A global network for operational flood risk reduction

Every year riverine flooding affects millions of people in developing countries, due to the large population exposure in the floodplains and the lack of adequate flood protection measures. Preparedness and monitoring are effective ways to reduce flood risk. State-of-the-art technologies relying on satellite remote sensing as well as numerical hydrological and weather predictions can detect and monitor severe flood events at a global scale. This paper describes the emerging role of the Global Flood Partnership (GFP), a global network of scientists, users, private and public organizations active in global flood risk management. Currently, a number of GFP member institutes regularly share results from their experimental products, developed to predict and monitor where and when flooding is taking place in near real-time. GFP flood products have already been used on several occasions by national environmental agencies and humanitarian organizations to support emergency operations and to reduce the overall socio-economic impacts of disasters. This paper describes a range of global flood products developed by GFP partners, and how these provide complementary information to support and improve current global flood risk management for large scale catastrophes. We also discuss existing challenges and ways forward to turn current experimental products into an integrated flood risk management platform to improve rapid access to flood information and increase resilience to flood events at global scale

Opioid Use After Discharge Following Primary Unilateral Total Knee Arthroplasty: How Much Are We Over-Prescribing?

BACKGROUND: The opioid crisis pressures orthopedic surgeons to reduce the amount of narcotics prescribed for post-operative pain management. This study sought to quantify post-operative opioid use after hospital discharge for primary unilateral total knee arthroplasty (TKA) patients. METHODS: A prospective cohort of primary unilateral TKA patients performed by one of 5 senior fellowship-trained arthroplasty surgeons were enrolled at a single institution. Detailed pain journals tracked all prescriptions and over-the-counter pain medications, quantities, frequencies, and visual analog scale pain scores. Narcotic and narcotic-like pain medications were converted to morphine milligram equivalents (MME). Statistical analysis was performed using Student\u27s t-test with α \u3c 0.05. RESULTS: Data from 89 subjects were analyzed; the average visual analog scale pain score was 6.92 while taking narcotics. The average number of days taking narcotics was 16.8 days. The distribution of days taking narcotics was right shifted with 52.8% of patients off narcotics after 2 week, and 74.2% off by 3 weeks post-op. The average MME prescribed was significantly greater than MME taken (866.6 vs 428.2, P \u3c .0001). The average number of narcotic pills prescribed was significantly greater than narcotic pills taken (105.1 vs 52.0, P \u3c .0001). The average excess narcotic pills prescribed per patient was 53.1 pills. About 48.3% took fewer than 40 narcotic pills; 75.3% took fewer than 75 narcotic pills. About 3.4% did not require any narcotics; 40.5% required a refill of narcotics. Also, 9.0% went home the day of surgery. CONCLUSION: Significantly more narcotics were prescribed than were taken in the post-operative period following TKA with an average 53.1 excess narcotic pills per patient. Adjusting prescribing patterns to match patient narcotic usage could reduce the excess narcotic pills following TKA

Opioid Use After Discharge Following Primary Unilateral Total Hip Arthroplasty: How Much Are We Overprescribing?

BACKGROUND: The opioid crisis pressures orthopedic surgeons to reduce the amount of narcotics prescribed for postoperative pain management. This study sought to quantify postoperative opioid use after hospital discharge for primary unilateral total hip arthroplasty (THA) patients. METHODS: A prospective cohort of primary unilateral THA patients were enrolled at a single institution. Detailed pain journals tracked all prescription and over-the-counter pain medication, quantity, frequency, and visual analog scale pain scores. Pain medications were converted to morphine milligram equivalents (MME). RESULTS: Data from 121 subjects were analyzed; the average visual analog scale pain score was 3.44 while taking narcotics. The average number of days taking narcotics was 8.46 days. The distribution of days taking narcotics was right shifted with 50.5% of patients off narcotics after 1 week, and 82.6% off by 2 weeks postoperatively. The average number of narcotic pills prescribed was significantly greater than narcotic pills taken (72.5 vs 28.8, P \u3c .0001). The average MME prescribed was significantly greater than MME taken (452.1 vs 133.8, P \u3c .0001). The average excess narcotic pills prescribed per patient was 51.7 pills. And 71.9% took fewer than 30 narcotic pills; 90.9% patients took fewer than 50 narcotic pills. Also, 10.7% did not require any narcotics; 9.9% required a refill of narcotics; and 33.1% went home the day of surgery. CONCLUSION: Significantly more narcotics were prescribed than were taken in the postoperative period following THA with an average 51.7 excess narcotic pills per patient. Adjusting prescribing patterns to match patient narcotic usage could reduce the excess narcotic pills following THA

Toward a national eDNA strategy for the United States

Abstract Environmental DNA (eDNA) data make it possible to measure and monitor biodiversity at unprecedented resolution and scale. As use‐cases multiply and scientific consensus grows regarding the value of eDNA analysis, public agencies have an opportunity to decide how and where eDNA data fit into their mandates. Within the United States, many federal and state agencies are individually using eDNA data in various applications and developing relevant scientific expertise. A national strategy for eDNA implementation would capitalize on recent scientific developments, providing a common set of next‐generation tools for natural resource management and public health protection. Such a strategy would avoid patchwork and possibly inconsistent guidelines in different agencies, smoothing the way for efficient uptake of eDNA data in management. Because eDNA analysis is already in widespread use in both ocean and freshwater settings, we focus here on applications in these environments. However, we foresee the broad adoption of eDNA analysis to meet many resource management issues across the nation because the same tools have immediate terrestrial and aerial applications