This land is your land, this could be marsh land: Property parcel characteristics of marsh migration corridors in Rhode Island, USA.

Salt marshes, critical habitats offering many ecosystem services, are threatened by development, accelerated sea level rise (SLR) and other anthropogenic stressors that are projected to worsen. As seas rise, some salt marshes can migrate inland if there is adjacent, permeable, undeveloped land available. Facilitating marsh migration is necessary for coastal resilience efforts, but extensive coastal development can make finding suitable migration corridors challenging. This work seeks to characterize changes in land use, ownership, and economic value at the property parcel level within current versus future marsh areas for the state of Rhode Island, USA. We find that most parcels currently containing salt marsh are publicly owned, whereas most adjacent parcels projected to contain new salt marsh in 2050 are privately owned. Additionally, parcels containing new marsh in 2050 have 47% higher per-hectare assessed values than parcels containing current marsh. We describe the locations and characteristics of parcels within migration corridors with the lowest per-hectare values that may be the most cost-effective for marsh conservation practitioners to protect. This study highlights the expanding land use types and landowner sets that will be involved in marsh conservation decisions, and the economic value of potential migration corridors where costly tradeoffs may be necessary to promote coastal resilience.

Segregation of formulated powders in direct compression process and evaluations by small bench-scale testers.

Powder segregation can cause severe issues in processes of pharmaceutical drugs for control of content uniformity if the powder is likely to be free or easy flowing. Assessing segregation intensity of formulated powders in a process is challenging at the formulation stage because of the limited availability of samples. An advanced segregation evaluation using small bench-scale testers can be useful for formulation decisions and suggestions of operation conditions in the process, which has not been practically investigated before. In this study, eight formulations (two co-processed excipients blended with one active pharmaceutical ingredient at different ratios) were used for the segregation study on two types of bench-scale testers (air-induced and surface rolling segregation tester), and a pilot simulation process rig as a comparative study. The results show that segregation measured on the bench-scale testers can give a good indication of the segregation intensity of a blend if the segregation intensity is not more than 20%. The comparison also shows that both the bench-scale testers have a good correlation to the process rig, respectively, which means either segregation tester can be used independently for the evaluation. A linear regression model was explored for prediction of segregation in the process.

Improving alignment in total knee arthroplasty: a cadaveric assessment of a surgical navigation tool with computed tomography imaging.

PURPOSE: To investigate the accuracy of an imageless, optical surgical navigation tool to assist with femoral and tibial bone cuts performed during TKA. PATIENTS AND METHODS: Six board-certified orthopedic surgeons participated in a laboratory cadaver investigation, performing femoral and tibial bone cuts with the assistance of a computer navigation tool. Femoral and tibial varus/valgus, tibial slope, femoral flexion, and both femoral and tibial rotation measurements from the device were compared with angular measurements calculated from computed tomography (CT) images of the knees. RESULTS: Measurements with the navigation tool were highly correlated with those obtained from CT scans in all three axes. For the distal femoral cut, the absolute mean difference in varus/valgus was 0.83° (SD 0.46°, r = 0.76), femoral flexion was 1.91° (SD 1.16°, r = 0.85), and femoral rotation was 1.29° (SD 1.01°, r = 0.88) relative to Whiteside's line and 0.97° (SD 0.56°, r = 0.81) relative to the posterior condylar axis. For the tibia, the absolute mean difference in varus/valgus was 1.08° (SD 0.64°, r = 0.85), posterior slope was 2.78° (SD 1.40°, r = 0.60), and rotation relative to the anteroposterior axis (posterior cruciate ligament to the medial third of the tibial tuberosity) was 2.98° (SD 2.54°, r = 0.79). CONCLUSION: Utilization of an imageless navigation tool may aid surgeons in accurately performing and monitoring femoral and tibial bone cuts, and implant rotation in TKA and thus, more accurately align TKA components.

Ultra-Low-Cost Disposable Hand-Held Clinical-Scale Propane Gas Hyperpolarizer for Pulmonary Magnetic Resonance Imaging Sensing.

Hyperpolarized magnetic resonance imaging (MRI) contrast agents are revolutionizing the field of biomedical imaging. Hyperpolarized Xe-129 was recently FDA approved as an inhalable MRI contrast agent for functional lung imaging sensing. Despite success in research settings, modern Xe-129 hyperpolarizers are expensive (up to $1M), large, and complex to site and operate. Moreover, Xe-129 sensing requires specialized MRI hardware that is not commonly available on clinical MRI scanners. Here, we demonstrate that proton-hyperpolarized propane gas can be produced on demand using a disposable, hand-held, clinical-scale hyperpolarizer via parahydrogen-induced polarization, which relies on parahydrogen as a source of hyperpolarization. The device consists of a heterogeneous catalytic reactor connected to a gas mixture storage can containing pressurized hyperpolarization precursors: propylene and parahydrogen (10 bar total pressure). Once the built-in flow valve of the storage can is actuated, the precursors are ejected from the can into a reactor, and a stream of hyperpolarized propane gas is ejected from the reactor. Robust operation of the device is demonstrated for producing proton sensing polarization of 1.2% in a wide range of operational pressures and gas flow rates. We demonstrate that the propylene/parahydrogen gas mixture can retain potency for days in the storage can with a monoexponential decay time constant of 6.0 ± 0.5 days, which is limited by the lifetime of the parahydrogen singlet spin state in the storage container. The utility of the produced sensing agent is demonstrated for phantom imaging on a 3 T clinical MRI scanner located 100 miles from the agent/device preparation site and also for ventilation imaging of excised pig lungs using a 0.35 T clinical MRI scanner. The cost of the device components is less than $35, which we envision can be reduced to less than $5 for mass-scale production. The hyperpolarizer device can be reused, recycled, or disposed.

Medication Deprescribing Among Patients With Type 2 Diabetes: A Qualitative Case Series of Lifestyle Medicine Practitioner Protocols.

This study is a qualitative case series of lifestyle medicine practitioners' protocols for medication de-escalation in the context of reduced need for glucose-lowering medications due to lifestyle modifications. Increasing numbers of lifestyle medicine practitioners report achieving reductions in medications among patients with type 2 diabetes, and in some cases remission, but limited data exist on the clinical decision-making process used to determine when and how medications are deprescribed. Practitioners interviewed here provide accounts of their deprescribing protocols. This information can serve as pilot data for other practitioners seeking examples of how deprescribing in the context of lifestyle medicine treatment is conducted.

Computer-Assisted Navigation Accurately Delivers Preoperative Targets for Acetabular Component Orientation During Direct Anterior Approach Total Hip Arthroplasty.

Despite its success, total hip arthroplasty (THA) remains associated with potentially significant complications associated with component malposition. Preoperative planning can mitigate some of these potential concerns; however, the accurate intraoperative delivery of preoperative targets can be challenging. Computer-assisted navigation may assist with intraoperative target delivery, although the integration of these two technologies is relatively uncommon. We retrospectively reviewed cases of THA planned with a computed tomography-based preoperative planning software and performed with the use of an imageless, computer-assisted navigation system. Postoperative acetabular component orientation from radiographs was compared with preoperative targets and intraoperative navigation measurements. A total of 76 patients were included in the analysis. The mean anteversion target (20.0°±3.1°) did not differ significantly from the mean intraoperative navigation measurement (20.5°±3.3°; P=.30; mean difference, 2.2°±2.3°). The mean radiographic measurement (26.6°±6.5°) differed from the target by a mean of 7.5°±6.1° (P<.001). The mean inclination target (38.4°±1.9°) did not differ significantly from the mean intra-operative measurement (38.0°±1.5°; P=.20; mean difference, 1.3°±1.7°) but differed from the radiographic measurement by a mean of 5.2°±4.2° (41.8°±5.6°; P<.001). No adverse events were reported in the 90-day period following the index procedure. Our study demonstrated that an imageless navigation system can accurately deliver computed tomography-derived preoperative targets for acetabular component orientation. Differences noted on radiographs may be due to the difference in patient positioning for the postoperative imaging (standing) as compared with preoperative imaging or surgery itself (supine). [Orthopedics. 2023;46(4):218-223.].

Hazardous and contaminated sites within salt marsh migration corridors in Rhode Island, USA.

As salt marshes attempt to migrate upland due to sea level rise, they will encounter many kinds of land development and infrastructure in highly populated, urbanized coastal communities. Hazardous and contaminated sites (HCSs) -- facilities and infrastructure that store, use, or release harmful substances -- are particularly concerning obstacles to salt marsh migration because of their potential to release contaminants if their structural integrity is compromised. Inventorying HCSs within migration pathways can inform coastal resilience planning. To understand what kinds of HCSs migrating marsh may encounter in Rhode Island, USA, we inventoried sites from federal and state sources, assigned contaminant hazard rankings to most sites, and overlayed them with projected marsh migration corridors. We found that HCSs are extensive across marsh migration corridors in the state, especially in urban areas. Among the most common HCSs in and around Rhode Island salt marshes are stormwater outfalls, underground storage tanks, and facilities registered with EPA's Resource Conservation and Recovery Act (RCRA) or EPA's National Pollutant Discharge Elimination System (NPDES). These sites pose varying hazards to human and aquatic life if breached, with some sites representing little or no threat but most posing some degree of hazard to their surroundings. This coastal HCSs inventory can inform prioritization and management of coastal salt marshes subject to accelerated sea level rise. Management decisions such as allowing marsh migration, implementing adaptation actions to build salt marsh elevation, or erecting physical barriers at marsh sites will influence future salt marsh extent, marshes' ability to provide ecosystem services, and public health exposures to toxic releases. In addition, as Rhode Island and other coastal states work to promote coastal resiliency, this type of inventory can inform decisions about which HCSs to prioritize for remediation and other climate adaptation actions. Marsh migration is just one potential consequence of sea level rise, so many of the considerations outlined here are widely applicable to the broader goal of preparing coastal communities for rising seas.

Evaluating the Functional Equivalency of Test Organism Performance in Negative and Solvent Controls During Chronic Sediment Ecotoxicity Studies Based on US Environmental Protection Agency Guidance.

The US Environmental Protection Agency (USEPA) considers sediment toxicity tests as conditional registration requirements for pesticides with soil Kd ≥50 L/kg-solid, Koc ≥1000 L/kg-organic carbon, or log Kow ≥3. The hydrophobicity of these compounds often necessitates use of solvents to ensure accurate and homogeneous dosing of spiked-sediment studies. For sediment tests, a volatile solvent (e.g., acetone) is generally used as a transient carrier. Due to low water solubility, test material is dissolved in a volatile solvent to create stock solutions. A measured aliquot of stock solution is then mixed with sand substrate, after which the solvent is evaporated. This spiking process results in negligible solvent exposure to organisms. In 2016, USEPA released final ecotoxicity test guidelines for subchronic freshwater (850.1735) and marine (850.1740) sediment test. These methods provide an option for conducting experiments with only a solvent control and no negative control. To adopt this testing strategy, functional equivalency between the negative and solvent control must be demonstrated. These test guidelines describe specific factors that should be considered for evaluating functional equivalency, including (a) the concentration of solvent in the test sediment after evaporation, (b) the levels of solvent that are known to affect organism health, (c) the known impurities in the solvent and their potential impact on organism health, and (d) the historical organism performance of solvent versus negative controls. Our analysis considers these factors and overall supports the elimination of the negative control requirement because this change is unlikely to impact the robustness or interpretability of spiked-sediment toxicity tests. Environ Toxicol Chem 2023;00:1-7. © 2023 CropLife America. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Determining the heat of desorption for cassava products based on data measured by an automated gravimetric moisture sorption system.

BACKGROUND: The isosteric heat of desorption is vital in evaluating the energy performance of food dryers. The isosteric heat of desorption was investigated for different cassava (Manihot esculenta Crantz) products prepared as flour or starch, with and without fermentation. An automated moisture sorption gravimetric analyser was used to measure the desorption isotherms over 10-90% relative humidity of the drying air at temperatures ranging from 25 to 65 °C. RESULTS: Analysis of variance showed an imperceptible contribution of the preparation method in the measured desorption data. This finding also agreed with microscopical images, which revealed the lack of compelling structural differences among different products. A set of empirical sorption equations suggested by the ASAE standard was examined over the measured desorption isotherms. The standard error of estimation was found to be in the acceptable range of 2.36-3.71%. Furthermore, the fulfilment of the enthalpy-entropy compensation theory was considered as an additional criterion in the thermodynamic results of different sorption equations, besides their fitting adequacy. The modified Chung-Pfost equation has proved to be the most suitable equation for cassava products, as it is capable of reflecting the temperature dependency of the isosteric heat of desorption. The net isosteric heat of desorption obtained was in the range of 540-1110 kJ kg-1 for 0.10 kg kg-1 dry-basis moisture content and 52-108 kJ kg-1 for 0.25 kg kg-1 dry-basis moisture content. CONCLUSION: These findings are technologically relevant for optimising common drying technologies such as flash and flatbed dryers. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Laying it on thick: Ecosystem effects of sediment placement on a microtidal Rhode Island salt marsh.

Heightened recognition of impacts to coastal salt marshes from sea-level rise has led to expanding interest in using thin-layer sediment placement (TLP) as an adaptation tool to enhance future marsh resilience. Building on successes and lessons learned from the Gulf and southeast U.S. coasts, projects are now underway in other regions, including New England where the effects of TLP on marsh ecosystems and processes are less clear. In this study, we report on early responses of a drowning, microtidal Rhode Island marsh (Ninigret Marsh, Charlestown, RI) to the application of a thick (10-48 cm) application of sandy dredged material and complimentary extensive adaptive management to quickly build elevation capital and enhance declining high marsh plant species. Physical changes occurred quickly. Elevation capital, rates of marsh elevation gain, and soil drainage all increased, while surface inundation, die-off areas, and surface ponding were greatly reduced. Much of the marsh revegetated within a few years, exhibiting aspects of classic successional processes leading to new expansive areas of high marsh species, although low marsh Spartina alterniflora recovered more slowly. Faunal communities, including nekton and birds, were largely unaffected by sediment placement. Overall, sediment placement provided Ninigret Marsh with an estimated 67-320 years of ambient elevation gain, increasing its resilience and likely long-term persistence. Project stakeholders intentionally aimed for the upper end of high marsh plant elevation growth ranges to build elevation capital and minimize maintenance costs, which also resulted in new migration corridors, providing pathways for future marsh expansion.

Comparative studies of powder flow predictions using milligrams of powder for identifying powder flow issues.

Characterising powder flowability can be challenging when sample quantity is insufficient for a conventional shear cell test, especially in the pharmaceutical industry, where the cost of the active pharmaceutical ingredient (API) used is expensive at an early stage in the drug product development. A previous study demonstrated that powder flowability could be predicted based on powder physical properties and cohesiveness using a small quantity of powder samples (50 mg), but it remained an open question regarding the accuracy of the prediction compared to that measured using industry-standard shear cell testers and its potential to substitute the existing testers. In this study, 16 pharmaceutical powders were selected for a detailed comparative study of the predictive model. The flowability of the powders was predicted using a Bond number and given consolidation stresses, σ1, coupled with the model, where the Bond number represents powder cohesiveness. Compared to the measurements using a Powder Flow Tester (Brookfield) and an FT4 (Freeman Technology) Powder Rheometer shear cell tester, the results showed a good agreement between the predictions and the measurements (<22 % difference) from the two shear cell testers with different consolidation stresses, especially for cohesive materials. The model correctly predicts the class of flowability for 14 and 12 of the 16 powders for the PFT and the FT4, respectively. The study demonstrated that the prediction method of powder flowability using a small sample (50 mg) could substitute a standard shear cell test (>15 g) if the available amount of sample is small.

The role of context in elucidating drivers of animal movement.

Despite its consequences for ecological processes and population dynamics, intra-specific variability is frequently overlooked in animal movement studies. Consequently, the necessary resolution to reveal drivers of individual movement decisions is often lost as animal movement data are aggregated to infer average or population patterns. Thus, an empirical understanding of why a given movement pattern occurs remains patchy for many taxa, especially in marine systems. Nonetheless, movement is often rationalized as being driven by basic life history requirements, such as acquiring energy (feeding), reproduction, predator-avoidance, and remaining in suitable environmental conditions. However, these life history requirements are central to every individual within a species and thus do not sufficiently account for the high intra-specific variability in movement behavior and hence fail to fully explain the occurrence of multiple movement strategies within a species. Animal movement appears highly context dependent as, for example, within the same location, the behavior of both resident and migratory individuals is driven by life history requirements, such as feeding or reproduction, however different movement strategies are utilized to fulfill them. A systematic taxa-wide approach that, instead of averaging population patterns, incorporates and utilizes intra-specific variability to enable predictions as to which movement patterns can be expected under a certain context, is needed. Here, we use intra-specific variability in elasmobranchs as a case study to introduce a stepwise approach for studying animal movement drivers that is based on a context-dependence framework. We examine relevant literature to illustrate how this context-focused approach can aid in reliably identifying drivers of a specific movement pattern. Ultimately, incorporating behavioral variability in the study of movement drivers can assist in making predictions about behavioral responses to environmental change, overcoming tagging biases, and establishing more efficient conservation measures.

Evaluation of alfaxalone total intravenous anesthesia in rabbits (Oryctolagus cuniculus) premedicated with dexmedetomidine or dexmedetomidine and buprenorphine.

OBJECTIVE: To evaluate alfaxalone for total intravenous anesthesia (TIVA) in rabbits premedicated with dexmedetomidine or dexmedetomidine and buprenorphine. STUDY DESIGN: Crossover study (part 1) with observational study (part 2). ANIMALS: A total of eight New Zealand White rabbits (Oryctolagus cuniculus), four female and four male, aged 12-16 weeks and weighing 2.8-3.5 kg in part 1. Separately, four additional rabbits in part 2. METHODS: Crossover study design with eight rabbits per treatment. Rabbits were administered treatment D, dexmedetomidine (0.2 mg kg-1), or treatment DB, dexmedetomidine (0.1 mg kg-1) and buprenorphine (0.05 mg kg-1) intramuscularly. Anesthesia was induced with alfaxalone intravenously until a supraglottic airway device was placed to deliver 100% oxygen. Anesthesia was maintained with alfaxalone (TIVA). Infusion rates were adjusted to achieve an absent pedal withdrawal reflex. Heart rate, respiratory rate, noninvasive blood pressure, end-tidal carbon dioxide partial pressure and peripheral hemoglobin oxygen saturation (SpO2) were recorded every 5 minutes. Subsequently, four rabbits underwent ovariohysterectomy using treatment DB and alfaxalone TIVA. RESULTS: The mean ± standard deviation alfaxalone infusion rate was 9.6 ± 2.6 and 4.5 ± 1.3 mg kg-1 hour-1 for treatments D and DB, respectively. In both treatments, blood pressure remained within acceptable range and SpO2 was > 95%. Postinduction apnea and respiratory depression were observed in both treatments and managed with manual positive pressure ventilation. Four separate rabbits underwent successful ovariohysterectomy with treatment DB and alfaxalone TIVA. One rabbit required supplementation with inhalant anesthesia; three rabbits were successfully maintained using alfaxalone TIVA alone. CONCLUSIONS AND CLINICAL RELEVANCE: Premedication with dexmedetomidine-buprenorphine combined with alfaxalone TIVA may be a viable alternative for performing abdominal surgery in the rabbit. The use of supplemental oxygen and ability to provide respiratory support are advised.

Environmental conditions constrain nursery habitat value in Australian sub-tropical estuaries.

High quality nursery grounds are important for species success and the long-term sustainability of fish stocks. However, even for important fisheries species, what constitutes nursery habitats is only coarsely defined, and details of specific requirements are often lacking. In this study we investigated upstream estuarine areas in central Queensland, Australia, to identify the environmental factors that constrain nursery ground utilization for important fisheries species. We used unbaited underwater video cameras to assess fish presence, and used a range of water quality sensors to record fluctuations in environmental conditions, likely to influence juveniles, over several months (e.g. tidal connection patterns, temperature, salinity and dissolved oxygen). We found that juveniles of three fisheries target species (Lutjanus argentimaculatus, Lutjanus russellii and Acanthopagrus australis) were common in the upstream sections of the estuaries. For each species, only a subset of the factors assessed were influential in determining nursery ground utilization, and their importance varied among species, even among the closely related L. argentimaculatus and L. russellii. Overall, tidal connectivity and the availability of complex structure, were the most influential factors. The reasons for the importance of connectivity are complex; as well as allowing access, tidal connectivity influences water levels, water temperature and dissolved oxygen - all important physiological requirements for successful occupation. The impact of variation in juvenile access to food and refuge in nursery habitat was not directly assessed. While crucial, these factors are likely to be subordinate to the suite of environmental characteristics necessary for the presence and persistence of juveniles in these locations. These results suggest that detailed environmental and biological knowledge is necessary to define the nuanced constraints of nursery ground value among species, and this detailed knowledge is vital for informed management of early life-history stages.

Prehospital Mechanical Ventilation: An NAEMSP Position Statement and Resource Document.

Airway emergencies and respiratory failure frequently occur in the prehospital setting. Patients undergoing advanced airway management customarily receive manual ventilations. However, manual ventilation is associated with hypo- and hyperventilation, variable tidal volumes, and barotrauma, among other potential complications. Portable mechanical ventilators offer an important strategy for optimizing ventilation and mitigating ventilatory complications.EMS clinicians, including those performing emergency response as well as interfacility transports, should consider using mechanical ventilation after advanced airway insertion.Prehospital mechanical ventilation techniques, strategies, and parameters should be disease-specific and should mirror in-hospital best practices.EMS clinicians must receive training in the general principles of mechanical ventilation as well as detailed training in the operation of the specific system(s) used by the EMS agency.Patients undergoing mechanical ventilation must receive appropriate sedation and analgesia.

Wernicke's encephalopathy and cranial nerve VII palsy in a 24-year-old patient with COVID-19.

BACKGROUND: Many documented secondary neurologic manifestations are associated with COVID-19, including mild peripheral and central nervous system disorders (such as hypo/anosmia, hypo/ageusia, and cranial nerve VII palsy) and severe problems (such as ischemic stroke, Guillain-Barré syndrome, and encephalitis). The list is growing. A new addition is non-alcohol Wernicke's encephalopathy. CASE PRESENTATION: We present the case of a 24-year-old male with no past medical history who developed stroke-like symptoms two days after testing positive for COVID-19. MRI of his brain showed T2 FLAIR hyperintensity in the splenium of the corpus collosum, mamillary bodies, periaqueductal gray matter, tectum, and ventral and dorsal medulla, an MRI signal concerning for non-alcohol Wernicke's encephalopathy. Our patient had no risk factors for Wernicke's encephalopathy. He was admitted and started on thiamine for Wernicke's encephalopathy and steroids for his cranial VII nerve palsy. Both his symptoms and imaging improved. He was discharged on oral thiamine. Follow-up in the Neurology Clinic has confirmed his continued stable state. CONCLUSIONS: This case is one of three documented cases of Wernicke's encephalopathy believed to be caused by COVID-19 in patients without risk factors or chronic alcohol use. Ours is also the first case in which Wernicke's encephalopathy presents with a concomitant cranial nerve VII palsy. While Emergency Medicine doctors must maintain a high index of suspicion for stroke in younger patients with COVID-19, our patient's case augments the correlation between COVID-19 and Wernicke's encephalopathy in patients without other risk factors for developing the syndrome.

Discovery of SY-5609: A Selective, Noncovalent Inhibitor of CDK7.

CDK7 has emerged as an exciting target in oncology due to its roles in two important processes that are misregulated in cancer cells: cell cycle and transcription. This report describes the discovery of SY-5609, a highly potent (sub-nM CDK7 Kd) and selective, orally available inhibitor of CDK7 that entered the clinic in 2020 (ClinicalTrials.gov Identifier: NCT04247126). Structure-based design was leveraged to obtain high selectivity (>4000-times the closest off target) and slow off-rate binding kinetics desirable for potent cellular activity. Finally, incorporation of a phosphine oxide as an atypical hydrogen bond acceptor helped provide the required potency and metabolic stability. The development candidate SY-5609 displays potent inhibition of CDK7 in cells and demonstrates strong efficacy in mouse xenograft models when dosed as low as 2 mg/kg.

A One Year Longitudinal Comparative Analysis of Visual Outcomes Between Femtosecond Laser-Assisted Cataract Surgery and Standard Phacoemulsification Cataract Surgery.

PURPOSE: To assess visual outcomes over time of femtosecond laser-assisted cataract surgery compared to standard phacoemulsification cataract surgery. DESIGN: A retrospective, single-center comparative study. METHODS: Patient data including demographics, ocular biometry, pre- and postoperative visual acuity, postoperative complications, primary (uncorrected distance visual acuity over time) and secondary visual outcomes (uncorrected near visual acuity, best distance visual acuity, patient complaints, satisfaction, and postoperative surgery) were gathered and statistically analyzed. Demographic differences between patients receiving femtosecond-laser assisted cataract surgery (FLACS) versus standard phacoemulsification cataract surgery (PCS) were corrected for outcome comparison. Safety, efficacy, predictability, and stability were analyzed for each procedure and compared. RESULTS: A total of 155 eyes in PCS and 143 eyes in FLACS were analyzed at 1 week, 3 months, and 1 year using odds ratio. The odds ratio of being 20/20 or better and 20/40 or better at the specified time periods were similar and statistically insignificant at all time periods analyzed except 20/20 or better for uncorrected distance visual acuity (UDVA) at 1 year (p=0.0001) and uncorrected near visual acuity (UNVA) at 1 week (p=0.02). In both cases, the odds of being 20/20 or better favored FLACS. Mean UDVA, UNVA, and best distance visual acuity (BDVA) were all similar and statistically insignificant between the two groups. Postoperative patient complaints, safety, efficacy, predictability, and stability between the two groups showed no statistical significance. CONCLUSION: Despite the odds ratio of being 20/20 or better favoring FLACS for UDVA at 1 year and UNVA at 1 week, the mean logMAR UDVA, BDVA, and UNVA were similar and statistically insignificant between the FLACS and PCS groups at 1 week, 3 months, and 1 year. Differences in visual acuity were likely due to differences other than surgical approaches. While both FLACS and PCS are appropriate approaches to cataract surgery, one does not appear to be superior when assessing longitudinal markers for visual acuity, safety, efficacy, predictability and stability.