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The purpose of this research is to identify how decision-makers within anchor institutions, using the context of higher education, determine the course of action in response to an improbable disaster event, such as the recent coronavirus disease 2019 (COVID-19) pandemic. A survey was conducted among higher education decision-makers during spring 2020 at the moment they were adapting to COVID-19. The survey aimed to identify policies and planning measures that may help Institutions of Higher Education learn from this experience to maintain continuity of operations should similar or unanticipated events occur in the future. With this knowledge, both assets and detriments contributing to community vulnerability can be better balanced to inform decision-making. The outcomes of the analysis and shared reflections inform the development of future policy and strengthen existing processes for preparedness and mitigation planning for unexpected events.

In the United States, most floodplain relocation (or buyout) programs focus on moving homeowners, then deal separately with what happens with the land afterward. These programs typically divide processes for relocation planning, engagement, funding, and implementation from those related to post-buyout land management and restoration. The structural and operational conditions that lead to this separation of roles and responsibilities miss out on opportunities to create more synergistic socio-ecological strategies that may produce healthier outcomes for both people and the environment. In other domains, research shows that healthy people and healthy environments can co-create each other through more virtuous cycles. In this perspective essay, we argue that we can better create such virtuous cycles in floodplain relocation programs by integrally considering social and ecological components. Such efforts can encourage more people to decide to relocate, thereby creating more contiguous places to restore. They can also empower more residents to help steward these sites, an action that in turn helps heal and strengthen flood-affected communities. These arguments, while particular to the United States, have resonance for floodplain management and land use planning worldwide., Competing Interests: Conflict of interest Linda Shi is an editorial board member of Socio-Ecological Practice Research. She was not involved in the peer-review or handling of the manuscript, and has no other competing interests to disclose. All coauthors have no conflict of interests to declare that are relevant to the content of this article., (© The Author(s) 2023.)

Climate change-exacerbated flooding has renewed interest in property buyouts as a pillar of managed retreat from coastal zones and floodplains in the United States. However, federal buyout programs are widely critiqued for being inaccessible and inequitable. To learn whether and how subnational buyout programs overcome these limitations, we examined five leading US state, county, and local buyout programs to see what they teach us about redesigning future federal policies. Our mixed-methods research used interviews and document analysis to develop case studies, juxtaposed subnational strategies against a review of critiques of federal buyouts, and focus group discussions with subnational buyout managers and experts to identify limitations of their programs. We find that subnational programs can be more inclusive and better respond to resident needs as compared to existing federal programs due to their access to dedicated, non-federal funding and their standing institutional status, which allows them to learn and evolve over time. Nevertheless, these programs lack coordination with and control over agencies that permit development and produce affordable housing. This gives buyout programs limited power in shaping the overall equity of who lives in floodplains and who has access to affordable, resilient housing after a buyout. Their experiences suggest federal programs can support managed retreat nationwide by increasing support for institutional and staff capacity at state and county levels, encouraging efforts to bridge institutional silos at subnational levels, and holistically mainstream climate considerations into regional floodplain development, affordable housing production, and flood risk mitigation., (© The Author(s) 2022.)

High-grade dysplastic spondylolisthesis (HGDS) is a subset of L5-S1 spondylolisthesis that occurs due to dysmorphic anatomy at the lumbosacral junction, often resulting in sagittal imbalance. Enhanced understanding of global sagittal alignment has led many to preferentially treat HGDS with reduction and fusion to restore sagittal balance. The purpose of this article is to review published surgical techniques for obtaining sagittal correction in HGDS and to evaluate the current evidence regarding the associated surgical complications., (Copyright © 2018 Elsevier Inc. All rights reserved.)

AKI after cardiac surgery remains strongly associated with mortality and lacks effective treatment or prevention. Preclinical studies suggest that cell-based interventions may influence functional recovery. We conducted a phase 2, randomized, double-blind, placebo-controlled trial in 27 centers across North America to determine the safety and efficacy of allogeneic human mesenchymal stem cells (MSCs) in reducing the time to recovery from AKI after cardiac surgery. We randomized 156 adult subjects undergoing cardiac surgery with evidence of early AKI to receive intra-aortic MSCs (AC607; n =67) or placebo ( n =68). The primary outcome was the time to recovery of kidney function defined as return of postintervention creatinine level to baseline. The median time to recovery of kidney function was 15 days with AC607 and 12 days with placebo (25th, 75th percentile range, 10-29 versus 6-21, respectively; hazard ratio, 0.81; 95% confidence interval, 0.53 to 1.24; P =0.32). We did not detect a significant difference between groups in 30-day all-cause mortality (16.7% with AC607; 11.8% with placebo) or dialysis (10.6% with AC607; 7.4% with placebo). At follow-up, 12 patients who received AC607 and six patients who received placebo had died. Rates of other adverse events did not differ between groups. In these patients with AKI after cardiac surgery, administration of allogeneic MSCs did not decrease the time to recovery of kidney function. Our results contrast with those in preclinical studies and provide important information regarding the potential effects of MSCs in this setting., (Copyright © 2018 by the American Society of Nephrology.)