the lowest category of adherence. Although CD4 cell count increased substantially over time, there was no significant association with adherence by the methods. Multiple strategies can be used successfully to monitor treatment adherence. Persons with ≥95% adherence by any method used in this study were more likely to have a favorable treatment outcome.

Subspecies designations within temperate species’ ranges often reflect populations that were isolated by past continental glaciation, and glacial vicariance is believed to be a primary mechanism behind the diversification of several subspecies of North American cervids. We used genetics and the fossil record to study the phylogeography of three moose subspecies (Alces alces andersoni, A. a. gigas, and A. a. shirasi) in western North America. We sequenced the complete mitochondrial genome (16,341 base pairs; n = 60 moose) and genotyped 13 nuclear microsatellites (n = 253) to evaluate genetic variation among moose samples. We also reviewed the fossil record for detections of all North American cervids to comparatively assess the evidence for the existence of a southern refugial population of moose corresponding to A. a. shirasi during the last glacial maximum of the Pleistocene. Analysis of mtDNA molecular variance did not support distinct clades of moose corresponding to currently recognized subspecies, and mitogenomic haplotype phylogenies did not consistently distinguish individuals according to subspecies groupings. Analysis of population structure using microsatellite loci showed support for two to five clusters of moose, including the consistent distinction of a southern group of moose within the range of A. a. shirasi. We hypothesize that these microsatellite results reflect recent, not deep, divergence and may be confounded by a significant effect of geographic distance on gene flow across the region. Review of the fossil record showed no evidence of moose south of the Wisconsin ice age glaciers ≥ 15,000 years ago. We encourage the integration of our results with complementary analyses of phenotype data, such as morphometrics, originally used to delineate moose subspecies, for further evaluation of subspecies designations for North American moose.

Objective:To assess whether a community water service is associated with the frequency of sugar-sweetened beverages (SSB) consumption, obesity, or perceived health status in rural Alaska.Design:We examined the cross-sectional associations between community water access and frequency of SSB consumption, body mass index categories, and perceived health status using data from the 2013 and 2015 Alaska Behavioral Risk Factor Surveillance System (BRFSS). Participants were categorized by zip code to ‘in-home piped water service’ or ‘no in-home piped water service’ based on water utility data. We evaluated the univariable and multivariable (adjusting for age, household income and education) associations between water service and outcomes using log-linear survey-weighted generalized linear models.Setting:Rural Alaska, USA.Subjects:Eight hundred and eighty-seven adults, aged 25 years and older.Results:In unadjusted models, participants without in-home water reported consuming SSB more often than participants with in-home water (1·46, 95 % CI: 1·06, 2·00). After adjustment for potential confounders, the effect decreased but remained borderline significant (1·29, 95 % CI: 1·00, 1·67). Obesity was not significantly associated with water service but self-reported poor health was higher in those communities without in-home water (1·63, 95 % CI: 1·05, 2·54).Conclusions:Not having access to in-home piped water could affect behaviours surrounding SSB consumption and general perception of health in rural Alaska.

This paper examines two new methods to generate gridded agricultural Gross Domestic Product (GDP) and compares the results with a traditional method. In the case of Brazil, these two new methods of spatial disaggregation and cross-entropy outperform the prediction of agricultural GDP from the traditional method that distributes agricultural GDP using rural population. The paper finds that the best prediction method is spatial disaggregation using a regression approach for all the key crops and contributors to agricultural GDP. However, the issue of degrees of freedom is an important limiting factor, as the approach requires sufficient subnational data. The cross-entropy method with readily available spatially distributed crop, livestock, forest, and fish allocation far outperforms the traditional method, at least in the case of Brazil, and can operate with national- and/or subnational-level data.

BACKGROUND Despite the high prevalence of tobacco use among Alaska Native (AN) people, tobacco cessation interventions developed specifically for this group are lacking. Social media hold promise as a scalable intervention strategy to promote smoking treatment utilization and cessation, given the barriers to treatment delivery (ie, geographic remoteness, limited funding, climate, and travel costs) in the state of Alaska (AK). Building on a longstanding tobacco control research partnership with the AK Tribal Health System, in this study, we are developing and pilot-testing a culturally relevant, Facebook (FB)-delivered intervention that incorporates a digital storytelling approach adapted from the effective Centers for Disease Control Tips from Former Smokers campaign. OBJECTIVE This study aims to promote evidence-based smoking treatment (eg, state quitline and Tribal cessation programs) uptake and cessation among AN people. METHODS This study fulfills the objectives for stage 1 of the National Institute on Drug Abuse behavioral integrative treatment development program. In stage 1a, we will use a mixed method approach to develop the FB intervention. Cultural variance and surface/deep structure frameworks will address the influence of culture in designing health messages. These developmental activities will include qualitative and quantitative assessments, followed by beta testing of proposed intervention content. In stage 1b, we will conduct a randomized pilot trial enrolling 60 AN adults who smoke. We will evaluate the feasibility, uptake, consumer response, and potential efficacy of the FB intervention compared with a control condition (quitline/treatment referral only). Primary outcome measures include feasibility and biochemically verified smoking abstinence at 1-, 3-, and 6-month follow-ups. Secondary outcomes will include self-reported smoking cessation treatment utilization and abstinence from tobacco/nicotine products. We will also explore interdependence (relationship orientation and collaborative efforts in lifestyle change) as a culturally relevant mediator of intervention efficacy. RESULTS The study enrolled 40 participants for phase 1, with data saturation being achieved at 30 AN people who smoke and 10 stakeholders. For phase 2, we enrolled 40 participants. Qualitative assessment of proposed intervention content was completed with 30 AN smokers and 10 stakeholders. We are currently analyzing data from the quantitative assessment with 40 participants in preparation for the beta testing, followed by the randomized pilot trial. CONCLUSIONS The project is innovative for its use of social media communication tools that are culturally relevant in a behavioral intervention designed to reach AN people statewide to promote smoking treatment utilization and cessation. The study will further advance tobacco cessation research in an underserved disparity group. If the pilot intervention is successful, we will have a blueprint to conduct a large randomized controlled efficacy trial. Our approach could be considered for other remote AN communities to enhance the reach of evidence-based tobacco cessation treatments. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15155

Alaska Native (AN) children experience one of the highest reported rates of severe early childhood caries (S-ECC). Serum vitamin D concentrations in AN childbearing women in the Yukon Kuskokwim Delta (YKD) region have decreased since the 1960s to currently low levels, related to a decrease in traditional marine diet. Recent studies suggest an association between prenatal vitamin D (25(OH)D) concentrations in mothers and S-ECC in their infants. We used independent t tests to analyze the influence of prenatal 25(OH)D levels in YKD AN mothers on S-ECC in their children using data collected in the Maternal Organics Monitoring Study (MOMS). Maternal 25(OH)D levels were assessed at prenatal visits and in cord blood. We queried electronic dental records to assess early childhood caries (ECC) status using highest decayed, missing, filled, primary teeth (dmft) scores at 12 to 59 mo of age. We examined prenatal and cord blood for 76 and 57 mother/infant pairs, respectively. Children 12 to 35 mo of age with “deficient” cord blood (25(OH)D

Author(s): Patten, Christi A; Koller, Kathryn R; Flanagan, Christie A; Hiratsuka, Vanessa Y; Hughes, Christine A; Wolfe, Abbie W; Decker, Paul A; Fruth, Kristin; Brockman, Tabetha A; Korpela, Molly; Gamez, Diana; Bronars, Carrie; Murphy, Neil J; Hatsukami, Dorothy; Benowitz, Neal L; Thomas, Timothy K | Abstract: ObjectiveThere is some evidence for biomarker feedback when combined with cessation counseling for reducing smoking in pregnancy. This randomized controlled pilot study evaluated feasibility and potential efficacy of a social-cognitive theory (SCT)-based biomarker feedback intervention among pregnant Alaska Native (AN) smokers.MethodsParticipants were randomly assigned to receive three study calls (10-20 min each): (1) biomarker feedback intervention (n = 30) including personalized cotinine results and feedback on their baby's likely exposure to carcinogen metabolite NNAL, or (2) contact control usual care condition based on the 5As (n = 30). Assessments were conducted at baseline, post-treatment, and delivery.ResultsHigh rates of treatment compliance, study retention, and treatment acceptability were observed in both groups. 7-day point prevalence smoking abstinence rates at delivery verified with urinary cotinine were the same in both study groups (20% intent-to-treat analysis, 26% per-protocol). SCT-based measures did not change differentially from baseline by study group.ConclusionThis trial supports the feasibility and acceptability of providing biomarker feedback within the clinical care delivery system, but the intervention did not promote increased smoking cessation during pregnancy compared to usual care.Practice implicationsEfforts are needed to promote the usual care and to develop alternative biomarker feedback messaging for pregnant AN women.

The Philippines is much more prone to climate change effects than are many other countries. The potential impact on the agriculture sector is of particular concern, given its vital role in the economy and for vulnerable households. Most research warns of the negative impact of climate change on yields for major cereal crops, which could threaten food security and hinder the long-run development process. Incremental adaptation through the introduction of new crop varieties, improved agricultural management practices, and more efficient irrigation are expected to reduce yield losses. However, efforts to promote systemwide adjustment would have broader effects, especially as the risk of climate change increases. This study proposes a new approach for adaptation strategies by exploring policy reform in agriculture as a transformative way to help economic agents adapt to climate change. We specifically explore the rice policy reform currently being pursued by the government through the abolishment of the rice quota program. We find this reform could help transform the agricultural and economic system by allowing scarce resources move from low- to high-productivity sectors, thus increasing the country’s adaptive capacity. However, the rice farmer and vulnerable groups that are prone to climate shocks are adversely affected by the policy. Thus, we introduce alternative intervention policies to complement the reform agenda by providing a cash transfers program to vulnerable groups or a subsidy to support rice farmers. Both offer less impact in economic efficiency gains, but the cash transfer program is superior in terms of supporting the vulnerable group in coping with climate change under the rice reform policy. This shows that the transformational adaptation strategy may create a welfare loss to certain agents but that adding government intervention could act as the second-best policy and become a transition pathway before the whole system transforms to reach the optimal efficiency point when the intervention program is eventually phased out.

Palm oil production has increased rapidly over the past two decades in response to rising demand for its use in food, energy, and industrial applications. Expansion of oil palm plantations presents a dilemma, as they can displace forests and peatlands, leading to biodiversity losses and increased greenhouse gas emissions. Although projections show that expansion of oil palm area will slow with faster yield growth, important concerns remain that will require careful attention from policymakers.