Environmental hazards and disaster researchers have demonstrated strong associations between sociodemographic indicators, such as age and socio-economic status (SES), and hazard exposures and health outcomes for individuals and in certain communities. At the same time, behavioral health and risk communications research has examined how individual psychology influences adaptive strategies and behaviors in the face of hazards. However, at present, we do not understand the explanatory mechanisms that explain relationships between larger scale social structure, individual psychology, and specific behaviors that may attenuate or amplify risk. Extreme heat presents growing risks in a rapidly warming and urbanizing world. This dissertation examines the social and behavioral mechanisms that may explain inequitable health outcomes from exposure to concurrent extreme heat and electrical power failure in Phoenix, AZ and extreme heat in Detroit, MI. Exploratory analysis of 163 surveys in Phoenix, AZ showed that age, gender, and respondent’s racialized group identity did not relate to thermal discomfort and self-reported heat illness, which were only predicted by SES (StdB = -0.52, p < 0.01). Of the explanatory mechanisms tested in the study, only relative air conditioning intensity and thermal discomfort explained self-reported heat illness. Thermal discomfort was tested as both a mechanism and outcome measure. Content analysis of 40 semi-structured interviews in Phoenix, AZ revealed that social vulnerability was associated with an increase in perceived hazard severity (StdB = 0.44, p < 0.01), a decrease in perceived adaptation efficacy (StdB = -0.38, p = 0.02), and an indirect increase (through adaptive efficacy) in maladaptive intentions (StdB = 0.18, p = 0.01). Structural equation modeling of 244 surveys in Phoenix, AZ and Detroit, MI revealed that relationships between previous heat illness experience, perceived heat risk, and adaptive intentions were significantly moderated by adaptive capacity: high adaptive capacity households were more likely to undertake adaptive behaviors, and those decisions were more heavily influenced by risk perceptions and previous experiences. However, high adaptive capacity households had lower risk perceptions and fewer heat illness experiences than low adaptive capacity households. A better understanding of the mechanisms that produce social vulnerability can facilitate more salient risk messaging and more targeted public health interventions. For example, public health risk messaging that provides information on the efficacy of specific adaptations may be more likely to motivate self-protective action, and ultimately protect populations.

Urban climate conditions are the physical manifestation of formal and informal social forces of design, policy, and urban management. The urban design community (e.g. planners, architects, urban designers, landscape architects, engineers) impacts urban development through influential built projects and design discourse. Their decisions create urban landscapes that impact physiological and mental health for people that live in and around them. Therefore, to understand possible opportunities for decision-making to support healthier urban environments and communities, this dissertation examines the role of neighborhood design on the thermal environment and the effect the thermal environment has on mental health. In situ data collection and numerical modeling are used to assess current and proposed urban design configurations in the Edison Eastlake public housing community in central Phoenix for their efficacy in cooling the thermal environment. A distributed lagged non-linear model is used to investigate the relative risk of hospitalization for schizophrenia in Maricopa County based on atmospheric conditions. The dissertation incorporates both an assessment of design strategies for the cooling of the thermal environment and an analysis of the existing thermal environment’s relationship with mental health. By reframing the urban design of neighborhoods through the lens of urban climate, this research reinforces the importance of incorporating the community into the planning process and highlights some unintended outcomes of prioritizing the thermal environment in urban design.

To address the dearth of knowledge about person-based and trip-level exposure, we developed the Icarus model. Icarus uses mesoscale traffic model—activity-based model—to analyze the heat exposure of regions of interest at an individual level. The goal with Icarus was to design accurate, granular models of population and temperature behavior for a target region, which could be transformed into a heat exposure model by means of simulation and spatial-temporal joining. By combining and implementing the most robust software and data available, Icarus was able to capture person-based exposure with unparalleled detail. Here we describe the model methodology. We use the metropolitan region of Phoenix, Arizona, USA to carry out a case study using Icarus.

We present results from experiments at the Linac Coherent Light Source (LCLS) demonstrating that serial femtosecond crystallography (SFX) can be performed to high resolution (~2.5 Å) using protein microcrystals deposited on an ultra-thin silicon nitride membrane and embedded in a preservation medium at room temperature. Data can be acquired at a high acquisition rate using x-ray free electron laser sources to overcome radiation damage, while sample consumption is dramatically reduced compared to flowing jet methods. We achieved a peak data acquisition rate of 10 Hz with a hit rate of ~38%, indicating that a complete data set could be acquired in about one 12-hour LCLS shift using the setup described here, or in even less time using hardware optimized for fixed target SFX. This demonstration opens the door to ultra low sample consumption SFX using the technique of diffraction-before-destruction on proteins that exist in only small quantities and/or do not produce the copious quantities of microcrystals required for flowing jet methods.

Photosynthesis, a process catalysed by plants, algae and cyanobacteria converts sunlight to energy thus sustaining all higher life on Earth. Two large membrane protein complexes, photosystem I and II (PSI and PSII), act in series to catalyse the light-driven reactions in photosynthesis. PSII catalyses the light-driven water splitting process, which maintains the Earth’s oxygenic atmosphere. In this process, the oxygen-evolving complex (OEC) of PSII cycles through five states, S₀ to S₄, in which four electrons are sequentially extracted from the OEC in four light-driven charge-separation events. Here we describe time resolved experiments on PSII nano/microcrystals from Thermosynechococcus elongatus performed with the recently developed technique of serial femtosecond crystallography. Structures have been determined from PSII in the dark S₁ state and after double laser excitation (putative S₃ state) at 5 and 5.5 Å resolution, respectively. The results provide evidence that PSII undergoes significant conformational changes at the electron acceptor side and at the Mn₄CaO₅ core of the OEC. These include an elongation of the metal cluster, accompanied by changes in the protein environment, which could allow for binding of the second substrate water molecule between the more distant protruding Mn (referred to as the ‘dangler’ Mn) and the Mn₃CaO_x cubane in the S₂ to S₃ transition, as predicted by spectroscopic and computational studies. This work shows the great potential for time-resolved serial femtosecond crystallography for investigation of catalytic processes in biomolecules.

It has been suggested that the extended intensity profiles surrounding Bragg reflections that arise when a series of finite crystals of varying size and shape are illuminated by the intense, coherent illumination of an x-ray free-electron laser may enable the crystal’s unit-cell electron density to be obtained ab initio via well-established iterative phasing algorithms. Such a technique could have a significant impact on the field of biological structure determination since it avoids the need for a priori information from similar known structures, multiple measurements near resonant atomic absorption energies, isomorphic derivative crystals, or atomic-resolution data. Here, we demonstrate this phasing technique on diffraction patterns recorded from artificial two-dimensional microcrystals using the seeded soft x-ray free-electron laser FERMI. We show that the technique is effective when the illuminating wavefront has nonuniform phase and amplitude, and when the diffraction intensities cannot be measured uniformly throughout reciprocal space because of a limited signal-to-noise ratio.

Microbes in the gastrointestinal tract are under selective pressure to manipulate host eating behavior to increase their fitness, sometimes at the expense of host fitness. Microbes may do this through two potential strategies: (i) generating cravings for foods that they specialize on or foods that suppress their competitors, or (ii) inducing dysphoria until we eat foods that enhance their fitness. We review several potential mechanisms for microbial control over eating behavior including microbial influence on reward and satiety pathways, production of toxins that alter mood, changes to receptors including taste receptors, and hijacking of the vagus nerve, the neural axis between the gut and the brain. We also review the evidence for alternative explanations for cravings and unhealthy eating behavior. Because microbiota are easily manipulatable by prebiotics, probiotics, antibiotics, fecal transplants, and dietary changes, altering our microbiota offers a tractable approach to otherwise intractable problems of obesity and unhealthy eating.

Background: Most excess deaths that occur during extreme hot weather events do not have natural heat recorded as an underlying or contributing cause. This study aims to identify the specific individuals who died because of hot weather using only secondary data. A novel approach was developed in which the expected number of deaths was repeatedly sampled from all deaths that occurred during a hot weather event, and compared with deaths during a control period. The deaths were compared with respect to five factors known to be associated with hot weather mortality. Individuals were ranked by their presence in significant models over 100 trials of 10,000 repetitions. Those with the highest rankings were identified as probable excess deaths. Sensitivity analyses were performed on a range of model combinations. These methods were applied to a 2009 hot weather event in greater Vancouver, Canada.

Results: The excess deaths identified were sensitive to differences in model combinations, particularly between univariate and multivariate approaches. One multivariate and one univariate combination were chosen as the best models for further analyses. The individuals identified by multiple combinations suggest that marginalized populations in greater Vancouver are at higher risk of death during hot weather.

Conclusions: This study proposes novel methods for classifying specific deaths as expected or excess during a hot weather event. Further work is needed to evaluate performance of the methods in simulation studies and against clinically identified cases. If confirmed, these methods could be applied to a wide range of populations and events of interest.

Background: Medical and public health scientists are using evolution to devise new strategies to solve major health problems. But based on a 2003 survey, medical curricula may not adequately prepare physicians to evaluate and extend these advances. This study assessed the change in coverage of evolution in North American medical schools since 2003 and identified opportunities for enriching medical education.

Methods: In 2013, curriculum deans for all North American medical schools were invited to rate curricular coverage and perceived importance of 12 core principles, the extent of anticipated controversy from adding evolution, and the usefulness of 13 teaching resources. Differences between schools were assessed by Pearson’s chi-square test, Student’s t-test, and Spearman’s correlation. Open-ended questions sought insight into perceived barriers and benefits.

Results: Despite repeated follow-up, 60 schools (39%) responded to the survey. There was no evidence of sample bias. The three evolutionary principles rated most important were antibiotic resistance, environmental mismatch, and somatic selection in cancer. While importance and coverage of principles were correlated (r = 0.76, P < 0.01), coverage (at least moderate) lagged behind importance (at least moderate) by an average of 21% (SD = 6%). Compared to 2003, a range of evolutionary principles were covered by 4 to 74% more schools. Nearly half (48%) of responders anticipated igniting controversy at their medical school if they added evolution to their curriculum. The teaching resources ranked most useful were model test questions and answers, case studies, and model curricula for existing courses/rotations. Limited resources (faculty expertise) were cited as the major barrier to adding more evolution, but benefits included a deeper understanding and improved patient care.

Conclusion: North American medical schools have increased the evolution content in their curricula over the past decade. However, coverage is not commensurate with importance. At a few medical schools, anticipated controversy impedes teaching more evolution. Efforts to improve evolution education in medical schools should be directed toward boosting faculty expertise and crafting resources that can be easily integrated into existing curricula.