Data Harbor (United States)

The American Board of Plastic Surgery (ABPS) has collected data on cosmetic surgery from member surgeons since 2003. These data offer valuable information on national trends in clinical practice. The present study was performed to analyze trends in rhinoplasty over the last decade. Tracer data were compared between two cohorts 2012-2016 (early cohort "EC") and 2017-2021 (recent cohort "RC"). Data included patient demographics and surgical techniques. Results were considered in the context of current EBM-based guidance in the plastic surgery literature. Data from 730 rhinoplasties (270 EC and 460 RC) were analyzed. The median age was 30years, and the most common patient concern was the nasal dorsum (79%). In the RC group, fewer patients voiced concerns about tip projection (58% vs 43%, p = 0.0002) and more complained of functional airway problems (38% vs 49%, p = 0.004). An open approach was most common (83%). Septoplasty (47% vs 52%, p = 0.005), caudal septum repositioning (14% vs 23%, p = 0.002), and tip rotation maneuvers (32% vs 49%, p < 0.0001) became more popular. There was also an increase in the use of spreader grafts (35% vs 45%, p = 0.01) and columellar strut grafts (42% vs 50%, p = 0.04), while there has been a decrease in alar base resection (17% vs 10%, p = 0.007) and non-cartilaginous dorsum/radix augmentation (9% vs 4%, p = 0.02). ABPS tracer data provide an excellent resource for the objective assessment of procedures in plastic surgery. The present study is the first to highlight evolving trends in rhinoplasty over the last 10years. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

As part of the continuous certification process, the American Board of Plastic Surgery collects case data for specific tracer procedures in aesthetic surgery to assess practice improvement by the diplomates. These case-based data provide valuable information on national trends in clinical practice. The current study was performed to analyze practice patterns in aesthetic primary breast augmentation. Breast augmentation tracer data were reviewed from 2005 to 2021 and grouped into an early cohort (EC), from 2005 through 2014, and a recent cohort (RC), from 2015 through 2021. Fisher exact tests and two-sample t tests compared demographic characteristics of the patients, surgical techniques, and complication rates. Patients in the RC were slightly older (34 versus 35 years; P < 0.001), more likely to have ptosis greater than 22 cm (20% versus 23%; P < 0.0001), less likely to smoke (12% versus 8%; P < 0.0001), and less likely to undergo a preoperative mammogram (29% versus 24%; P < 0.0001). From a technical standpoint, inframammary incisions have become more common (68% versus 80%; P < 0.0001), whereas periareolar incision use has decreased (24% versus 14%; P < 0.0001). Submuscular plane placement has increased (22% versus 56%; P < 0.0001), while subglandular placement has decreased (19% versus 7%; P < 0.0001). Silicone implants are most popular (58% versus 82%; P < 0.0001). Textured implant use increased from 2011 (2%) to 2016 (16%), followed by a sharp decline to 0% by 2021. Trends follow U.S. Food and Drug Administration approvals and warnings. This study highlights evolving trends in aesthetic breast augmentation over the past 16 years. The most common technique remains a smooth silicone prosthesis placed in the subpectoral plane through an inframammary incision.

The American Board of Orthopaedic Surgery (ABOS) is the national organization charged with defining education standards for graduate medical education in orthopaedic surgery. The purpose of this article is to describe initiatives taken by the ABOS to develop assessments of competency of residents to document their progress toward the independent practice of orthopaedic surgery and provide feedback for improved performance during training. These initiatives are called the ABOS Knowledge, Skills, and Behavior Program. Web-based assessment tools have been developed and validated to measure competence. These assessments guide resident progress through residency education and better define the competency level by the end of training. The background and rationale for these initiatives and how they serve as steps toward competency-based education in orthopaedic residency education in the United States will be reviewed with a vision of a hybrid of time and competency-based orthopaedic residency education that will remain 5 years in length, with residents assessed using standardized tools.

PURPOSE: A sixteen-year review of liposuction tracer data collected from diplomates of the American Board of Plastic Surgery (ABPS) as part of the Continuous Certification process was performed to evaluate for predominant practice patterns and changes in specific practice patterns over this time. METHODS: Liposuction tracer data were collected from 2005-2021, comparing tracer data from 2005-2014 to those from 2015-2021 using Fisher’s exact test and Student’s t-test. RESULTS: 2810 patients with an average age of 42 years were evaluated, of which 84% were female. In the later cohort (2015-2021), in-office procedures increased significantly. Concerning the body area of liposuction, abdomen, flank, and back have increased, while thighs and knees have decreased. Power-assisted lipectomy has grown in popularity, and significant increases were noted in the volume of wetting solution and lipoaspirate. Surgeons are performing procedures concomitantly with liposuction more often, and more mid-surgical position changes from prone to supine were noted. Perioperative heparin and low-molecular-weight heparin (LMWH) use have significantly increased. CONCLUSION: The present study is the first to objectively assess evolving trends in the clinical practice of liposuction over the last sixteen years. These data illustrate an increase in outpatient procedures, a shift in technique towards power-assisted liposuction, and greater surgical focus on the trunk (abdomen, flanks, and back).

Abstract This research examines the impact of increasing the stringency of renewable portfolio standards (RPS) on the consumption of energy produced from renewable sources. Putting prior findings in the context of policy learning, first we focus on technological innovation, factor endowments, and economic energy dependence of American states to track how RPS have proliferated and strengthened. Next, we look at the net effect of this RPS evolution on state fossil fuel energy divestment. To evaluate the interplay between: a) the political desire to lower fossil fuel use, b) technological feasibility to do so, and c) the economic trade‐offs and risks, we focus on the industrial sector dependence on energy security and affordability. Our results indicate that energy security is a priority and even in light of increasing RPS stringency, states with relatively weak but mandatory RPS are leaders in aggregate renewable energy consumption. This fact is due to favoring biofuel and hydro generation rather than solar and wind because of lower deployment costs.

Meeting abstracts Novel interventions are needed for the treatment of women with metastatic ovarian cancer that causes 14,000 deaths each year in the USA. Retrospective analysis of tumor infiltrating lymphocytes (TIL) infused into patients who achieved complete, durable regressions of metastatic

Meeting abstracts Adoptive cell therapy (ACT) of tumor infiltrating lymphocytes (TIL) has shown the ability to induce complete regression of stage IV melanoma. Two challenges associated TIL ACT are that (i) T cells are capable of different anti-tumor effector functions including cytotoxicity,