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We measured food availability and diet composition of juvenile salmonids over multiple years and seasons before and during the world’s largest dam removal on the Elwha River, Washington State. We conducted these measurements over three sediment-impacted sections (the estuary and two sections of the river downstream of each dam) and compared these to data collected from mainstem tributaries not directly affected by the massive amount of sediment released from the reservoirs. We found that sediment impacts from dam removal significantly reduced invertebrate prey availability, but juvenile salmon adjusted their foraging so that the amount of energy in diets was similar before and during dam removal. This general pattern was seen in both river and estuary habitats, although the mechanisms driving the change and the response differed between habitats. In the estuary, the dietary shifts were related to changes in invertebrate assemblages following a hydrological transition from brackish to freshwater caused by sediment deposition at the river’s mouth. The loss of brackish invertebrate species caused fish to increase piscivory and rely on new prey sources such as plankton. In the river, energy provided to fish by Ephemeroptera, Plecoptera, and Trichoptera taxa before dam removal was replaced first by terrestrial invertebrates, and then by sediment-tolerant taxa such as Chironomidae. The results of our study are consistent with many others that have shown sharp declines in invertebrate density during dam removal. Our study further shows how those changes can move through the food web and affect fish diet composition, selectivity, and energy availability. As we move further along the dam removal response trajectory, we hypothesize that food web complexity will continue to increase as annual sediment load now approaches natural background levels, anadromous fish have recolonized the majority of the watershed between and above the former dams, and revegetation and microhabitats continue to develop in the estuary.

The Society of General Internal Medicine (SGIM) represents the world’s leading academic general internists, dedicated to creating a just system of care in which all people can achieve optimal health. SGIM recognizes that to achieve this vision, we must expand our reach beyond the medical office and hospital bedside to identify and address the broader structures and living conditions that influence health—the social determinants of health (SDOH). Centuries of institutionalized oppression in the form of racism, sexism, and other forms of bigotry have created and perpetuated disadvantage. These underlying social values have translated into public policies and structures which affect the distribution ofmoney and power across society. These in turn have shaped living conditions and access to resources, which influence health behaviors and access to care, and ultimately health outcomes. SGIM acknowledges the full spectrum of SDOH including upstream policies, midstream environmental and behavioral factors, and downstream individual and clinical issues. We highlight an important distinction between societal SDOH that require policy and systems-level change, with downstream unmet individual social needs, like homelessness or food insecurity. The entire range of SDOH impacts the work we do, our ability to care for our individual patients, our partnerships with local community organizations, and our impact on population health and equity. SDOH should also be integrated in how we teach future physicians and collaborate with our colleagues in public health, social work, government, research, and partners in non-health sectors.

The management of unruptured intracranial aneurysms requires knowledge of the natural history of these lesions and the risks of repairing them.A total of 2621 patients at 53 participating centers in the United States, Canada, and Europe were enrolled in the study, which had retrospective and prospective components. In the retrospective component, we assessed the natural history of unruptured intracranial aneurysms in 1449 patients with 1937 unruptured intracranial aneurysms; 727 of the patients had no history of subarachnoid hemorrhage from a different aneurysm (group 1), and 722 had a history of subarachnoid hemorrhage from a different aneurysm that had been repaired successfully (group 2). In the prospective component, we assessed treatment-related morbidity and mortality in 1172 patients with newly diagnosed unruptured intracranial aneurysms.In group 1, the cumulative rate of rupture of aneurysms that were less than 10 mm in diameter at diagnosis was less than 0.05 percent per year, and in group 2, the rate was approximately 11 times as high (0.5 percent per year). The rupture rate of aneurysms that were 10 mm or more in diameter was less than 1 percent per year in both groups, but in group 1, the rate was 6 percent the first year for giant aneurysms (or =25 mm in diameter). The size and location of the aneurysm were independent predictors of rupture. The overall rate of surgery-related morbidity and mortality was 17.5 percent in group 1 and 13.6 percent in group 2 at 30 days and was 15.7 percent and 13.1 percent, respectively, at 1 year. Age independently predicted surgical outcome.The likelihood of rupture of unruptured intracranial aneurysms that were less than 10 mm in diameter was exceedingly low among patients in group 1 and was substantially higher among those in group 2. The risk of morbidity and mortality related to surgery greatly exceeded the 7.5-year risk of rupture among patients in group 1 with unruptured intracranial aneurysms smaller than 10 mm in diameter.

Either Actinomyces israeli, A. naeslundii, or Arachnia propionica was found, by immunofluorescence studies, in cervicovaginal mucus from 36% of 50 women. One or more of these organisms were found in a surprising 27% of those with neither intrauterine contraceptive devices (IUDs) nor intravaginal foreign bodies. The only common finding was abundant vaginal mucus, and no clinical features were more serious than vaginal itching, odor, or vague discomfort. Among those women who harbored actinomycetes, the average duration of continuous IUD use was 5.3 years; the comparable figure for those with no infection was 2.1 years.This study compares the presence of Actinomyces in the vaginas of women with and without IUDs. Mucus samples were collected from the external cervical os of 50 randomly selected women. The smears were air-dried, heat-fixed, and stained directly with fluorescent antibody conjugates for A. israelii, A. naeslundii, and Arachnia propionica (Actinomyces species with clinical significance in human beings). A fluorescent microscope with oil immersion magnification of about 400x was used, and identification of the specific organisms depended upon both cellular morphologic features and the brilliant greenish yellow fluorescence of the cell membrane. Either 1 of 3 A. species was positively identified in 18 of 50 patients (36%). 1 or more species were found in 8 of 30 patients with no internal devices (27%). Of 18 IUD wearers, 8 were positive for Actinomyces (44%). 1 patient with a retained vaginal tampon and another 1 with a pessary also had positive smears. A. israelii and Arachnia propionica were the most commonly identified species. If the organism was found, average duration of continuous IUD use was 5.3 years (range, 1 to 15 years). Where these organisms do not exist, average continuous use was 2.1 years. Age of patients positive for Actinomyces ranged from 18 to 52 years. These findings do not show the true incidence of these organisms in either the general population or IUD wearers. However, they suggest the presence of such organisms in asymptomatic women, with or without intravaginal devices. Papanicolaou staining is not sufficient in identifying the presence of the organisms. Further studies must be done. The immunofluorescence technique is a simple, rapid and universally available technique for identifying the organism. Further studies should be done to determine whether these organisms lie dormant until some pathogens or trauma precipitate disease. Also, the disease actinomycosis should be carefully distinguished from the mere presence of Actinomycetaceae in the vagina.

The production of field peas for canning purposes has played an important part in Utah's agriculture, furnishing some of the intensity needed on her small farms. Peas are a crop that can be handled largely with the labor of the operator and his family and has not required any specialized machinery for their production. They are a suitable alfalfa nurse crop and in most areas do not compete greatly with other crops grown for the farmer's time.

Since 1946, the cost of producing canning peas has been investigated on a continuing basis by the Utah Agricultural Experiment Station. The original comprehensive study was made in 1946. A second study was completed in 1951. The most recent study was made in 1961. In between the major studies annual costs of production have been calculated.

Present and potential fruit farmers are asking the question, "How much do I have invested in an acre of fruit by the time the trees are old enough to produce a paying crop?" or "How much would I have to invest to bring an acre of young trees into production?" Sometimes the question is "How much do trees add to the value of bare land?" or "How much value must I depreciate my trees each year to recover my investment by the time their productive life has passed?"

Dairymen have a continuing problem in maintaining herd size. Disease, injuries, and low production, make it necessary for them to cull animals from their herds. Replacements equal to a complete herd turnover are necessary every two to six years. Consequently, many are wondering as to the most profitable practice to supply the needed replacements in the herd. Three alternatives are available: Dairymen can produce herd replacements. They can purchase either heifers or cows. They can contract with growers specializing in raising heifers to provide replacements. Since all dairy enterprises differ to some degree, each dairyman should seek a specific solution to his herd replacement problem.

Dry land farming is an essential part of the economy of northern Utah. With wheat in surplus production and subsequent crop controls a serious problem has developed in the area. The State Agricultural Statistician and the Agricultural Stabilization and Conservation Committee report that between thirty thousand and forty thousand acres have been taken from wheat production and are available for crops other than wheat.

This study of hog production as an alternative farm enterprise was undertaken to develop information that could be used to help answer the question frequently asked of what comparative economic position hog production has on Utah farms.

Field corn for grain, silage, or pasturing has been produced in Utah since its settlement by the Mormon Pioneers. Those reporting data, however, have made no division of production and value of the different uses of corn until recent years. Previous to 1959 all field corn was reported in grain equivalents for the state as a whole. No county data are reported in Utah except by the Agricultural Census and, hence, only at 5 year intervals. While there has always been some corn harvested for grain each year, the bulk of the corn grown in Utah has been for silage. In recent years, however, there has been increased interest in producing grain corn because shifting price relations with other feed grains have made corn production more attractive.

Sweet corn for canning purposes has been grown commercially in Utah for more than 40 years. For two decades before 1940, the acreage varied between 400 and 800 acres. It increased from 600 acres in 1942 to 6,300 in 1949 and was down to 4,470 acres in 1959. In 1959, there were five counties in Utah where farmers grew more than 100 acres of canning corn. This accounted for 98 percent of all canning corn reported. Of these, Utah County had 2,468 acres or 55 percent of the total, Cache had 1,059 acres or 23 percent, Box Elder had 483 acres or 11 percent, Davis 217 acres or 5 percent, and Salt Lake had 161 acres or 4 percent.

Production of canning tomatoes is an important enterprise on many farms in Utah. In 1949 this crop brought about $1,772,000 and in 1951, nearly $2,750,000 to the farmers of the state (appendix table 1). Nearly all the canning tomatoes of the state are produced in the counties at the west of the Wasatch Mountains. In order of importance, these are: Davis, Weber, Utah, Box Elder, and Salt Lake (appendix table 2). Since tomatoes are processed relatively close to where they are grown, the income to farmers is not a complete measure of the importance of the tomato enterprise to this area. The degree of success attained in tomato production varies rather widely among farmers. Some growers apparently produce tomatoes at a profit regularly year after year, while others seemingly make no profits. The reasons for this have not been well known. The exact requirements, costs, and returns have not been known on a comprehensive scale. Comparisons with other enterprises that are, or might be, conducted on the same farms have been limited by lack of specific data. In an endeavor to obtain a better understanding of the problems, the officers of the Davis County Canning Crops Association, and the county agricultural agent, requested the Agricultural Experiment Station to study the economics of producing tomatoes. This is a report of the study that followed. It covers the crops produced in 1948 and 1949.

The canning corn enterprise is becoming increasingly important to the farmers of Utah. For two decades prior to 1940, the acreage used in canning corn production varied between 400 and 800 acres; however, it has increased from 600 acres in 1942 to 6,300 acres in 1949. This increase has been larger, both in percentage and in absolute amount, than for any other intertilled or orchard crop in the state during the same period of time. In 1949 the farm value of canning corn sold was $567,000. Peas and tomatoes were the only canning crops which exceeded it in value. Counties producing significant quantities of canning corn before 1945 were Box Elder, Weber, Davis, Salt Lake, and Utah. A small amount was also produced in Cache County and transported to a canning factory in Box Elder County. In 1946 processing equipment was installed in Cache County; and as a result of canning this product locally, corn became an important crop to many Cache County farmers in that year. In 1949 Cache County was second only to Utah County in the farm production of sweet corn In the state. It had 25 percent of the corn-producing farms, 27 percent of the corn acreage, and 25 percent of the total value of the crop.

The production of celery by farmers in Utah has undergone important changes in the past five or six years. The most notable have been centered around the introduction of the new green type (Pascal) celery. The methods of production have advanced rapidly, the quality of the product has been greatly improved, the yield per acre has been increased at least twofold, and the acreage has been expanded. With the growing impetus of the industry have come requests for information on cost and return to the farmer and for an analysis of other economic and physical factors associated with the industry. Few economic data have been available for the use of those interested in the new developments in celery production. To provide more current data on celery production in Utah, the Utah Agricultural Experiment Station conducted a study on cost and efficiency of producing celery in Utah for the years 1945 and 1947.

Peach production in Utah is an important fruit enterprise. Preliminary estimates place Utah's 1947 peach crop at about 933,000 bushels, valued at about $1,679,000. This is equal to about 1.2 percent of the value of all agricultural commodities produced in the state, and about 27 percent of the value of Utah's fruit crop. The 1947 peach crop was, however, about 27 percent, or 200,000 bushels larger than the ten-year average, 1937 to 1946, and was the second largest crop on record in the last thirty years. In terms of value the 1947 crop was exceeded only by the crops of 1943 and 1944.

For a number of years the Agricultural Experiment Station has measured and reported the costs and returns in the production of the important agricultural enterprises on Utah farms. These studies have been initiated by a detailed investigation of a sufficient number of farms to reflect the average conditions of the enterprise under study. In each succeeding year sufficient additional field and other data are collected to reflect the changes in prices, costs, and method of production to determine the current costs and returns for that year. Periodically detailed studies have been repeated for each enterprise and the data kept current by the method described above.

The production of broilers in Utah has become increasingly important in the last few years. Data are not available prior to 1950 but in that year the gross income from the production of broilers was $629,000. In 1951 almost one and a half million broilers were produced bringing a gross income of $1,322,000 to Utah producers. With the rapid growth in recent years has come a demand for information about this new industry from producers, prospective producers, processors of meat and feed, agricultural leaders, and agricultural advisers. As with most new industries little specific information has been available concerning the economics of production and no printed information has been available for Utah conditions.