Objectives. To illustrate the effects that minor social or environmental disruptions could have on the food access of low-income households in Philadelphia, Pennsylvania, and provide suggestions for how cities can better incorporate food into emergency planning. Methods. Using publicly available data and stakeholder interviews (n = 8) in 2017, we projected the number of meals that would be missed during environmental and social disruptions in Philadelphia, a major US city with a high poverty rate. Results. As our projections in Philadelphia indicate, even just 3 days of school closures could result in as many as 405 600 missed meals for school-aged children. Conclusions. These scenarios provide valuable lessons for other cities to proactively plan for food access continuity in times of uncertainty. Public Health Implications. City planners and other city agencies need to include food as a routine part of emergency planning and redefine the threshold at which emergency response protocols are triggered to better ensure protection of low-income and underserved populations.

Background: There are no guidelines on the safety of magnetic resonance imaging (MRI) in patients with breast tissue expanders with metallic/magnetic components. This narrative review was conducted to better understand what is currently known and to identify gaps in knowledge. Methods: A literature search was performed using PubMed and Embase and the following terms: “breast” AND (“imaging” OR “MRI” OR “resonance”) AND “expander,” with no date limitations. The authors identified 153 citations in PubMed and 154 citations in Embase. Results: Nineteen publications were relevant for analysis: two retrospective studies, 10 case reports, six nonclinical studies, and one physician survey. All studies acknowledged the risks of using magnetic resonance imaging in patients with tissue expanders. Complications reported included breast/chest pain, discomfort, or burning sensation (46.2 percent); expander or infusion port displacement (38.5 percent); and magnetic resonance signal loss (23.1 percent). Increases in expander/tissue temperature and torque occurred with magnetic resonance imaging, causing pain or expander displacement. In some cases, no complications were reported. The retrospective studies and nonclinical analyses suggested that magnetic resonance imaging may not create serious problems if special precautions are taken. The case reports varied in their recommendations, with some recommending avoiding magnetic resonance imaging and others recommending exercising caution. The survey indicated that surgeons are uncertain about performing magnetic resonance imaging in patients with tissue expanders. Conclusions: The evidence on whether to perform magnetic resonance imaging in patients with tissue expanders with magnetic ports varies but underscores proceeding with caution. The risk-to-benefit profile for each patient must be weighed in each situation.