Feedbacks Regulating the Salinization of Coastal Landscapes.

The impact of saltwater intrusion on coastal forests and farmland is typically understood as sea-level-driven inundation of a static terrestrial landscape, where ecosystems neither adapt to nor influence saltwater intrusion. Yet recent observations of tree mortality and reduced crop yields have inspired new process-based research into the hydrologic, geomorphic, biotic, and anthropogenic mechanisms involved. We review several negative feedbacks that help stabilize ecosystems in the early stages of salinity stress (e.

Initial soil moisture and soil texture control the impact of storm surges in coastal forests.

Flooding and salinization triggered by storm surges threaten the survival of coastal forests. The forest root zone (top 40 cm of soil) is the most affected by surge flooding. Determining the effect of a storm surge on edaphic conditions is essential to estimate vegetation response.

Offshore freshened groundwater reservoirs controlled by submarine faults with a complex dependency on antecedent hydrogeological conditions.

Offshore Freshened Groundwater (OFG) reservoirs are gaining attention, as evidence suggests they are more prevalent worldwide than previously thought. OFG systems are generally classified as either passive, a relic of ancient, lower sea levels, or as active, with an onshore-offshore hydrogeologic connection and associated discharge offshore. Previous studies on the mechanisms of OFG were conducted in various hydrogeologic settings, but the role of faults remains understudied.

Perioperative Management of Buprenorphine at an Urban Academic Medical Center.

Introduction: Buprenorphine is a partial mu opioid receptor agonist with high affinity to its receptor, which raises concerns of blocking or displacing full opioid agonists when used during the perioperative period of surgical patients. However, buprenorphine itself has high analgesic potency and discontinuing buprenorphine may lead to suboptimal pain control and risk for opioid use disorder relapse. There is limited data for the continuation of buprenorphine perioperatively.

American Insurance Coverage of Endovenous Ablation for Greater and Lesser Saphenous Varicose Veins.

Background: Severe cases of varicose veins can cause psychological distress as well as physical symptoms including skin discoloration, wounds, and burning sensations. One intervention, endovenous laser/radiofrequency ablation, is variably covered by insurance. Insurance coverage for this procedure was assessed for all indications of endovenous laser/radiofrequency ablation as medically necessity criteria.

Effect of Implant Maintenance on Incidence of Peri-implantitis and Early Implant Failure: Retrospective Cohort Study.

Maintaining dental implants and managing peri-implant tissues has become integral to dental practice. Owing to the larger number of implants placed, the number of peri-implant lesions is increasing. Periodontal implant maintenance therapy (PIMT) provides a conservative long-term treatment modality to monitor and maintain implants.

Drivers of barrier island water-table fluctuations and groundwater salinization.

Barrier islands are threatened by climate change as sea-level rise and higher frequency storm surge lead to more flooding and saltwater intrusion. Vegetation plays a vital role in preventing erosion of barrier islands due to aeolian and hydrological forces. However, vegetation on barrier islands is threatened by rising water tables causing hypoxic conditions and storm-surge overwash introducing saline water to the root zone.

Patient-Specific Implant Customization for Treatment of Internal Orbital Fractures Using Office-Based Three-Dimensional Printing.

Objective: Three-dimensional (3D) modeling technology aids the reconstructive surgeon in designing and tailoring individualized implants for the reconstruction of complex craniofacial fractures. Three-dimensional modeling and printing have traditionally been outsourced to commercial vendors but can now be incorporated into both private and academic craniomaxillofacial practices. The goal of this report is to present a low-cost, standardized office-based workflow for restoring bony orbital volume in traumatic orbital fractures.

Multicenter study evaluating target attainment of anti-Factor Xa levels using various enoxaparin prophylactic dosing practices in adult trauma patients.

Study Objective: Enoxaparin is standard of care for venous thromboembolism (VTE) prophylaxis in adult trauma patients, but fixed-dose protocols are suboptimal. Dosing based on body mass index (BMI) or total body weight (TBW) improves target prophylactic anti-Xa level attainment and reduces VTE rates. A novel strategy using estimated blood volume (EBV) may be more effective based on results of a single-center study.

A 10-Year Retrospective Review on the Use of Prophylactic Spinal Reconstruction in Spinal Surgery Involving High-Risk Patients.

Background: Spinal surgeries are being offered to a broader patient population who are both medically and surgically complex. History of prior spinal surgery, advanced age, and presence of comorbidities, such as obesity, malnutrition, steroid use, and tobacco use, are risk factors for postoperative complications. Prophylactic spinal reconstruction at the time of spinal surgery has been shown to have improved outcomes and decreased wound complications; however, outcomes focusing specifically on complex patients with a history of previous spinal surgery (or surgeries) have not been well described.

Lymphedema Surgical Education and Faculty Demographics in United States Plastic Surgery Residency Programs.

Background:  Recent advancements in supermicrosurgery and promising preliminary outcomes have led to a surge in physiologic lymphedema surgery. This study is the first to evaluate lymphedema surgical education among U.S.

Gender and Racial Representation of Invited Speakers From The Aesthetic Society Annual Meetings Over a 5-Year Period.

Background: Increased representation from both women and non-White ethnicities remains a topic of discussion in plastic surgery. Speakers at academic conferences are a form of visual representation of diversity within the field. This study determined the current demographic landscape of aesthetic plastic surgery and evaluated whether underrepresented populations receive equal opportunities to be invited speakers at The Aesthetic Society meetings.

The Surgical Management of Migraines and Chronic Headaches: A Cross-sectional Review of American Insurance Coverage.

Background: Migraine headache can be an extremely debilitating condition, with pharmacotherapy for prophylaxis or treatment of acute symptoms being unsuccessful in a large proportion of patients. Surgical management of migraine has recently gained popularity as an alternative to pharmacotherapy for severe disease. However, the novel nature of these procedures may lead to variable insurance coverage, limiting access to care.

Integrated effects of bioturbation, warming and sea-level rise on mobility of sulfide and metalloids in sediment porewater of mangrove wetlands.

Global warming and sea-level rise exert profound impacts on coastal mangrove ecosystems, where widespread benthic crabs change sediment properties and regulate material cycles. How crab bioturbation perturbs the mobilities of bioavailable arsenic (As), antimony (Sb) and sulfide in sediment-water systems and their variability in response to temperature and sea-level rise is still unknown. By combining field monitoring and laboratory experiments, we found that As was mobilized under sulfidic conditions while Sb was mobilized under oxic conditions in mangrove sediments.

A Comprehensive 6-mo Prostate Cancer Patient Empowerment Program Decreases Psychological Distress Among Men Undergoing Curative Prostate Cancer Treatment: A Randomized Clinical Trial.

Background: Although survival rates for newly diagnosed prostate cancer patients are very high, most of them will likely suffer significant treatment-related side effects, depression, or anxiety, affecting their quality of life.

Objective: The aim of this study was to examine the effects of a 6-mo online home-based physical, mental, and social support intervention, the Prostate Cancer Patient Empowerment Program (PC-PEP), on preventing psychological distress among men undergoing curative prostate cancer treatment.

Design, Setting, And Participants: In a crossover randomized clinical trial of 128 men aged 50-82 yr scheduled for curative prostate cancer surgery or radiotherapy (± hormone treatment), 66 received the 6-mo PC-PEP intervention and 62 were randomized to a waitlist-control arm and received the standard of care for 6 mo, and then PC-PEP to the end of the year.

Insurance Coverage of Dermabrasion and Chemical Peel Procedures: A Critical Analysis of 58 American Insurance Companies.

Introduction Dermabrasion and chemical peels are infrequently utilized methods of treatment for medical-grade conditions despite demonstrations of favorable outcomes. Insurance coverage status has previously been shown to impact availability and accessibility to specific treatments. The purpose of this study is to evaluate the rate of insurance coverage provided for dermabrasion and chemical peel procedures in the treatment of acne, acne scarring, and non-melanoma skin cancers (NMSC).

Insurance Coverage of Prophylactic Mastectomies: A National Review of the United States.

Background: Breast cancer is associated with a multitude of risk factors, such as genetic predisposition and mutations, family history, personal medical history, or previous radiotherapy. A prophylactic mastectomy (PM) may be considered a suitable risk-reducing procedure in some cases. However, there are significant discrepancies between national society recommendations and insurance company requirements for PM.

In vitro fertilization: a cross-sectional analysis of 58 US insurance companies.

Purpose: Infertility affects one in eight women in the USA. In vitro fertilization (IVF) is an effective but costly treatment that lacks uniform insurance coverage. We evaluated the current insurance coverage landscape for IVF in America.

Hydrologic Control on Arsenic Cycling at the Groundwater-Surface Water Interface of a Tidal Channel.

Historical industrial activities have resulted in soil contamination at sites globally. Many of these sites are located along coastlines, making them vulnerable to hydrologic and biogeochemical alterations due to climate change and sea-level rise. However, the impact of hydrologic dynamics on contaminant mobility in tidal environments has not been well studied.

An In Vitro Model of the Efficacy of Breast Implant Irrigant Solutions Against Gram-Negative Infections.

Background: In implant-based breast surgery, infections remain a clinically challenging complication. Surgeons often prophylactically address this risk by irrigating the implant at the time of placement. However, there remain few data on the ideal irrigant for gram-negative species.

Surface Water-Groundwater Connections as Pathways for Inland Salinization of Coastal Aquifers.

Coastal agricultural zones are experiencing salinization due to accelerating rates of sea-level rise, causing reduction in crop yields and abandonment of farmland. Understanding mechanisms and drivers of this seawater intrusion (SWI) is key to mitigating its effects and predicting future vulnerability of groundwater resources to salinization. We implemented a monitoring network of pressure and specific conductivity (SC) sensors in wells and surface waters to target marsh-adjacent agricultural areas in greater Dover, Delaware.

Integrated Plastic Surgery Residency Applicant Perceptions of Virtual Interviews.

Purpose: The 2020-2021 interview cycle for integrated plastic surgery applicants was the first to be held virtually because of the COVID-19 pandemic. Here, we detail the largest study on integrated plastic surgery applicant perceptions after the virtual interview cycle.

Methods: A 35-question institutional review board-approved survey was distributed to medical students who had applied to the Johns Hopkins/University of Maryland or University of California San Diego integrated residency programs during the 2020-2021 interview cycle.

Changes in Burn Surgery Operative Volume and Metrics due to COVID-19.

Due to COVID-19, hospitals underwent drastic changes to operating room policy to mitigate the spread of the disease. Given these unprecedented measures, we aimed to look at the changes in operative volume and metrics of the burn surgery service at our institution. A retrospective review was conducted for operative cases and metrics for the months of March to May for 2019, 2020, and 2021, which correspond with pre-COVID, early COVID (period without elective cases), and late COVID (period with resumed elective cases).