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Summary Infrastructure must become more resilient as the global climate changes and also more affordable in the economic and political context of a post-COVID world. We can solve this dual challenge and drive global infrastructure investment into a more sustainable direction by taking our cues from Nature.

Background Spinal cord herniation (SCH) is often described as occurring spontaneously in the thoracic spine, with few cases of cervical SCH reported as a late complication of traumatic brachial plexus avulsion. We present 2 cases of nerve root avulsion and pseudomeningocele formation, resulting in delayed cervical SCH and neurologic deterioration. Case Description Case 1: A 37-year old man presented with progressive leg weakness 2 years after experiencing traumatic C8 and T1 root avulsions. Magnetic resonance imaging (MRI) showed previously documented C8–T1 nerve avulsions with new SCH in a T1 pseudomeningocele. A C7–T1 costotransversectomy and C4–T4 instrumented fusion were completed, allowing SCH reduction and patch graft repair of the dural defects without the need for adhesiolysis. At last follow-up, the patient's leg weakness had resolved. Case 2: A 32-year old man presented with progressive right arm numbness, weakness, and signs of myelopathy 9 years after experiencing C8 and T1 root avulsions. MRI showed previously documented root avulsions and new SCH with extensive and compressive pseudomeningocele formation. A C7 transpedicular approach with C5–T1 instrumented fusion was completed for dural repair. A large pseudomeningocele was found and drained on drilling the C7 pedicle, and adhesiolysis was required at the spinal cord avulsion site to reduce the SCH and allow patch graft repair. At last follow-up, the patient's right arm weakness was improving, although numbness persisted. Conclusions SCH is a rare cause of delayed neurologic deterioration after brachial plexus avulsion, with few case reports describing its occurrence. We present 2 cases of this complication and describe its successful surgical treatment through dural repair after instrumented fusion.

Hurricanes and tropical storms are among the most frequent and costly natural disasters in the United States, and their impacts are expected to intensify in the future. Understanding the best predictors of hurricane damage in coastal areas is of paramount importance for reducing recovery costs and protecting coastal infrastructure and human lives. This project used surveys of 295 homeowners in coastal North Carolina to evaluate damage to estuarine shorelines and homes caused by Hurricane Matthew in 2016. Specifically, we were interested in the following questions: 1) did homes with hardened shorelines (e.g. bulkheads and riprap revetments) experience more or less damage than homes with natural shorelines during the storm; and, 2) what were the strongest predictors of hurricane damage to shorelines and homes. Overall, we found that past hurricane damage to shorelines was the strongest predictor of shoreline damage during Hurricane Matthew and that flood zone and past hurricane damage to homes were the strongest predictors of home damage. However, homes with bulkheads also sustained more hurricane damage than homes with natural shorelines, perhaps because homes with bulkheads were on average 2 times closer to the shoreline than homes with natural shorelines. Our results show patterns of repeated shoreline and home damage during hurricanes and indicate that environmental context and vulnerability can outweigh individual residents’ shoreline management decisions.

Species occupying similar habitat and functional niches will necessarily have some external force driving differentiation between them, thus creating complementarity, or otherwise face high competition for resources. In order to fully understand the role of each species in an ecosystem and their contributions to ecosystem function, it is important to understand the nature of these interactions. However, for species that occur in the same spatial niche and appear to occupy redundant functional niches, it is often difficult to distinguish between complementarity and redundancy and therefore to designate the functional role each species plays. We used two co-occurring fiddler crab species that are presumed to be functionally similar, Leptuca pugilator (sand fiddler crab) and Minuca pugnax (mud fiddler crab), to explore how species interactions may influence burrowing behavior. We ran manipulative mesocosm experiments to assess potential effects of species interactions on the number and location of burrows as well as the burrowing behavior of the crabs. Overall, sand fiddler crabs dug more burrows on average than mud fiddlers across all experiments while mud fiddlers were choosier about the location and sediment type of their burrows, suggesting complementarity in burrowing between the two species. Burrow counts in heterospecific treatments suggest that neither species interfered with nor enhanced burrow creation by the other species. However, increased burrow occupancy by mud fiddlers in the presence of sand fiddlers and aggressive behavior by mud fiddlers toward sand fiddlers suggest that mud fiddler crabs may receive refuge benefits from sand fiddler crabs through antagonistic rather than facilitative interactions. Thus, species-specific habitat use and interspecific interactions are likely influencing the role each species plays as a burrower and marsh ecosystem engineer .

Rapid human development in coastal areas is introducing significant amounts of novel habitat and leading to widespread habitat simplification. To predict how species will respond to these changes, it is important to understand how organisms interact with novel habitats versus naturally existing habitats. In this study, we used traditional fish sampling gear (fyke nets and minnow traps) and a Dual-Frequency Identification Sonar (DIDSON) to conduct fish surveys along natural and modified estuarine shorelines in North Carolina, USA. The overall objective of our study was to investigate how fish abundance and other community metrics change as a function of shoreline type (natural marsh, living shoreline, or bulkhead), sampling location (marsh platform or the shallow subtidal area offshore of the structure), and time of day (day or night). Using fyke nets, we caught significantly more fish and recorded higher species richness on the marsh platform at living shorelines versus natural marsh shorelines. However, we found no significant differences in fish abundance in the shallow unvegetated habitats seaward of the different shoreline types, which may have been affected by low sampling efficiency and replication when sampled using minnow traps and the DIDSON. Our findings, in conjunction with similar studies, may reflect a localized shoreline effect where the nursery enhancement observed at living shoreline sites is restricted to the living component of the shoreline (i.e., the marsh). Additionally, the preliminary results from our limited daytime versus nighttime DIDSON sampling show no significant differences in fish detections. This contrasts with many previous studies using traditional fish sampling techniques that report substantially higher fish catches at night. This unexpected finding is worthy of additional research as it may suggest that traditional fish sampling techniques are underestimating fish abundances during the day, perhaps due to visual gear avoidance. Ultimately, a careful consideration of the social and ecological goals of any shoreline stabilization project is needed before choosing a final design; however, maximizing habitat restoration and limiting the use of artificial materials is likely to confer the greatest ecological benefit.

Growing coastal populations, rising sea levels, and likely increases in the frequency of major storm events will intensify coastal vulnerability in coming decades. Decisions regarding how and when to fortify estuarine shorelines against coastal hazards, such as erosion, flooding, and attendant property damages, rest largely in the hands of waterfront-property owners. Traditionally, hard engineered structures (e.g. bulkheads, revetments, seawalls) have been used to protect coastal properties, based on the assumption that these structures are durable and effective at preventing erosion. This study evaluates the validity of these assumptions by merging results from 689 surveys of waterfront-property owners in NC with empirical shoreline damage data collected along estuarine shorelines after Hurricanes Irene (2011) and Arthur (2014). The data show: 1) homeowners perceive bulkheads to be the most durable and effective at preventing erosion, but also the most costly; 2) compared to residents with revetments and natural shorelines, property owners with bulkheads reported double the price to repair hurricane damage to their property and four times the cost for annual shoreline maintenance; 3) 93% of evident post-hurricane shoreline damage was attributable to bulkheads or bulkhead hybrids and a higher proportion of surveyed homeowners with bulkheads reported having property damage from hurricanes; and, 4) shoreline hardening increased by 3.5% from 2011 to 2016 along 39 km of the Outer Banks. These results suggest that bulkheads are not meeting waterfront property-owner expectations despite continued use, and that nature-based coastal protection schemes may be able to more effectively align with homeowner needs.

Spinal cord herniation (SCH) is a rare cause of myelopathy. When reported, SCH has most commonly been described as occurring spontaneously in the thoracic spine, and being idiopathic in nature (anterior thoracic spinal cord herniation, ATSCH) [1–3]. Several theories have been proposed to explain its occurrence, including congenital, inflammatory, and traumatic etiologies alike [1–4]. Even more rarely, SCH has been described to occur in the cervical spine in association with brachial plexus avulsion injuries (BPAI-SCH). In our accompanying article, “Late Cervical Spinal Cord Herniation Resulting from Post-Traumatic Brachial Plexus Avulsion Injury,” two cases of BPAI-SCH are presented and discussed in the context of the reviewed literature [5]. Here, pertinent accompanying follow-up data was collected and is presented for the cases, including postoperative radiographic outcome imaging. Furthermore, a table is presented comparing and contrasting ATSCH to BPAI-SCH. Although the two phenomena have been previously grouped together, this table highlights ATSCH and BPAI-SCH as distinct entities; more specifically, BPAI-SCH is a separate, long-term complicating feature of BPAI. This supplementary data helps treating physicians by increasing awareness and knowledge of BPAI-SCH as a distinct entity from ATSCH and cause of delayed neurological deterioration., Highlights • Myelopathy due to spinal cord herniation (SCH) is rare. • Brachial plexus avulsion injury associated SCH (BPAI-SCH) is a unique type of SCH. • Follow-up data for a case of BPAI-SCH treatment is presented. • BPAI-SCH is compared and contrasted with more common SCH subtypes. • BPAI-SCH recognition and treatment is essential for patient improvement.

Posterior decompressive procedures are a fundamental component of the surgical treatment of symptomatic cervical degenerative disease. Posterior approaches have the appeal of avoiding complications associated with anterior approaches such as esophageal injury, recurrent laryngeal nerve paralysis, dysphagia, and adjacent-level disease after fusion. Although open procedures are effective, the extensive subperiosteal stripping of the paraspinal musculature leads to increased blood loss, longer hospital stays, and more postoperative pain, and potentially contributes to instability. Minimally invasive access has been developed to limit approach-related morbidity. This article reviews current techniques in minimally invasive surgical management of cervical myelopathy and radiculopathy.