Sustainability in Aotearoa New Zealand’s food system is essential for environmental health (taiao ora) and human well-being (tangata ora). However, achieving resilience in our food system faces significant cross-sector challenges, requiring a national food strategy that addresses environmental, economic, and social pressures(1). This work aims to develop the first national computational model of Aotearoa New Zealand’s food system, integrating key factors into a decision support tool. The model aims to support food system resilience by offering an accessible platform that could help inform decisions to strengthen preparedness for shocks, while also providing insights to enhance everyday food security. The Kai Anamata mō Aotearoa (KAMA) model leverages new data and indigenous crop trials to combine work across agriculture, environment, and human wellbeing, forming a comprehensive tool to examine food system resilience. This model will capture the resources required, outputs produced, and wellbeing outcomes of our food system. The KAMA model was built using a flow-state modelling approach, which allows for flexible configuration of land uses and ensures that the model can adapt to future technologies and climate change scenarios. The preliminary development the KAMA model was used to demonstrate the current production system and applied to a regional case study from Te Tauihu, integrating region-specific food production data, including apples, kiwifruit, mussels, wine, and hops production. Outputs included labour, carbon dioxide emissions and mass of production. Beyond food production, this model will enable users to explore the impacts of land use for commodity production, the effects of trade, nutrient supply, and the broader implications for well-being. model will be made publicly accessible online to allow any interested individual to explore the future of the national food system.

Although current estimates suggest that global food production is enough to meet nutritional needs, there are still significant challenges with equitable distribution(1). Tackling these disparities is essential for achieving global nutrition security now and in the future. This study uses the DELTA Model® to analyse global nutrient supply dynamics at national resolution and address nutritional shortfalls in specific countries(2). By examining the distribution of food commodities and nutrients in 2020, we project the future food and nutrient production needs for 2050 to ensure adequate global supply. Our findings indicate that while some nutrients are sufficiently supplied on a global scale, many countries face significant national deficiencies in essential nutrients such as vitamins A, B12, B2, potassium, and iron. Addressing these gaps will require substantial increases in nutrient supply or redistribution. For example, a 1% increase in global protein, targeted at countries with insufficient protein, could close the 2020 gaps. However, if current consumption patterns persist, the global food system will need a 26% increase in production by 2050 to accommodate population growth and changing consumption patterns. Our study developed a framework for exploring future production scenarios. This involves reducing surplus national nutrient supply linearly over decades while simultaneously increasing production of undersupplied nutrients. This framework provides a more practical assessment of future needs, transitioning from idealized production scenarios to realistic projections. Our study investigated a potential future for nutrient supply to meet minimum requirements by 2050. Calcium and vitamin E are crucial, and production must be increased to address significant gaps, given their severe deficiencies in 2020. Energy and fibre production will be required to peak between 2030 and 2040 before stabilizing back near 2020 levels. Predicted changes in nutrient supply from 2020 to 2050 vary: while calcium and vitamin E will need to increase, phosphorus, thiamine and the indispensable amino acids can decrease without compromising global nutrition with only minor redistribution. These results are essential for determining the food supply required to achieve adequate global nutrient supply in the future. Incorporating these insights into global food balance models will provide key stakeholders with evidence, refine future projections, and inform policy decisions aimed at promoting sustainable healthy diets worldwide.

Background: Our prior six-year review (n=2165) revealed 24% of patients undergoing posterior decompression surgeries (laminectomy or discectomy) sought emergency department (ED) care within three months post-surgery. We established an integrated Spine Assessment Clinic (SAC) to enhance patient outcomes and minimize unnecessary ED visits through pre-operative education, targeted QI interventions, and early post-operative follow-up. Methods: We reviewed 13 months of posterior decompression data (n=205) following SAC implementation. These patients received individualized, comprehensive pre-operative education and follow-up phone calls within 7 days post-surgery. ED visits within 90 days post-surgery were tracked using provincial databases and compared to our pre-SAC implementation data. Results: Out of 205 patients, 24 (11.6%) accounted for 34 ED visits within 90 days post-op, showing a significant reduction in ED visits from 24% to 11.6%, and decreased overall ED utilization from 42.1% to 16.6% (when accounting for multiple visits by the same patient). Early interventions including wound monitoring, outpatient bloodwork, and prescription adjustments for pain management, helped mitigate ED visits. Patient satisfaction surveys (n=62) indicated 92% were “highly satisfied” and 100% would recommend the SAC. Conclusions: The SAC reduced ED visits after posterior decompression surgery by over 50%, with pre-operative education, focused QI initiatives, and its individualized, proactive approach.

Objectives/Goals: Personalized cancer therapy based on genomic testing is advancing patient care. Genomic alterations in fibroblast growth factor receptor (FGFR) predict response to FGFR inhibitors; however, the role of RNA expression and protein activation is not known. We propose to examine the phospho-proteomic signature in FGFR-altered cancers to identify new candidates for FGFR-targeted therapies. Methods/Study Population: In our preliminary study, we have curated a cohort of FGFR2 mutants (13 FGFR2-fusions and 4 FGFR2 point mutations) with known clinical outcomes to FGFR inhibitors and 8 FGFR2 wild-type (WT) cholangiocarcinoma tumor samples to investigate the phospho-proteomic fingerprint using a clinical grade reverse phase protein array (RPPA). RPPAs are high throughput quantitative antibody-based proteomics assays that can quantify hundreds of proteins in thousands of patient tissues providing a high degree of sensitivity through laser tumor microdissection (LCM). We have selected proteins in the FGFR signaling pathway including FGFR2, AKT, ERK1.2, STAT1/3, FRS2, and PLCg to define the range of phospho-proteomic signal between FGFR2 WT and mutant cancers. All samples will undergo evaluation with RNASeq for gene expression. Results/Anticipated Results: Our initial analysis defined the range of RNA expression of FGFR2 and pFGFR2 protein signal (Y653/654 and Y769) between FGFR2 WT and FGFR2 mutant samples. On average, the FGFR2 mutant cohort displayed higher FGFR2 RNA expression compared to the FGFR2 WT cohort. There is no apparent correlation between RNA expression and clinical response to FGFR-targeted therapy. However, in this small cohort, there is no significant difference in FGFR2 phosphorylation between FGFR2 WT and mutant cancers. RPPA analysis of FGFR downstream signaling proteins reveals a wide range of phosphorylation, but no significant difference between FGFR2 WT and mutant cancers. Discussion/Significance of Impact: These findings illustrate the complexities of FGFR signaling between FGFR2 WT and mutant cancers. These data suggest that tumors with genomically WT FGFR may display increased pFGFR2 and downstream signaling phospho-proteins. We propose a larger study of cholangiocarcinoma to evaluate evidence of FGFR pathway activation in WT tumors.

Excluding all animal-sourced foods may be associated with increased risks of nutrient deficiencies. As indispensable amino acids (IAAs) cannot be stored or endogenously produced, consistent protein consumption throughout the day is important to improve protein quality for optimal metabolic function(1). Assessment of protein adequacy needs to be undertaken at the meal rather than daily intake level because food combinations within each meal can be complementary and influence the overall amino acid profile of the meal(2).

Outcomes of our previous review found that among plant-sourced foods, soy, legumes, nuts and seeds provide greater protein content and quality(3). We hypothesise that variation in protein intake will exist both between vegan individuals and between observation days for the same individuals. Previous investigations of the relationship between meals and nutrient intake based on specified time windows for eating may have been subject to researcher bias in the definition of these windows. The main outcome of this study is to utilise time series clustering to determine the impact of dietary patterns on protein distribution, across the day.

Intake data was obtained using a four-day food diary from a cross-sectional survey of 193 New Zealand vegans (Ethical approval: HDEC 2022 EXP 12312). The inclusion criteria required participants to have followed an exclusive vegan diet for at least two years. A kernel density contour estimation was used to visualise protein distribution across eating occasions for all participants over four days. Dynamic Time Warping (DTW) was then used to align two temporal sequences (time series) to compute an output of distance(4) which was used for hierarchical clustering using the Ward.D2 method. An optimal cluster of 3 was identified using silhouette coefficient and domain knowledge.

Participants had a mean age of 39.4 years (SD=12.3), with 90.1% having attained a tertiary-level education or higher. Overall, mean protein intake was 1.11 g/kg/d (SD=0.39), with 8.29% of participants below the Estimated Average Requirements (EAR) and 24.3% of participants below the Recommended Dietary Allowance (RDA) for adults. The mean Acceptable Macronutrient Distribution Range (AMDR) for protein is 15.5% (SD=4.16), with 96.9% of participants within the recommended AMDR range (10-35%). Peak protein consumption was observed at 1230 and 1900. Sequential colour scale representing density found higher distribution of data points representing protein intake of less than 10g per eating occasion. Time series similar in shape and amplitude were assigned to the same cluster. Preliminary findings identified three different protein intake profiles across the day.

A small percentage of participants has protein intake below the daily requirements for adults. More occasions with lower protein intake per eating moment was observed. This approach classifies dietary patterns objectively for analysis of daily protein and IAA intake.

During 2016–2022, Medicare part D beneficiaries filled 8,674,460 clotrimazole-betamethasone dipropionate prescriptions. Annual rates were stable (30.9 prescriptions/1,000 beneficiary-years in 2022, enough for one in every 33 beneficiaries). Diagnostic testing was infrequent, particularly among internal medicine, family medicine, and general practitioners, suggesting potential opportunities to improve diagnostic and prescribing practices.

In December 2018, an outbreak of Salmonella Enteritidis infections was identified in Canada by whole-genome sequencing (WGS). An investigation was initiated to identify the source of the illnesses, which proved challenging and complex. Microbiological hypothesis generation methods included comparisons of Salmonella isolate sequence data to historical domestic outbreaks and international repositories. Epidemiological hypothesis generation methods included routine case interviews, open-ended centralized re-interviewing, thematic analysis of open-ended interview data, collection of purchase records, a grocery store site visit, analytic comparison to healthy control groups, and case–case analyses. Food safety hypothesis testing methods included food sample collection and analysis, and traceback investigations. Overall, 83 cases were identified across seven provinces, with onset dates from 6 November 2018 to 7 May 2019. Case ages ranged from 1 to 88 years; 60% (50/83) were female; 39% (22/56) were hospitalized; and three deaths were reported. Brand X profiteroles and eclairs imported from Thailand were identified as the source of the outbreak, and eggs from an unregistered facility were hypothesized as the likely cause of contamination. This study aims to describe the outbreak investigation and highlight the multiple hypothesis generation methods that were employed to identify the source.

An investigation into an outbreak of Salmonella Newport infections in Canada was initiated in July 2020. Cases were identified across several provinces through whole-genome sequencing (WGS). Exposure data were gathered through case interviews. Traceback investigations were conducted using receipts, invoices, import documentation, and menus. A total of 515 cases were identified in seven provinces, related by 0–6 whole-genome multi-locus sequence typing (wgMLST) allele differences. The median age of cases was 40 (range 1–100), 54% were female, 19% were hospitalized, and three deaths were reported. Forty-eight location-specific case sub-clusters were identified in restaurants, grocery stores, and congregate living facilities. Of the 414 cases with exposure information available, 71% (295) had reported eating onions the week prior to becoming ill, and 80% of those cases who reported eating onions, reported red onion specifically. The traceback investigation identified red onions from Grower A in California, USA, as the likely source of the outbreak, and the first of many food recall warnings was issued on 30 July 2020. Salmonella was not detected in any tested food or environmental samples. This paper summarizes the collaborative efforts undertaken to investigate and control the largest Salmonella outbreak in Canada in over 20 years.

The aim of this study was to apply a comprehensive mathematical model designed to assess the current and future availability of food, as well as the resulting nutrient availability and intake, in the context of the Norwegian population. The model explores various scenarios, including self-sufficiency levels for food supply and impacts on nutrition recommendations. A food mass balance charting production, import, export, feed, seed, and consumer allocation in the Norwegian food system provided insights into the nutrients available to the population. The analysis included a comparison with two versions of the Nordic Nutrient Recommendations (NNR)1, with the latest version recommending substantial changes in food consumption compared to current dietary patterns in Norway. The nutrient analysis compared the food mass to Matvaretabellen2 and was supplemented with data from the United Nations World Population Prospects3 and the Food and Agriculture Organisation/World Health Organisation/United Nations4 report to ensure comprehensive nutrient analysis. Micronutrient gaps were observed in Iodine (94% of the target intake) and Vitamin D (46% of the target intake), while saturated-fatty acids slightly exceeded the recommended requirements (107% of the upper limit) based on the current baseline scenario. The updated NNR4 recommends changes to specific food categories, namely fruits, vegetables, nuts, and seeds. A secondary scenario testing compared against the updated NNR found that increasing the availability of the supply of these groups does not result in any new nutrient gaps, demonstrating the feasibility of addressing the issue on a national supply basis. These approach offers a mathematical-modelling based tool that can be used to provide information for a national food system. Leveraging the model’s capacity to simulate various scenarios, informed decisions to optimise self-sufficiency levels and align food supply with recommended nutritional guidelines can be made. To improve the model, higher data resolution and clearer categorisation of food groups are required which can then be linked into a more complete national food system. The mathematical model presented in this study provides a framework for understanding of food and nutrient availability in Norway. By identifying critical nutrient gaps and potential solutions, this research contributes knowledge for a healthier and sustainable food future for the nation.

Helium or neopentane can be used as surrogate gas fill for deuterium (D2) or deuterium-tritium (DT) in laser-plasma interaction studies. Surrogates are convenient to avoid flammability hazards or the integration of cryogenics in an experiment. To test the degree of equivalency between deuterium and helium, experiments were conducted in the Pecos target chamber at Sandia National Laboratories. Observables such as laser propagation and signatures of laser-plasma instabilities (LPI) were recorded for multiple laser and target configurations. It was found that some observables can differ significantly despite the apparent similarity of the gases with respect to molecular charge and weight. While a qualitative behaviour of the interaction may very well be studied by finding a suitable compromise of laser absorption, electron density, and LPI cross sections, a quantitative investigation of expected values for deuterium fills at high laser intensities is not likely to succeed with surrogate gases.

A Canadian outbreak investigation was initiated in January 2022 after a cluster of cases of Shiga-toxin-producing Escherichia coli (STEC) O157 was identified through whole genome sequencing (WGS). Exposure information was collected through case interviews. Traceback investigations were conducted, and samples from case homes, retail, and the manufacturer were tested for STEC O157. Fourteen cases were identified in two provinces in Western Canada, with isolates related by 0–5 whole genome multi-locus sequence typing allele differences. Symptom onset dates ranged from 11 December 2021 to 7 January 2022. The median age of cases was 29.5 (range 0–61); 64% were female. No hospitalisations or deaths were reported. Of 11 cases with information available on fermented vegetable exposures, 91% (10/11) reported consuming Kimchi Brand A during their exposure period. The traceback investigation identified Manufacturer A in Western Canada as the producer. One open and one closed sample of Kimchi Brand A tested positive for STEC O157, with isolates considered genetically related by WGS to the outbreak strain. Napa cabbage within the kimchi product was hypothesised as the most likely source of contamination. This paper summarises the investigation into this STEC O157 outbreak associated with kimchi, the first reported outside of East Asia.