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Summary: Introduction: Despite increasing popularity of platelet‐rich plasma (PRP) in treating aging facial skin, the quality of evidence supporting its use is poor due to the lack of consistent methods of its preparation and application. Objective: This study was conducted to assess treatment efficacy and patient satisfaction with a single PRP treatment prepared with a simplified preparation and application technique. Methods: Four millilitre of PRP were injected into 6 standardized points on each side of the face. Outcomes were assessed by independent physician evaluation of pretreatment and posttreatment photographs using the Wrinkle Severity Rating Scale (WSRS) and Global Aesthetic Improvement Scale (GAIS). In addition, patient‐reported outcomes were evaluated using the FACE‐Q. Results: Thirty‐one participants ranging from 27 to 71 years of age (median, 38; IQR 32‐58) were recruited for this study. Posttreatment WSRS scores improved in only 1 patient; the GAIS scores of 14 patients indicated aesthetic improvement. Analysis of FACE‐Q scores revealed statistically significant increases in participant satisfaction with overall facial appearance and cheeks. The most frequently reported adverse effects were tenderness (23.4%; 7 of 31), facial tightness (20.0%; 6 of 31), and swelling (20.0%; 6 of 31). Conclusions: A simple method of PRP preparation offers modest benefit in treating the effects of skin aging and photodamage. Future research studies should alter our methods using a stepwise approach to optimize the treatment of aging facial skin with PRP. [ABSTRACT FROM AUTHOR]

Increased emphasis on competency-based learning modules and widespread departure from traditional models of Halstedian apprenticeship have made surgical simulation an increasingly appealing component of medical education. Surgical simulators are available in numerous modalities, including virtual, synthetic, animal, and non-living models. The ideal surgical simulator would facilitate the acquisition and refinement of surgical skills prior to clinical application, by mimicking the size, color, texture, recoil, and environment of the operating room. Simulation training has proven helpful for advancing specific surgical skills and techniques, aiding in early and late resident learning curves. In this review, the current applications and potential benefits of incorporating simulation-based surgical training into residency curriculum are explored in depth, specifically in the context of plastic surgery. Despite the prevalence of simulation-based training models, there is a paucity of research on integration into resident programs. Current curriculums emphasize the ability to identify anatomical landmarks and procedural steps through virtual simulation. Although transfer of these skills to the operating room is promising, careful attention must be paid to mastery versus memorization. In the authors' opinions, curriculums should involve step-wise employment of diverse models in different stages of training to assess milestones. To date, the simulation of tactile experience that is reminiscent of real-time clinical scenarios remains challenging, and a sophisticated model has yet to be established. [ABSTRACT FROM AUTHOR]

Gender dysphoria ( Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ) is characterized by a marked discrepancy between one’s birth-assigned sex and one’s gender identity and is sometimes addressed by gender-affirming surgery. As public visibility and institutional support for the transgender and gender non-conforming population continue to increase, the demand for competent multidisciplinary teams of medical professionals equipped to care for this population is expected to rise—including plastic surgeons, urologists, gynecologists, endocrinologists, and breast surgeons, among others. Genital reconstruction procedures for the male-to-female and female-to-male transgender patient present unique surgical challenges that continue to evolve from their respective origins in the 19th and 20th centuries. A historical review of surgical techniques and standards of care attendant to gender-affirming medicine is presented, with foremost emphasis placed on how techniques for genital reconstruction in particular continue to evolve and advance. In addition, the current status of transition-related health care in the United States, including research gaps and contemporary clinical challenges, is reviewed. Frey JD, Poudrier G, Thomson JE, Hazen A. A Historical Review of Gender-Affirming Medicine: Focus on Genital Reconstruction Surgery. J Sex Med 2017;14:991–1002. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has coincided with a powerful upsurge in antiracist activism in the United States, linking many forms and consequences of racism to public and environmental health. This commentary develops the concept of eco-pandemic injustice to explain interrelationships between the pandemic and socioecological systems, demonstrating how COVID-19 both reveals and deepens structural inequalities that form along lines of environmental health. Using Pellow's critical environmental justice theory, we examine how the crisis has made more visible and exacerbated links between racism, poverty, and health while providing opportunities to enact change through collective embodied health movements. We describe new collaborations and the potential for meaningful opportunities at the intersections between health, antiracist, environmental, and political movements that are advocating for the types of transformational change described by critical environmental justice. [ABSTRACT FROM AUTHOR]

Websites have become the primary means by which the US federal government communicates about its operations and presents information for public consumption. However, the alteration or removal of critical information from these sites is often entirely legal and done without the public's awareness. Relative to paper records, websites enable governments to shape public understanding in quick, scalable, and permissible ways. During the Trump administration, website changes indicative of climate denial prompted civil society organizations to develop tools for tracking online government information sources. We in the Environmental Data & Governance Initiative (EDGI) illustrate how five data visualization techniques can be used to document and analyze changes to government websites. We examine a large sample of websites of US federal environmental agencies and show that between 2016 and 2020: 1) the use of the term "climate change" decreased by an estimated 38%; 2) access to as much as 20% of the Environmental Protection Agency's website was removed; 3) changes were made more to Cabinet agencies' websites and to highly visible pages. In formulating ways to visualize and assess the alteration of websites, our study lays important groundwork for both systematically tracking changes and holding officials more accountable for their web practices. Our techniques enable researchers and watchdog groups alike to operate at the scale necessary to understand the breadth of impact an administration can have on the online face of government. [ABSTRACT FROM AUTHOR]