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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]

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]

Immediately after President Trump's inauguration, U.S. federal science agencies began deleting information about climate change from their websites, triggering alarm among scientists, environmental activists, and journalists about the administration's attempt to suppress information about climate change and promulgate climate denialism. The Environmental Data & Governance Initiative (EDGI) was founded in late 2016 to build a multidisciplinary collaboration of scholars and volunteers who could monitor the Trump administration's dismantling of environmental regulations and science deemed harmful to its industrial and ideological interests. One of EDGI's main initiatives has been training activists and volunteers to monitor federal agency websites to identify how the climate-denialist ideology is affecting public debate and science policy. In this paper, we explain how EDGI's web-monitoring protocols are being incorporated into college curricula. Students are trained how to use the open-source online platforms that EDGI has created, but are also trained in how to analyze changes, determine whether they are significant, and contextualize them for a public audience. In this way, EDGI's work grows out of STS work on "critical making" and "making and doing." We propose that web-monitoring exemplifies an STS approach to responsive and responsible knowledge production that demands a more transparent and trustworthy relationship between the state and the public. EDGI's work shows how STS scholars can establish new modes of engagement with the state, and create spaces where the public can not only define and demand responsible knowledge practices, but also participate in the process of creating STS inspired forms of careful, collective and public knowledge construction.

Introduction: The complex anatomy and function of the native penis is difficult to surgically replicate. Metoidioplasty and radial forearm flap phalloplasty (RFFP) are the 2 most commonly utilized procedures for transgender neophallus construction., Methods: A MEDLINE search for metoidioplasty and RFFP in female-to-male genital reconstruction was performed. Primary outcome measures were subsequently compared. A systematic review was planned in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyse guidelines. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was utilized to evaluate the quality of evidence., Results: Using Population, Intervention, Comparison and Outcomes tool criteria, a total of 188 articles were identified; 7 articles related to metoidioplasty and 11 articles related to RFFP met inclusion criteria. The GRADE quality of evidence was low to very low for all included studies. In studies examining metoidioplasty, the average study size and length of follow-up were 54 patients and 4.6 years, respectively (1 study did not report [NR]). Eighty-eight percent underwent a single-stage reconstruction (0 NR), 87% reported an aesthetic neophallus (3 NR), and 100% reported erogenous sensation (2 NR). Fifty-one percent of patients reported successful intercourse (3 NR), and 89% of patients achieved standing micturition (3 NR). In studies examining RFFP, the average study size and follow-up were 60.4 patients and 6.23 years, respectively (6 NR). No patients underwent single-stage reconstructions (8 NR). Seventy percent of patients reported a satisfactorily aesthetic neophallus (4 NR), and 69% reported erogenous sensation (6 NR). Forty-three percent reported successful penetration of partner during intercourse (6 NR), and 89% achieved standing micturition (6 NR). Compared with RFFP, metoidioplasty was significantly more likely to be completed in a single stage ( P < 0.0001), have an aesthetic result ( P = 0.0002), maintain erogenous sensation ( P < 0.0001), achieve standing micturition ( P = 0.001), and have a lower overall complication rate ( P = 0.02)., Conclusions: Although the current literature suggests that metoidioplasty is more likely to yield an "ideal" neophallus compared with RFFP, any conclusion is severely limited by the low quality of available evidence.