Sea-level rise will likely accelerate rock coast cliff retreat rates.

Coastal response to anthropogenic climate change is of central importance to the infrastructure and inhabitants in these areas. Despite being globally ubiquitous, the stability of rock coasts has been largely neglected, and the expected acceleration of cliff erosion following sea-level rise has not been tested with empirical data, until now. We have optimised a coastal evolution model to topographic and cosmogenic radionuclide data to quantify cliff retreat rates for the past 8000 years and forecast rates for the next century. Here we show that rates of cliff retreat will increase by up to an order of magnitude by 2100 according to current predictions of sea-level rise: an increase much greater than previously predicted. This study challenges conventional coastal management practices by revealing that even historically stable rock coasts are highly sensitive to sea-level rise and should be included in future planning for global climate change response.

The Presence of Ghost Publications Among Canadian Plastic Surgery Residency Applicants: How Honest Are Canadians?

Background: Physicians with history of unprofessional behaviour during their medical training are shown to be 3 times more likely to have board disciplinary action later in their career. One realm in which unprofessional behaviour takes place is the phenomenon of unverifiable publications or "ghost publications." To that end, this study aims to assess the rate of ghost publications among a recent cohort of Canadian Plastic Surgery residency applicants to determine if this phenomenon is geographic in nature. Methods: The current study was a retrospective, cross-sectional observational study; a review of all residency applications submitted to a single Canadian Plastic Surgery residency program from 2015 to 2018 was performed and all their listed publications were verified for accuracy. The review was conducted by a third party librarian and a research coordinator blinded to the authors identifying information. "Ghost publication" was defined as any publication listed as "published," "accepted," or "in-press" that did not exist in the literature. Results: A total of 196 applications of 186 applicants were submitted over the span of 4 years. A total of 362 publications listed as peer-reviewed articles, belonging to 114 applications were extracted and reviewed. Among the 362 publications listed as peer-reviewed articles, 2 could not be found in the literature (0.55%). Additionally, 42 citations were found with 48 minor differences than what was cited. Conclusions: The rate of ghost publications among recent applicants to a Plastic Surgery residency program is low (less than 1%). Future studies should investigate methods to further improve and instill the value of professionalism in our future plastic surgery trainees.

Historique: Il est démontré que les médecins qui adoptent un comportement non professionnel pendant leur formation risquent trois fois plus de recevoir des sanctions disciplinaires de leur ordre pendant leur carrière. Le phénomène des publications non vérifiables, ou publications fictives, représente l'un des volets du comportement non professionnel. La présente étude vise à évaluer la fréquence de publications fictives dans une récente cohorte de candidats canadiens à la résidence en plasturgie pour déterminer si ce phénomène est de nature géographique. Méthodologie: Dans la présente étude d'observation transversale et rétrospective, toutes les candidatures en résidence déposées à un seul programme de résidence canadien en plasturgie entre 2015 et 2018 ont été examinées, et l'exactitude de toutes les publications présentées a été vérifiée. Un tiers bibliothécaire et un coordonnateur de recherche ne connaissant pas les données nominatives des auteurs ont effectué l'analyse. Une publication fictive désignait toute publication présentée comme « publiée ¼, « acceptée ¼ ou « sous presse ¼, mais qui n'existait pas dans les revues scientifiques. Résultats: Au total, 196 demandes de 186 candidats ont été déposées sur une période de quatre ans. Les chercheurs ont extrait et examiné 362 publications présentées comme des articles dotés d'un comité de lecture, cités par 114 candidats. De ces 362 publications, les chercheurs n'en ont pas trouvé deux dans les revues scientifiques (0,55 %) et ont relevé 42 citations comportant 48 différences mineures par rapport à la version originale. Conclusions: Les récents candidats à un programme de résidence en plasturgie s'approprient peu de publications fictives (moins de 1 %). De prochaines études devraient porter sur des méthodes pour améliorer et inculquer la valeur du professionnalisme chez les futurs résidents en plasturgie.

Medical Student Mentorship in Surgery: Lessons Learnt and Future Directions.

BACKGROUND: Mentorship is one of the cornerstones of surgical education, providing students with the tools to navigate the challenges of the transition from a trainee to a surgeon. OBJECTIVES: Our study aims to describe the characteristics of successful mentorship of medical students who successfully matched into surgical fields, and to provide medical students practical information on how to successfully find and maintain successful mentoring relationships. METHODS: In this multi-center cross-sectional observational study, 2 surveys; 1 for mentees, defined as junior surgical residents (medical students who matched into surgical specialties), and 1 for mentors, defined as staff surgeons, were used to collect data between August 1, 2020 to November 1, 2020. The study was retrospective in nature and did not directly assess survey participants while they were in medical school, but rather while they were residents, retrospectively answering regarding their experiences as medical students. The surveys contained 24 questions pertaining to demographics, the dynamics of mentor-mentee relationships, qualities sought in a mentee, and barriers/benefits to mentorship. RESULTS: A total of 111 attending surgeons and 138 surgical residents completed the surveys. Seventy-eight percent of surgeons had mentored at least 1 medical student, while 74.6% of residents had at least 1 mentor during medical school. The top three mentee qualities reported by mentors were willingness to learn, being a hard worker, and curiosity. There was a significant disparity between mentors' and mentees' perceptions of the importance of scientific curiosity as a mentee trait (p < 0.05). Mentors and mentees have different perceived barriers to forming successful mentorships. CONCLUSIONS: While the majority of students have experienced fruitful mentoring relationships, the differences in perception of mentors and mentees still represent barriers to be overcome to allow mentorship in surgery to flourish.

Photographic assessment of postsurgical facial scars epidermally sutured with rapidly absorbable polyglactin 910 or nylon: A randomized clinical trial.

BACKGROUND: Surgeons use absorbable and nonabsorbable sutures for epidermal wound closure. No large, randomized studies have compared the effect of these suture types on facial scar appearance. OBJECTIVE: To assess postsurgical facial scar appearance using either rapidly absorbable polyglactin 910 or nylon for epidermal closure. METHODS: Randomized, blinded, split-scar clinical trial. A total of 105 patients with facial wounds resulting from Mohs micrographic surgery excisions were randomly assigned for epidermal closure with rapidly absorbable 5-0 polyglactin 910 (Vicryl Rapide) on one half of the repair and 5-0 nylon (Ethilon) on the other half. Two physicians (1 dermatologist and 1 plastic surgeon), unaware of the original suture location, examined photographs of each healed wound at 6 months after surgery and graded the appearance of each half of the scar using the visual analog scale, wound evaluation scale, and Stony Brook Scar Evaluation Scale. RESULTS: At 6 months, there was no significant difference in the combined mean (standard deviation) visual analog scale scores (83.1 [14.2] and 83.0 [13.7]), Stony Brook Scar Evaluation Scale scores (4.3 [0.9] and 4.4 [0.9]), or wound evaluation scale scores (5.3 [1.1] and 5.2 [1.1]) for rapidly absorbable polyglactin 910 versus nylon (P = .72, .57, and .21, respectively). LIMITATIONS: Single institution. CONCLUSIONS: Both rapidly absorbable polyglactin 910 and nylon sutures placed through the epidermis resulted in an equivalent photographic appearance of facial scars at 6 months after surgery.

Free-Wilson Analysis of Comprehensive Data on Phosphoinositide-3-kinase (PI3K) Inhibitors Reveals Importance of N-Methylation for PI3Kδ Activity.

Phosphoinositide-3-kinase δ (PI3Kδ) is a critical regulator of cell growth and transformation and has been explored as a therapeutic target for a range of diseases. Through the exploration of the thienopyrimidine scaffold, we have identified a ligand-efficient methylation that leads to remarkable selectivity for PI3Kδ over the closely related isoforms. Interrogation through the Free-Wilson analysis highlights the innate selectivity the thienopyrimidine scaffold has for PI3Kδ and provides a predictive model for the activity against the PI3K isoforms.

Unequivocal Experimental Evidence of the Relationship between Emission Energies and Aurophilic Interactions.

In this paper, we describe experimental evidence of a change in the emission energy as a function of the Au-Au distance. We have employed a luminescent complex exhibiting an aurophilic interaction, which is weak enough to allow its length to be modified by external pressure but rigid enough to confer structural stability on the complex. By determining the crystal structures and emission characteristics over a range of pressures, we have identified an exponential relationship between the energy of the emitted light and the metal-metal distances under pressure. This result can be indirectly related to the repulsive branch of the fitted function representing the energy of the system in the ground state at different Au-Au distances. The relativistic nature of gold appears to play an important role in the behavior of this complex.

Free Functional Muscle Transfer for Thumb Opposition.

Traumatic injuries and other conditions resulting in thenar loss and loss of opposition function can cause significant functional limitations. There are limited options available to restore function and bulk to the thenar musculature. A 26-year-old man had an unfortunate accident at work with a machine mixer creating a crush injury to his left hand. This required several debridements due to the tissue injury and resulted in loss of the thenar muscles and ability to oppose the thumb. He recovered well from the initial injury, however, was left with difficulty with grasp and holding objects due to the loss of thenar motion and strength. His function was also affected by the loss of bulk. He successfully underwent a free functional muscle reconstruction with his serratus anterior. This case report is a description of his reconstruction and a review of the literature. The patient had an excellent outcome. He obtained active opposition and improved grip strength, improving his activities of daily living and vocational life. The serratus anterior muscle can successfully be used for thumb opposition reconstruction. This case report demonstrates good outcomes for both motion and bulk restoration.

Penile necrosis secondary to purpura fulminans: a case report and review of literature.

We report the case of a 60-year-old Hispanic male with widespread necrotic purpuric lesions involving the penile, suprapubic, inguinal and hip dermis due to purpura fulminans. Purpura fulminans describes a rare syndrome involving intravascular thrombosis and hemorrhagic infarction of the skin; this rapidly progressing syndrome features vascular collapse and disseminated intravascular coagulation. This patient's penile necrosis involved the majority of the penile shaft and glans penis, and ultimately required partial glansectomy and repeated debridement for treatment. Subsequently, full thickness skin grafting was completed for reconstruction with good effect. While reports of penile necrosis secondary to various causes are documented in the literature, no prior reports describe penile necrosis secondary to purpura fulminans.

Free functional muscle transfer for the upper extremity.

Free functional muscle transfers are an excellent treatment option in patients when significant time has passed after a nerve injury. In addition, they are the treatment of choice for reconstruction of established Volkmann's ischemic contracture, muscle loss from trauma, or tumor resection, and in congenital muscle absence. In cases where there is both soft tissue and functional muscle loss, free functional muscle transfers can address these problems together. This article focuses on the key principles for functional reconstruction of the upper extremity with free functional muscle transfers.