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Background: Artificial Intelligence (AI) offers an approach to predictive modeling. The model learns to determine specific patterns of undesirable outcomes in a dataset. Therefore, a decision-making algorithm can be built based on these patterns to prevent negative results. This systematic review aimed to evaluate the usefulness of AI in breast reconstruction. Methods: A systematic review was conducted in August 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, EMBASE, SCOPUS, and Google Scholar online databases were queried to capture all publications studying the use of artificial intelligence in breast reconstruction. Results: A total of 23 studies were full text-screened after removing duplicates, and twelve articles fulfilled our inclusion criteria. The Machine Learning algorithms applied for neuropathic pain, lymphedema diagnosis, microvascular abdominal flap failure, donor site complications associated to muscle sparing Transverse Rectus Abdominis flap, surgical complications, financial toxicity, and patient-reported outcomes after breast surgery demonstrated that AI is a helpful tool to accurately predict patient results. In addition, one study used Computer Vision technology to assist in Deep Inferior Epigastric Perforator Artery detection for flap design, considerably reducing the preoperative time compared to manual identification. Conclusions: In breast reconstruction, AI can help the surgeon by optimizing the perioperative patients' counseling to predict negative outcomes, allowing execution of timely interventions and reducing the postoperative burden, which leads to obtaining the most successful results and improving patient satisfaction. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review explores the evidence surrounding the efficacy of preventing and treating lymphedema through surgical means. Recent Findings: Sentinel Lymph Node Biopsy (SLNB) has significantly reduced the need for axillary lymph node dissection (ALND), decreasing lymphedema rates. Axillary Reverse Mapping (ARM) techniques offer the opportunity to identify and preserve lymphatics during surgery. Immediate lymphatic reconstruction through lymphatic or lymphatic venous anastomosis and free lymph node transfer attempt to maintain continued post-operative lymphatic flow, further mitigating BCRL risks and optimizing patient outcomes. Summary: A growing body of data is evaluating surgical techniques for lymphedema prevention and treatment. Improvements in patients' quality of life have been reported with these techniques. Further research should focus on randomized controlled trials and prospective studies to investigate patient indications, technique selection, long-term durability, and personalized patient strategies. [ABSTRACT FROM AUTHOR]

Small island developing States, such as those in the Pacific, are often prone to multiple hazards that have potential to result in disaster and / or restrict development. Hazard data can be limited in resolution or omitted in or near SIDS' coasts, but a growing and improved range of datasets are becoming available. Through an analysis of approximately 100 policy documents on hazards and disaster risk management in Pacific island nations, we found: limited information on hazards and how they manifest to disasters at local levels, thus not fully connecting drivers and subsequent risk; at times a non-specific multi-hazard approach prompting the need to address more specific hazards; and restricted temporal and spatial scales of analysis that potentially limit continuity of actions where mitigation methods evolve. These limitations suggest that appropriate and timely high resolution hazard data is needed from the top-down to underpin the design and development of local disaster risk management plans, simultaneous to local, bottom-up knowledge and interpretation to bring the realities of such hazard data to life. Developing and ensuring openly available hazard data will enable island States to develop more robust, inclusive disaster risk management plans and mitigation policies, plus aid inter-island comparison for communal learning. [ABSTRACT FROM AUTHOR]

Land subsidence is impacting large populations in coastal Asia via relative sea-level rise (RSLR). Here we assesses these risks and possible response strategies for China, including estimates of present rates of RSLR, flood exposure and risk to 2050. In 2015, each Chinese coastal resident experienced on average RSLR of 11 to 20 mm/yr. This is 3 to 5 times higher than climate-induced SLR, reflecting that people are concentrated in subsiding locations. In 2050, assuming these subsidence rates continue, land area, population and assets exposed to the 100-year coastal flood event is 20%-39%, 17%-37% and 18%-39% higher than assuming climate change alone, respectively. Realistic subsidence control measures can avoid up to two thirds of this additional growth in exposure, with adaptation required to address the residual. This analysis emphasizes subsidence as a RSLR hazard in China that requires a broad-scale policy response, utilizing subsidence control combined with coastal adaptation. Chinese coastal populations are concentrated in subsiding locations, and also subject to sea-level rise. Here the authors find that more areas, population and assets are exposed to coastal flooding by 2050 but realistic subsidence control measures can avoid additional risks. [ABSTRACT FROM AUTHOR]

The Paris Agreement aims to constrain global warming to ‘well below 2 °C’ and to ‘pursue efforts’ to limit it to 1.5 °C above pre-industrial levels. We quantify global and regional risk-related metrics associated with these levels of warming that capture climate change–related changes in exposure to water scarcity and heat stress, vector-borne disease, coastal and fluvial flooding and projected impacts on agriculture and the economy, allowing for uncertainties in regional climate projection. Risk-related metrics associated with 2 °C warming, depending on sector, are reduced by 10–44% globally if warming is further reduced to 1.5 °C. Comparing with a baseline in which warming of 3.66 °C occurs by 2100, constraining warming to 1.5 °C reduces these risk indicators globally by 32–85%, and constraining warming to 2 °C reduces them by 26–74%. In percentage terms, avoided risk is highest for fluvial flooding, drought, and heat stress, but in absolute terms risk reduction is greatest for drought. Although water stress decreases in some regions, it is often accompanied by additional exposure to flooding. The magnitude of the percentage of damage avoided is similar to that calculated for avoided global economic risk associated with these same climate change scenarios. We also identify West Africa, India and North America as hotspots of climate change risk in the future. [ABSTRACT FROM AUTHOR]

Sea levels will rise, even with stringent climate change mitigation. Mitigation will slow the rate of rise. There is limited knowledge on how the costs of coastal protection vary with alternative global warming levels of 1.5 to 4.0 °C. Analysing six sea-level rise scenarios (0.74 to 1.09 m, 50th percentile) across these warming levels, and five Shared Socioeconomic Pathways, this paper quantifies the economic costs of flooding and protection due to sea-level rise using the Dynamic Interactive Vulnerability Assessment (DIVA) modelling framework. Results are presented for World Bank income groups and five selected countries from the present to 2100. Annual sea flood damage costs without additional adaptation are more influenced by socio-economic development than sea-level rise, indicating that there are opportunities to control risk with development choices. In contrast, annual sea dike investment costs are more dependent on the magnitude of sea-level rise. In terms of total costs with adaptation, upper middle, low middle and low income groups are projected to have higher relative costs as a proportion of GDP compared with high income groups. If low income countries protected now, flood costs could be reduced after 2050 and beyond. However, without further adaptation, their coasts will experience growing risks and costs leaving them increasingly reliant on emergency response measures. Without mitigation or adaptation, greater inequalities in damage costs between income groups could result. At country level, annual sea flood damage costs without additional adaptation are projected to rapidly increase with approximately 0.2 m of sea-level rise, leaving limited time to plan and adapt. [ABSTRACT FROM AUTHOR]

An extensive focus on written language in early literacy instruction and assessment for emergent bilinguals places students at a disadvantage since they are learning English as a new language. Typically, classroom instruction has a narrow view of literacy and is dominated by a focus on tested skills, with little emphasis on the diverse backgrounds and experiences of today's students. In order to value the rich meaning-making process that emergent bilinguals bring with them to the classroom, this article explores the ways in which technology affords multimodal composing opportunities. A case of one emergent bilingual, Alon, whose home language is Tagalog, is presented to showcase his text productions as responses to children's literature. The findings help extend an understanding of articulating meaning through talk, contributions of written language, and the importance of the visual mode. This case helps educators see the need to take into account a cohesive portrait of composing processes as a way to make sense of the strengths of emergent bilingual students in English-only classrooms. [ABSTRACT FROM AUTHOR]

Climate change impacts on coastal zones could be significant unless adaptation is undertaken. One particular macroeconomic dimension of sea level rise (SLR) impacts that has received no attention so far is the potential stress of SLR impacts on public budgets. Adaptation will require increased public expenditure to protect assets at risk and could put additional stress on public budgets. We analyse the macroeconomic effects of SLR adaptation and impacts on public budgets. We include fiscal indicators in a climate change impact assessment focusing on SLR impacts and adaptation costs using a computable general equilibrium model extended with a detailed description of the public sector. Coastal protection expenditure is financed issuing government bonds, meaning that coastal adaptation places an additional burden on public budgets. SLR impacts are examined using several scenarios linked to three different Representative Concentration Pathways: 2.6, 4.5, and 8.5, and two Shared Socioeconomic Pathways: SSP2 and SSP5. Future projections of direct damages of mean and extreme SLR and adaptation costs are generated by the Dynamic Interactive Vulnerability Assessment framework. Without adaptation, all regions of the world will suffer a loss and public deficits increase respect to the reference scenario. Higher deficits imply higher government borrowing from household savings reducing available resources for private investments therefore decreasing capital accumulation and growth. Adaptation benefits result from two mechanisms: (i) the avoided direct impacts, and (ii) a reduced public deficit effect. This allows for an increased capital accumulation, suggesting that support to adaptation in deficit spending might trigger positive effects on public finance sustainability. [ABSTRACT FROM AUTHOR]

Large-area coastal exposure and impact analysis has focussed on using sea-level rise (SLR) scenarios and has placed little emphasis on socioeconomic scenarios, while neglecting spatial variations of population dynamics. We use the Dynamic Interactive Vulnerability Assessment (DIVA) Framework to assess the population exposed to 1 in 100-year coastal flood events under different population scenarios, that are consistent with the shared socioeconomic pathways (SSPs); and different SLR scenarios, derived from the representative concentration pathways (RCPs); and analyse the effect of accounting for regionalised population dynamics on population exposure until 2100. In a reference approach, we use homogeneous population growth on national level. In the regionalisation approaches, we test existing spatially explicit projections that also account for urbanisation, coastal migration and urban sprawl. Our results show that projected global exposure in 2100 ranges from 100 million to 260 million, depending on the combination of SLR and population scenarios and method used for regionalising the population projections. The assessed exposure based on the regionalised approaches is higher than that derived from the reference approach by up to 60 million people (39%). Accounting for urbanisation and coastal migration leads to an increase in exposure, whereas considering urban sprawl leads to lower exposure. Differences between the reference and the regionalised approaches increase with higher SLR. The regionalised approaches show highest exposure under SSP5 over most of the twenty-first century, although total population in SSP5 is the second lowest overall. All methods project the largest absolute growth in exposure for Asia and relative growth for Africa. [ABSTRACT FROM AUTHOR]

The response of coastal wetlands to sea-level rise during the twenty-first century remains uncertain. Global-scale projections suggest that between 20 and 90 per cent (for low and high sea-level rise scenarios, respectively) of the present-day coastal wetland area will be lost, which will in turn result in the loss of biodiversity and highly valued ecosystem services1-3. These projections do not necessarily take into account all essential geomorphological4-7 and socio-economic system feedbacks8. Here we present an integrated global modelling approach that considers both the ability of coastal wetlands to build up vertically by sediment accretion, and the accommodation space, namely, the vertical and lateral space available for fine sediments to accumulate and be colonized by wetland vegetation. We use this approach to assess global-scale changes in coastal wetland area in response to global sea-level rise and anthropogenic coastal occupation during the twenty-first century. On the basis of our simulations, we find that, globally, rather than losses, wetland gains of up to 60 per cent of the current area are possible, if more than 37 per cent (our upper estimate for current accommodation space) of coastal wetlands have sufficient accommodation space, and sediment supply remains at present levels. In contrast to previous studies1-3, we project that until 2100, the loss of global coastal wetland area will range between 0 and 30 per cent, assuming no further accommodation space in addition to current levels. Our simulations suggest that the resilience of global wetlands is primarily driven by the availability of accommodation space, which is strongly influenced by the building of anthropogenic infrastructure in the coastal zone and such infrastructure is expected to change over the twenty-first century. Rather than being an inevitable consequence of global sea-level rise, our findings indicate that large-scale loss of coastal wetlands might be avoidable, if sufficient additional accommodation space can be created through careful nature-based adaptation solutions to coastal management. A global modelling approach shows that in response to rises in global sea level, gains of up to 60% in coastal wetland areas are possible, if appropriate coastal management solutions are developed to help support wetland resilience. [ABSTRACT FROM AUTHOR]

Even if climate change mitigation is successful, sea levels will keep rising. With subsidence, relative sea-level rise represents a long-term threat to low-lying deltas. A large part of coastal Bangladesh was analysed using the Delta Dynamic Integrated Emulator Model to determine changes in flood depth, area and population affected given sea-level rise equivalent to global mean temperature rises of 1.5, 2.0 and 3.0 °C with respect to pre-industrial for three ensemble members of a modified A1B scenario. Annual climate variability today (with approximately 1.0 °C of warming) is potentially more important, in terms of coastal impacts, than an additional 0.5 °C warming. In coastal Bangladesh, the average depth of flooding in protected areas is projected to double to between 0.07 and 0.09 m when temperatures are projected at 3.0 °C compared with 1.5 °C. In unprotected areas, the depth of flooding is projected to increase by approximately 50% to 0.21-0.27 m, whilst the average area inundated increases 2.5 times (from 5 to 13% of the region) in the same temperature frame. The greatest area of land flooded is projected in the central and north-east regions. In contrast, lower flood depths, less land area flooded and fewer people are projected in the poldered west of the region. Over multi-centennial timescales, climate change mitigation and controlled sedimentation to maintain relative delta height are key to a delta’s survival. With slow rates of sea-level rise, adaptation remains possible, but further support is required. Monitoring of sea-level rise and subsidence in deltas is recommended, together with improved datasets of elevation. [ABSTRACT FROM AUTHOR]

With many inhabited islands only at about 1 m above mean sea level, the Maldives is among the nations most threatened by coastal flooding and sea level rise. However, the understanding of recent coastal flood events in the Maldives is limited and is important to understanding future flood threats. This paper assesses (1) the sea level and wave climate of the Maldives, (2) the sea level and wave conditions during recent coastal flood events, and (3) the implications for flood management and future research. The analysis uses observed still water levels (1987-2015) and hindcast wave conditions (1979-2015). Two significant flood events on 10-13 April 1987 and 15-17 May 2007 are examined in detail. This shows that coastal flooding in the Maldives occurs due to multiple interacting sources. These include long-period (up to 20 s) energetic waves generated in the Southern Ocean combined with spring tides. Wave run-up (mainly wave set-up) appears an essential mechanism for a flood, but is currently poorly quantified. However, as sea levels continue to rise the conditions that produce a flood will occur more frequently, suggesting that flooding will become common in the Maldives. This analysis is a starting point for future research and highlights the need to continue research on flood sources, pathways and receptors, and plan adaptation measures. Priorities include monitoring of waves, sea levels and flood events, and a better understanding of set-up (and other shallow water processes over reefs). [ABSTRACT FROM AUTHOR]

Biosolids contain inorganic and organic contaminants, including pharmaceutical and personal care products (PPCPs) that have accounted for a series of emerging contaminants, such as triclosan (TCS) and the hormone 17α-ethinylestradiol (EE2). The general aim of this study was to evaluate the effects of biosolid application on EE2 and TCS adsorption and bioavailability in soils through testing with wheat plants. For the bioavailability study, sand and two soils, Lampa and Lo Prado, were used. The sand and soils were treated using two biosolid application rates (0 and 90 mg ha), and the EE2 and TCS concentrations in the biosolids were determined as 0.54 ± 0.06 and 8.31 ± 0.19 mg kg, respectively. The concentration observed in wheat plants indicated that EE2 and TCS are mainly concentrated in the roots rather than in the shoots. Furthermore, the bioavailability of the compounds in plants depends on the properties of the contaminants and the soil. Adsorption studies showed that increasing the soil organic matter content increases the adsorption of TCS and EE2 on these substrates and that both compounds follow the Freundlich adsorption model. The desorption procedure indicated that availability for both TCS and EE2 depended on the soil type because TCS and EE2 were small in the Lampa soil with and without biosolid application and TCS increased by nearly 50% in the Lo Prado soil. The Lo Prado soil had an acidic pH (5.9) and the Lampa soil had a neutral pH of 7.3, and the organic carbon content was smaller. [ABSTRACT FROM AUTHOR]

The potential impact of climate change on port operations and infrastructures has received much less attention than the corresponding impact for beach systems. However, ports have always been vulnerable to weather extremes and climate change could enhance such occurrences at timescales comparable to the design lifetime of harbour engineering structures. The analysis in this paper starts with the main climatic variables affecting harbour engineering and exploitation. It continues with a review of the available projections for such variables first at global scale and then at a regional scale (Catalan coast in the western Mediterranean) as a study case for similar environments in the planet. The detailed assessment of impacts starts from downscaled projections for mean sea level and wave storms (wind not considered in the paper). This is followed by an analysis of the port operations and infrastructure performance that are relevant from a climate perspective. The key climatic factors here considered are relative sea level, wave storm features (height, period, direction and duration) and their combined effect, which is expected to produce the highest impacts. The paper ends with a discussion and some examples of analyses aiming at port adaptation to future climate change. [ABSTRACT FROM AUTHOR]

The Sundarbans mangrove ecosystem, located in India and Bangladesh, is recognized as a global priority for biodiversity conservation and is an important provider of ecosystem services such as numerous goods and protection against storm surges. With global mean sea-level rise projected as up to 0.98 m or greater by 2100 relative to the baseline period (1985-2005), the Sundarbans - mean elevation presently approximately 2 m above mean sea-level - is under threat from inundation and subsequent wetland loss; however the magnitude of loss remains unclear. We used remote and field measurements, geographic information systems and simulation modelling to investigate the potential effects of three sea-level rise scenarios on the Sundarbans within coastal Bangladesh. We illustrate how the Sea Level Affecting Marshes Model (SLAMM) is able to reproduce the observed area losses for the period 2000-2010. Using this calibrated model and assuming that mean sea-level is a better proxy than the SLAMM assumed mean lower low water for Mangrove area delineation, the estimated mangrove area net losses (relative to year 2000) are 81-178 km, 111-376 km and 583-1393 km for relative sea-level rise scenarios to 2100 of 0.46 m, 0.75 m and 1.48 m, respectively and net subsidence of ±2.5 mm/year. These area losses are very small (<10 % of present day area) and significantly smaller than previous research has suggested. Our simulations also suggest that erosion rather than inundation may remain the dominant loss driver to 2100 under certain scenarios of sea-level rise and net subsidence. Only under the highest scenarios does inundation due to sea-level rise become the dominant loss process. [ABSTRACT FROM AUTHOR]

Policy makers from around the world are trying to emulate successful innovation systems in order to support economic growth. At the same time, innovation governance systems are being put in place to ensure a better integration of stakeholder views into the research and development process. In Europe, one of the most prominent and newly emerging governance frameworks is called Responsible Research and Innovation (RRI). This article aims to substantiate the following points: (1) The concept of RRI and the concept of justice can be used to derive similar ethical positions on the nano-divide. (2) Given the ambitious policy aims of RRI (e.g. economic competitiveness enhancer), the concept may be better suited to push for ethical outcomes on access to nanotechnology and its products rather than debates based on justice issues alone. It may thus serve as a mediator concept between those who push solely for competitiveness considerations and those who push solely for justice considerations in nano-technology debates. (3) The descriptive, non-normative Systems of Innovation approaches (see below) should be linked into RRI debates to provide more evidence on whether the approach advocated to achieve responsible and ethical governance of research and innovation (R&I) can indeed deliver on competitiveness (in nano-technology and other fields). [ABSTRACT FROM AUTHOR]

Pycroft et al. (Environ Resour Econ 1-29, ) used incorrect and outdated data to study the economic impact of sea level rise. They misinterpret some of their input data, and fail to exploit the strengths of their computable general equilibrium model and previously developed methods to study impacts and adaptation. [ABSTRACT FROM AUTHOR]

Purpose: Triclosan (TCS, 5-chloro-2-(2,4-dichlorophenoxy) phenol) an antimicrobial compound used in a range of household products, is an emerging hydrophobic organic contaminant, that may be incorporated into soil through the application of biosolids. The present study assessed the bioavailable fraction of TCS in a soil-biosolid system using wheat ( Triticum aestivum) plant assays and a predictive extraction method using a solution of hydroxypropyl-β-cyclodextrin (HPCD) to determine if it was a reliable surrogate for this bioassay. Materials and methods: Three soils were obtained from the central region of Chile (Cuesta Vieja, Polpaico, and Taqueral). Biosolid was obtained from a regional wastewater treatment plant. The soils were amended with biosolids at different rates (30, 60, 90, and 200 Mg ha). The TCS concentration was determined in biosolids, soil, and plant samples via gas chromatography coupled with mass spectrometry (GC-MS). Results and discussion: The total TCS concentration in the biosolids was 5.45 mg kg. The results of the TCS extraction from the wheat plants (roots and shoots) indicated that TCS was primarily found in the roots. TCS uptake by the plant varied based on soil properties. The predictive capability of the HPCD extraction was assessed using a simple linear correlation test for TCS concentration in wheat plants. Conclusions: The study yielded a linear relationship, which demonstrated the validity of the chemical method as a biosimulation technique. [ABSTRACT FROM AUTHOR]

Due to complexities of creating sea-level rise scenarios, impacts of climate-induced sea-level rise are often produced from a limited number of models assuming a global uniform rise in sea level. A greater number of models, including those with a pattern reflecting regional variations would help to assure reliability and a range of projections, indicating where models agree and disagree. This paper determines how nine new patterned-scaled sea-level rise scenarios (plus the uniform and patterned ensemble mean rises) influence global and regional coastal impacts (wetland loss, dry land loss due to erosion and the expected number of people flooded per year by extreme sea levels). The DIVA coastal impacts model was used under an A1B scenario, and assumed defences were not upgraded as conditions evolved. For seven out of nine climate models, impacts occurred at a proportional rate to global sea-level rise. For the remaining two models, higher than average rise in sea level was projected in northern latitudes or around populated coasts thus skewing global impact projections compared with the ensemble global mean. Regional variability in impacts were compared using the ensemble mean uniform and patterned scenarios: The largest relative difference in impacts occurred around the Mediterranean coast, and the largest absolute differences around low-lying populated coasts, such as south, south-east and east Asia. Uniform projections of sea-level rise impacts remain a useful method to determine global impacts, but improved regional scale models of sea-level rise, particularly around semi-enclosed seas and densely populated low-lying coasts will provide improved regional impact projections and a characterisation of their uncertainties. [ABSTRACT FROM AUTHOR]