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Christine K Kim,1,2 Steven Carter,2,3 Cinthia Kim,2 Tara Shooshani,1,2 Urmi Mehta,2,4 Kailey Marshall,2 Ryan G Smith,1,2,5 Alexander Knezevic,2,6– 8 Kavita Rao,1,2 Olivia L Lee,2 Marjan Farid2 1Department of Ophthalmology, University of California, Irvine, School of Medicine, 1001 Health Sciences Rd, Irvine, CA, 92617, USA; 2Gavin Herbert Eye Institute at University of California, Irvine School of Medicine, 850 Health Sciences Rd, Irvine, CA, 92617, USA; 3Miramar Eye Specialists Medical Group, Ventura, CA, 93003, USA; 4St John’s Episcopal Hospital, Far Rockaway, NY, 11691, USA; 5Pacific Eye Institute, Upland, CA 91786, USA; 6Macy Eye Center, Los Angeles, CA, 90048, USA; 7Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA; 8Jules Stein Eye Institute at University of California, Los Angeles, CA, 90095, USACorrespondence: Christine K Kim, Gavin Herbert Eye Institute at University of California, Irvine School of Medicine, 850 Health Sciences Road, Irvine, CA, 92617, USA, Tel +1 818 279 5029, Email chriskk4@hs.uci.eduPurpose: To elucidate risk factors for meibomian gland disease (MGD) and understand associated changes in meibography and in relation to ocular surface disease.Patients and Methods: As part of the standard workup for ocular surface disease at a tertiary academic center, 203 patients received an ocular history and lifestyle questionnaire. The questionnaire included detailed inquiries about ocular health and lifestyle, including makeup use, cosmetic eyelid procedures, screen time, and contact lens habits. Subjects also took the standardized patient evaluation of eye dryness (SPEED) II questionnaire. Meibomian gland (MG) dropout and structural changes were evaluated on meibography and scored by three independent graders using meiboscores. Statistical analysis was conducted to identify significant risk factors associated with MG loss.Results: This retrospective, cross-sectional study included 189 patients (378 eyes) with high-quality images for grading, and the average age was 67 years (77% female). Patients older than 45 years had significantly more dropout than younger patients (p < 0.01). Self-reported eye makeup use did not significantly impact MG loss. Patients with a history of blepharoplasty trended toward higher meiboscores, but the difference was not statistically significant. Self-reported screen time did not affect meiboscores. Contact lens use over 20 years was associated with significant MG loss (p < 0.05). SPEED II scores had no relationship to meiboscores (p = 0.75).Conclusion: Older age is a significant risk factor for MG loss. Any contact lens use over 20 years also impacted MG dropout. Highlighting the incongruence of symptoms to signs, SPEED II scores showed no relationship to the structural integrity of MGs.Keywords: dry eye, meibomian gland dropout, meiboscore, ocular surface disease

Abstract Background Anthropogenic pressures and climate change threaten the capacity of ecosystems to deliver a variety of services, including protecting coastal communities from hazards like flooding and erosion. Human interventions aim to buffer against or overcome these threats by providing physical protection for existing coastal infrastructure and communities, along with added ecological, social, or economic co-benefits. These interventions are a type of nature-based solution (NBS), broadly defined as actions working with nature to address societal challenges while also providing benefits for human well-being, biodiversity, and resilience. Despite the increasing popularity of NBS for coastal protection, sometimes in lieu of traditional hardened shorelines (e.g., oyster reefs instead of bulkheads), gaps remain in our understanding of whether common NBS interventions for coastal protection perform as intended. To help fill these knowledge gaps, we aim to identify, collate, and map the evidence base surrounding the performance of active NBS interventions related to coastal protection across a suite of ecological, physical, social, and economic outcomes in salt marsh, seagrass, kelp, mangrove, shellfish reef, and coral reef systems. The resulting evidence base will highlight the current knowledge on NBS performance and inform future uses of NBS meant for coastal protection. Methods Searches for primary literature on performance of NBS for coastal protection in shallow, biogenic ecosystems will be conducted using a predefined list of indexing platforms, bibliographic databases, open discovery citation indexes, and organizational databases and websites, as well as an online search engine and novel literature discovery tool. All searches will be conducted in English and will be restricted to literature published from 1980 to present. Resulting literature will be screened against set inclusion criteria (i.e., population, intervention, outcome, study type) at the level of title and abstract followed by full text. Screening will be facilitated by a web-based active learning tool that incorporates user feedback via machine learning to prioritize articles for review. Metadata will be extracted from articles that meet inclusion criteria and summarized in a narrative report detailing the distribution and abundance of evidence surrounding NBS performance, including evidence clusters, evidence gaps, and the precision and sensitivity of the search strategy.

Bulk metallic glasses can exhibit novel material properties for engineering scale components, but the experimental discovery of new alloy compositions is time intensive and thwarts the rate of discovery. This study presents an experimental, high-throughput methodology to increase the speed of discovery for potential bulk metallic glass alloys. A well-documented system, Mg-Cu-Y, was used as a model system. A laser additive manufacturing technique, directed energy deposition, was used for the in situ alloying of elemental powders to synthesize discrete compositions in the ternary system. The laser processing technique can supply the necessary cooling rates of 103–104 Ks−1 for bulk metallic glass formation. The in situ alloying enables the rapid synthesis of compositional libraries with larger sample sizes and discrete compositions than are provided by combinatorial thin films. Approximately 1000 discrete compositions can be synthesized in a day. Surface smoothness, as discerned by optical reflectivity, can suggest glass-forming alloys. X-ray diffraction coupled with energy dispersive X-ray spectroscopy can further refine amorphous alloy signatures and compositions. Transmission electron microscopy confirms amorphous samples. The tiered rate of amorphous alloy synthesis and characterization can survey a large compositional space and permits a glass-forming range to be identified within one week, making the process at least three orders of magnitude faster than other discrete composition techniques such as arc-melting or melt-spinning.

Rising sea levels, extreme weather events, and unsustainable coastal zone development pose serious threats to growing coastal communities. Human actions, such as shoreline development and hardening in at-risk areas, can damage nearshore ecosystems and exacerbate existing risks to coastal populations. A comprehensive understanding of shoreline changes in response to development, storm events, and sea-level rise is needed to effectively mitigate coastal hazards and promote adaptive and resilient coastlines. To determine whether human modification of shorelines can be accurately quantified and assessed over time, we evaluated past and present shoreline mapping and classification efforts in the United States. We coupled a review of available US shoreline data with a survey of coastal planners and managers involved with US state shoreline mapping programs. Using these data, we estimated the current extent of shoreline modification along the Atlantic, Pacific, and Gulf US coasts. However, we found that quantifying shoreline modifications over time nationally—or even within a single state—is currently infeasible due to changes in shoreline resolution associated with advances in shoreline mapping methodologies and a lack of regularly updated shoreline maps. State-level analysis from surveys revealed that 20 US coastal states have undertaken shoreline mapping projects, with sixteen tracking shoreline type and/or condition. However, of the 36 shoreline maps and databases identified, only half (18) were updated regularly or had planned updates. Lacking shoreline change data, coastal communities risk accepting increasingly degraded coastal zones and making poor management decisions based on shifted baselines. Thus, we recommend increasing the scale and funding for several ongoing innovative shoreline mapping efforts. These efforts are particularly focused on improving and standardizing shoreline mapping techniques, as well as establishing accurate baselines for shoreline conditions in the United States. Without accurate baselines and regular, consistent updates to shoreline data, managers cannot manage shorelines in a way that effectively mitigates coastal hazards while also promoting socio-ecological resilience in a changing climate.

Abstract Rapid global degradation of coastal habitats can be attributed to anthropogenic activities associated with coastal development, aquaculture, and recreational surface water use. Restoration of degraded habitats has proven challenging and costly, and there is a clear need to develop novel approaches that promote resilience to human‐caused disturbances. Positive interactions between species can mitigate environmental stress and recent work suggests that incorporating positive interactions into restoration efforts may improve restoration outcomes. We hypothesized that the addition of a potential facultative mutualist, the native hard clam (Mercenaria mercenaria), could enhance seagrass bed recovery from disturbance. We conducted two experiments to examine the independent and interacting effects of hard clam addition and physical disturbance mimicking propeller scarring on mixed community Zostera marina and Halodule wrightii seagrass beds in North Carolina. Adding clams to seagrass beds exposed to experimental disturbance generally enhanced seagrass summer growth rates and autumn shoot densities. In contrast, clam addition to non‐disturbed seagrass beds did not result in any increase in seagrass growth rates or shoot densities. Clam enhancement of autumn percent cover relative to areas without clam addition was most prominent after Hurricane Dorian, suggesting that clams may also enhance seagrass resilience to repeated disturbances. By June of the next growing season, disturbed areas with clam additions had greater percent cover of seagrass than disturbed areas without clam additions. Beds that were disturbed in April had higher percent cover than areas disturbed in June of the previous growing season. Our results suggest that the timing and occurrence of physical disturbances may modify the ability of clams to facilitate seagrass resiliency and productivity. Understanding when and how to utilize positive, interspecific interactions in coastal restoration is key for improving restoration success rates.

Abstract Shoreline hardening is a major driver of biodiversity and habitat loss in coastal ecosystems yet remains a common approach to coastal management globally. Using surveys of waterfront residents in North Carolina, USA, we sought to identify factors influencing individual shore‐protection decisions and ultimately impacting coastal ecosystems, particularly coastal wetlands. We found that neighboring shore condition was the best predictor of respondent shore condition. Respondents with hardened shorelines were more likely to have neighbors with hardened shorelines, and to report that neighbors influenced their shore‐protection choices than respondents with natural shorelines. Further, respondents who expressed climate‐change skepticism and preference for shoreline hardening were opposed to shoreline‐hardening restrictions. Despite preferring hardening, respondents ranked wetlands as highly valuable for storm protection and other ecosystem services, suggesting a disconnect between the ecological knowledge of individuals and social norms of shore‐protection decisions. However, our results also suggest that efforts to increase the installation of living shorelines have the potential to conserve and restore important coastal habitats and support biodiversity along shorelines that may otherwise be degraded by hardening. Further, encouraging waterfront‐property owners who have adopted living shorelines to recommend them to neighbors may be an effective strategy to initiate and reinforce pro‐conservation social norms.

Coastal marine ecosystems provide critical goods and services to humanity but many are experiencing rapid degradation. The need for effective restoration tools capable of promoting large-scale recovery of coastal ecosystems in the face of intensifying climatic stress has never been greater. We identify four major challenges for more effective implementation of coastal marine ecosystem restoration (MER): (1) development of effective, scalable restoration methods, (2) incorporation of innovative tools that promote climate adaptation, (3) integration of social and ecological restoration priorities, and (4) promotion of the perception and use of coastal MER as a scientifically credible management approach. Tackling these challenges should improve restoration success rates, heighten their recognition, and accelerate investment in and promotion of coastal MER. To reverse the accelerating decline of marine ecosystems, we discuss potential directions for meeting these challenges by applying coastal MER tools that are science-based and actionable. For coastal restoration to have a global impact, it must incorporate social science, technological and conceptual advances, and plan for future climate scenarios.

Active restoration is becoming an increasingly important conservation intervention to counteract the degradation of marine coastal ecosystems. Understanding what has motivated the scientific community to research the restoration of marine coastal ecosystems and how restoration research projects are funded is essential if we want to scale-up restoration interventions to meaningful extents. Here, we systematically review and synthesize data to understand the motivations for research on the restoration of coral reefs, seagrass, mangroves, saltmarsh, and oyster reefs. We base this analysis off a published database of marine restoration studies, originally designed to estimate the cost and feasibility of marine coastal restoration, derived from mostly scientific studies published in peer-reviewed and some gray literature. For the present study, the database was updated with fields aimed at assessing the motivations, outcomes, and funding sources for each project. We classify restoration motivations into five categories: biotic, experimental, idealistic, legislative, and pragmatic. Moreover, we evaluate the variables measured and outcomes reported by the researchers and evaluate whether projects adhered to the Society for Ecological Restoration's (SER) standards for the practice of ecological restoration. The most common motivation of the scientific community to study restoration in marine coastal ecosystems was experimental i.e., to seek experimental data to answer ecological research questions or improve restoration approach, as expected since mostly peer-reviewed literature was evaluated here. There were differences in motivations among the five coastal ecosystems. For instance, biodiversity enhancement was the most common case for a biotic motivation in mangrove restoration projects. The most common metrics evaluated were growth/productivity, survivorship, habitat function, physical attributes, and reproduction. For most ecosystems, ecological outcomes were frequently reported, with socio-economic implications of the restoration rarely mentioned, except for mangroves. Projects were largely funded by governmental grants with some investment from private donations, non-governmental organizations, and the involvement of volunteers. Our findings and database provide critical data to align future research of the scientific community with the real social, economic and policy needs required to scale-up marine coastal restoration projects.

In an era of rapid coastal population expansion and habitat degradation, restoration is becoming an increasingly important strategy for combating coastal habitat loss and maintaining ecosystem services. In particular, techniques that use habitat restoration alone or restoration in combination with built infrastructure to provide coastal protective services are growing in popularity. These novel approaches, often called living shorelines, have the potential to expand the reach and applicability of coastal restoration projects. To understand how living shorelines research has expanded over time, we conducted a scoping review of English-language peer-reviewed articles. We included papers that self-identified as living shorelines research, as well as studies that used other related terminology, to investigate trends in publication rates, geography, site characteristics, and outcomes measured. Using a systematic search protocol, we compiled a database of 46 papers; the earliest study was published in 1981, and the earliest study to use the term living shoreline was published in 2008. Eighty-three percent of studies were conducted in North America, followed by 11% in Asia, and 7% in Europe, but the use of the term living shoreline was almost exclusively restricted to North America. Saltmarshes, oyster reefs, mangroves, and freshwater vegetation were used in living shoreline designs, but 91% of studies also incorporated structural materials like oyster shell and rock. Most living shorelines research was conducted at sites that were

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. Keywords: Spinal cord herniation, Nerve root avulsion, Brachial plexus injury, Complication, Pseudomeningocoele

Coastal fisheries are in decline worldwide, and aquaculture has become an increasingly popular way to meet seafood demand. While finfish aquaculture can have substantial adverse effects on coastal ecosystems due mostly to necessary feed inputs, bivalves graze on natural phytoplankton and are often considered for their positive ecosystem services. We conducted two independent studies to investigate the effects of long-line Crassostrea gigas oyster aquaculture on Zostera marina seagrass beds and associated epibiont communities in Akkeshi-ko estuary, Japan. Results from both studies yielded no evidence of an effect of oyster aquaculture on the morphology, density, or biomass of Z. marina, but significant differences were apparent in the epibiont community. Reference seagrass beds located away from aquaculture had higher seagrass epiphyte loads and higher abundances of amphipods. Conversely, seagrass beds below aquaculture lines had higher sessile polychaete biomass and higher isopod abundances. Our results suggest that the presence of oyster aquaculture may have indirect effects on seagrass by changing epibiont community composition and relative abundances of species. One proposed mechanism is that cultured oysters feed on epiphytic diatoms and epiphyte propagules before they can settle on the seagrass, which reduces epiphyte loads and influences subsequent faunal settlement. If carefully implemented and monitored, long-line oyster aquaculture may be a sustainable option to consider as bivalve aquaculture expands to meet global seafood demand, but further work is needed to fully assess and generalize the community-level effects on seagrass epibionts.

Sophie Carter,1,* Alexandre Caron,2,* Denis Richard,2 Frédéric Picard1 1Faculty of Pharmacy, 2Faculty of Medicine, Dept Anatomy and Physiology, Université Laval, Québec, QC, Canada *These authors contributed equally to the work Abstract: Obesity is a global epidemic associated with aging-like cellular processes; in both aging and obesity, resistance to hormones such as insulin and leptin can be observed. Leptin is a circulating hormone/cytokine with central and peripheral effects that is released mainly by subcutaneous white adipose tissue. Centrally, leptin controls food intake, energy expenditure, and fat distribution, whereas it controls (among several others) insulin sensitivity, free fatty acids (FFAs) oxidation, and lipolysis in the periphery. Aging is associated with important changes in both the distribution and the composition of adipose tissue. Fat is redistributed from the subcutaneous to the visceral depot and increased inflammation participates in adipocyte dysfunction. This redistribution of adipose tissue in favor of visceral fat influences negatively both longevity and healthy aging as shown in numerous animal models. These modifications observed during aging are also associated with leptin resistance. This resistance blunts normal central and peripheral functions of leptin, which leads to a decrease in neuroendocrine function and insulin sensitivity, an imbalance in energy regulation, and disturbances in lipid metabolism. Here, we review how age-related leptin resistance triggers metabolic disturbances and affects the longevity of obese patients. Furthermore, we discuss the potential impacts of leptin resistance on the decline of brown adipose tissue thermogenesis observed in elderly individuals. Keywords: leptin, obesity, aging, insulin sensitivity, brown adipose tissue

Background: Fatigue is a multidimensional problem affecting patients suffering from Parkinson’s disease (PD). It is ranked as one of the most bothersome symptom of patients with Parkinson’s disease. The study primarily aims to determine the presence of fatigue among clinically stable and independent Filipino patients suffering from idiopathic PD. Methods: This study is a prospective cross-sectional study. Recruited patients and control group were all Filipinos. Only independent patients with idiopathic, stable and non-fluctuating PD were included in the study. Those eligible underwent a multitude of screening tests to rule out presence of dementia (Mini Mental Status Examination, MMSE), depression (Montgomery-Åsberg Depression Rating Scale, MADRS), anxiety (Hamilton Anxiety Scale, HAM-A) and sleep disturbance. Disease severity was assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS) and fatigue severity using both the Multicomponent Fatigue Index (MFI) and Fatigue Severity Inventory (FSI). Results: Twenty-eight patients underwent the study. The mean Hoehn and Yahr staging was 1.79. Patients with PD scored higher on both FSI and MFI (individual dimension scores and total score) as compared to the normal controls. Conclusions: The outcome of the study confirmed the presence of fatigue (general, physical, mental), even in clinically stable and independent patients suffering from idiopathic PD, when compared with age-matched healthy controls.

Objectives: To (1) investigate the relationships between students’ characteristics and their (a) perceptions of research in general and (b) attitudes towards pharmacy practice research; (2) identify strategies that could be used by pharmacy educators to promote research interest in pharmacy practice; and (3) identify perceived barriers to the pursuit or completion of a pharmacy practice research degree. Methods: A survey was administered to all students enrolled in each year of the four-year pharmacy undergraduate program, University of Sydney, Australia. Perceptions of research in general were measured using 4 items on a five-point semantic-differential scale and attitudes towards pharmacy practice research were measured using 16 items on a five-point Likert scale. Student characteristics were also collected as were responses to open-ended questions which were analysed using content analysis. Results: In total 853 students participated and completed the survey (83% response rate). Participants’ characteristics were associated with some but not all aspects of research and pharmacy practice research. It appeared that positive attitudes and perspectives were influenced strongly by exposure to the ‘research’ process through projects, friends or mentors, previous degrees or having future intentions to pursue a research degree. Results from both the quantitative and qualitative analyses suggest positive attitudes and perceptions of research can be nurtured through the formal inclusion in research processes, particularly the utility of practice research in clinical practice across the four years of study. Participants indicated there was a lack of awareness of the needs, benefits and career opportunities associated with pharmacy practice research and voiced clear impediments in their career path with respect to the choice of practice research-related careers. Conclusions: Future research should investigate changes in perceptions and attitudes in a single cohort over the four-year degree, other factors influencing students’ perceptions and attitudes, and evaluate the effectiveness of research promoting strategies and programs.

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.

Inorganic semiconductor nanocrystals interfaced with spin-triplet exciton-accepting organic molecules have emerged as promising materials for converting incoherent long-wavelength light into the visible range. However, these materials to date have made exclusive use of nanocrystals containing toxic elements, precluding their use in biological or environmentally sensitive applications. Here, we address this challenge by chemically functionalizing non-toxic silicon nanocrystals with triplet-accepting anthracene ligands. Photoexciting these structures drives spin-triplet exciton transfer from silicon to anthracene through a single 15 ns Dexter energy transfer step with a nearly 50% yield. When paired with 9,10-diphenylanthracene emitters, these particles readily upconvert 488-640 nm photons to 425 nm violet light with efficiencies as high as 7 ± 0.9% and can be readily incorporated into aqueous micelles for biological use. Our demonstration of spin-triplet exciton transfer from silicon to molecular triplet acceptors can critically enable new technologies for solar energy conversion, quantum information and near-infrared driven photocatalysis.