Harnessing ecological theory to enhance ecosystem restoration.

Ecosystem restoration can increase the health and resilience of nature and humanity. As a result, the international community is championing habitat restoration as a primary solution to address the dual climate and biodiversity crises. Yet most ecosystem restoration efforts to date have underperformed, failed, or been burdened by high costs that prevent upscaling. To become a primary, scalable conservation strategy, restoration efficiency and success must increase dramatically. Here, we outline how integrating ten foundational ecological theories that have not previously received much attention - from hierarchical facilitation to macroecology - into ecosystem restoration planning and management can markedly enhance restoration success. We propose a simple, systematic approach to determining which theories best align with restoration goals and are most likely to bolster their success. Armed with a century of advances in ecological theory, restoration practitioners will be better positioned to more cost-efficiently and effectively rebuild the world's ecosystems and support the resilience of our natural resources.

Long-term data reveal that grazer density mediates climatic stress in salt marshes.

Understanding how climate and local stressors interact is paramount for predicting future ecosystem structure. The effects of multiple stressors are often examined in small-scale and short-term field experiments, limiting understanding of the spatial and temporal generality of the findings. Using a 22-year observational dataset of plant and grazer abundance in a southeastern US salt marsh, we analyzed how changes in drought and grazer density combined to affect plant biomass. We found: (1) increased drought severity and higher snail density both correlated with lower plant biomass; (2) drought and snail effects interacted additively; and, (3) snail effects had a threshold, with additive top-down effects only occurring when snails were present at high densities. These results suggest that the emergence of multiple stressor effects can be density dependent, and they validate short-term experimental evidence that consumers can augment environmental stress. These findings have important implications for predicting future ecosystem structure and managing natural ecosystems.

Herbivory limits success of vegetation restoration globally.

Restoring vegetation in degraded ecosystems is an increasingly common practice for promoting biodiversity and ecological function, but successful implementation is hampered by an incomplete understanding of the processes that limit restoration success. By synthesizing terrestrial and aquatic studies globally (2594 experimental tests from 610 articles), we reveal substantial herbivore control of vegetation under restoration. Herbivores at restoration sites reduced vegetation abundance more strongly (by 89%, on average) than those at relatively undegraded sites and suppressed, rather than fostered, plant diversity. These effects were particularly pronounced in regions with higher temperatures and lower precipitation. Excluding targeted herbivores temporarily or introducing their predators improved restoration by magnitudes similar to or greater than those achieved by managing plant competition or facilitation. Thus, managing herbivory is a promising strategy for enhancing vegetation restoration efforts.

Ultra-high-resolution photon-counting detector computed tomography of the lungs: Phantom and clinical assessment of radiation dose and image quality.

PURPOSE: Photon-counting-detector computed tomography (PCD-CT) offers enhanced noise reduction, spatial resolution, and image quality in comparison to energy-integrated-detectors CT (EID-CT). These hypothesized improvements were compared using PCD-CT ultra-high (UHR) and standard-resolution (SR) scan-modes. METHODS: Phantom scans were obtained with both EID-CT and PCD-CT (UHR, SR) on an adult body-phantom. Radiation dose was measured and noise levels were compared at a minimum achievable slice thickness of 0.5 mm for EID-CT, 0.2 mm for PCD-CT-UHR and 0.4 mm for PCD-CT-SR. Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were calculated for five tissue densities. Additionally, data from 25 patients who had PCD-CT of chest were reconstructed at 1 mm and 0.2 mm (UHR) slice-thickness and compared quantitatively (SNR) and qualitatively (noise, quality, sharpness, bone details). RESULTS: Phantom PCD-CT-UHR and PCD-CT-SR scans had similar measured radiation dose (16.0mGy vs 15.8 mGy). Phantom PCD-CT-SR (0.4 mm) had lower noise level in comparison to EID-CT (0.5 mm) (9.0HU vs 9.6HU). PCD-CT-UHR (0.2 mm) had slightly higher noise level (11.1HU). Phantom PCD-CT-SR (0.4 mm) had higher SNR in comparison to EID-CT (0.5 mm) while achieving higher resolution (Bone 115 vs 96, Acrylic 14 vs 14, Polyethylene 11 vs 10). SNR was slightly lower across all densities for PCD-CT UHR (0.2 mm). Interestingly, CNR was highest in the 0.2 mm PCD-CT group; PCD-CT CNR was 2.45 and 2.88 times the CNR for 0.5 mm EID-CT for acrylic and poly densities. Clinical comparison of SNR showed predictably higher SNR for 1 mm (30.3 ± 10.7 vs 14.2 ± 7, p = 0.02). Median subjective ratings were higher for 0.2 mm UHR vs 1 mm PCD-CT for nodule contour (4.6 ± 0.3 vs 3.6 ± 0.1, p = 0.02), bone detail (5 ± 0 vs 4 ± 0.1, p = 0.001), image quality (5 ± 0.1 vs 4.6 ± 0.4, p = 0.001), and sharpness (5 ± 0.1 vs 4 ± 0.2). CONCLUSION: Both UHR and SR PCD-CT result in similar radiation dose levels. PCD-CT can achieve higher resolution with lower noise level in comparison to EID-CT.

Left atrial calcification on chest CT: atrial ablation replaces rheumatic heart disease as the most identified etiology.

Purpose: Left atrial calcification (LAC), a primarily radiologic diagnosis, has been associated with rheumatic heart disease (RHD) and rheumatic fever (RF). However, left atrial calcification continues to be observed despite a significant decrease in the prevalence of rheumatic heart disease. The purpose of this study was to investigate other possible etiologies of left atrial calcification. Material and methods: This retrospective, observational single-center study included patients from 2017 to 2022 identified as having left atrial calcification as well as age- and sex-matched controls. The prevalence of rheumatic heart disease, atrial ablation, and mitral valve disease was compared, and odds ratios were calculated for each independent variable. Results: Sixty-two patients with left atrial calcifications were included and compared with 62 controls. 87.1% of patients in the left atrial calcifications cohort had a history of atrial fibrillation compared with 21% in the control cohort (p < 0.001). 16.1% of patients in the calcifications cohort presented a history of rheumatic fever compared with zero in the control cohort (p = 0.004). 66.1% of the left atrial calcifications cohort had a history of atrial ablation compared with 6.5% of the control group (p < 0.001). The odds ratio for left atrial calcification was 19.0 vs. 4.8 for rheumatic fever (comparative odds = 4.0 for atrial ablation vs. rheumatic fever). Multivariable log model found atrial ablation to explain 79.8% of left atrial calcifications identified. Conclusions: Our study found a 4-fold higher association between history of atrial ablation and left atrial calcification compared with rheumatic heart disease, suggesting a potential shift in etiology.

Non-contrast computed tomography findings for identification of chronically occluded coronary artery bypass grafts.

BACKGROUND: Detecting occlusions of coronary artery bypass grafts using non-contrast computed tomography (CT) series is understudied and underestimated. PURPOSE: To evaluate morphological findings for the diagnosis of chronic coronary artery bypass graft occlusion on non-contrast CT and investigate performance statistics for potential use cases. MATERIAL AND METHODS: Seventy-three patients with coronary artery bypass grafts who had CT angiography of the chest (non-contrast and arterial phases) were retrospectively included. Two readers applied pre-set morphologic findings to assess the patency of a bypass graft on non-contrast series. These findings included vessel shape (linear-band like), collapsed lumen and surgical graft marker without a visible vessel. Performance was tested using the simultaneously acquired arterial phase series as the ground truth. RESULTS: The per-patient diagnostic accuracy for occlusion was 0.890 (95% confidence interval = 0.795-0.951). Venous grafts overall had an 88% accuracy. None of the left internal mammary artery to left anterior descending artery arterial graft occlusions were detected. The negative likelihood ratio for an occluded graft that is truly patent was 0.121, demonstrating a true post-test probability of 97% for identifying a patent graft as truly patent given a prevalence of 20% occlusion at a median 8.4 years post-surgery. Neither years post-surgery, nor number of vessels was associated with a significant decrease in reader accuracy. CONCLUSION: Evaluation of coronary bypass grafts for chronic occlusion on non-contrast CT based off vessel morphology is feasible and accurate for venous grafts. Potential use cases include low-intermediate risk patients with chest pain or shortness of breath for whom non-contrast CT was ordered, or administration of iodine-based contrast is contraindicated.

Application of an artificial intelligence ensemble for detection of important secondary findings on lung ventilation and perfusion SPECT-CT.

RATIONALE: Single-photon-emission-computerized-tomography/computed-tomography(SPECT/CT) is commonly used for pulmonary disease. Scant work has been done to determine ability of AI for secondary findings using low-dose-CT(LDCT) attenuation correction series of SPECT/CT. METHODS: 120 patients with ventilation-perfusion-SPECT/CT from 9/1/21-5/1/22 were included in this retrospective study. AI-RAD companion(VA10A,Siemens-Healthineers, Erlangen, Germany), an ensemble of deep-convolutional-neural-networks was evaluated for the detection of pulmonary nodules, coronary artery calcium, aortic ectasia/aneurysm, and vertebral height loss. Accuracy, sensitivity, specificity was measured for the outcomes. Inter-rater reliability were measured. Inter-rater reliability was measured using the intraclass correlation coefficient (ICC) by comparing the number of nodules identified by the AI to radiologist. RESULTS: Overall per-nodule accuracy, sensitivity, and specificity for detection of lung nodules were 0.678(95%CI 0.615-0.732), 0.956(95%CI 0.900-0.985), and 0.456(95%CI 0.376-0.543), respectively, with an intraclass correlation coefficient (ICC) between AI and radiologist of 0.78(95%CI 0.71-0.83). Overall per-patient accuracy for AI detection of coronary artery calcium, aortic ectasia/aneurysm, and vertebral height loss was 0.939(95%CI 0.878-0.975), 0.974(95%CI 0.925-0.995), and 0.857(95%CI 0.781-0.915), respectively. Sensitivity for coronary artery calcium, aortic ectasia/aneurysm, and vertebral height loss was 0.898(95%CI 0.778-0.966), 1 (95%CI 0.958-1), and 1 (95%CI 0.961-1), respectively. Specificity for coronary artery calcium, aortic ectasia/aneurysm, and vertebral height loss was 0.969(95% CI 0.893-0.996), 0.897 (95% CI 0.726-0.978), and 0.346 (95% CI 0.172-0.557), respectively. CONCLUSION: AI ensemble was accurate for coronary artery calcium and aortic ectasia/aneurysm, while sensitive for aortic ectasia/aneurysm, lung nodules and vertebral height loss on LDCT attenuation correction series of SPECT/CT.

Coastal resilience surges as living shorelines reduce lateral erosion of salt marshes.

A growing suite of research has demonstrated that nature-based shoreline stabilization methods can increase resilience of coastal ecosystems by improving their capacity to return to predisturbance states. Previous work suggests that during hurricanes, living shorelines promote vertical accretion and experience less damage than traditional shoreline stabilization alternatives. Nevertheless, there is limited research looking at the impacts of major storm events on living shorelines and most studies have investigated a small number of sites. This study used in situ real-time kinematic (RTK)-GPS surveys to quantify the resilience (via the lateral change in shore position) of 17 living shoreline sites before and after a Category 1 hurricane event (Hurricane Florence, 2018). By doing so, this study seeks to understand the capacity of living shorelines (marsh with seaward breakwater or sill) to provide storm protection as compared to unaltered natural fringing salt marshes. After Hurricane Florence, living shorelines on average experienced significantly less lateral erosion compared to unprotected control segments (shoreline change rates of 0.015 and -0.31 m year-1 , respectively). This study also explores how environmental siting variables (i.e., scarp presence, fetch, and bottom sediment) and sill design variables (i.e., sill material, width, and height) influence short- and long-term erosion. living shorelines were found to reduce erosion of fringing marsh edge among projects with a range of installation ages, structural materials, sill widths, and sill heights, and they were able to provide protection from erosion across a range of fetch, scarp, and bottom sediment conditions. Living shoreline siting and sill design may be suitable for broader environmental conditions than previously known. This study shows that living shorelines can increase resilience by reducing erosion of fringing salt marshes, promoting lateral building up of shoreline zones during short-term disturbance events, and from their long-term presence. Integr Environ Assess Manag 2022;18:82-98. © 2021 SETAC.

The Reciprocal Effects of Language Proficiency and Depression among Low-Income Latinx Youth.

Extant research associates language with essential social and emotional processes. Although the risk for depression among Latinx youth in the United States is well documented, the link between their language proficiency and depressive symptoms remains poorly understood. Further, research employing standardized language assessments with Latinx early adolescents is scarce and reciprocal associations between language proficiency and depressive symptoms have not been examined. This longitudinal study addressed these gaps by investigating the relation between language proficiency and depression in a sample of 218 dual language Latinx students of predominantly low-income backgrounds (Mage = 12.1, SD = 1.1; 49.1% female) recruited from seven public schools in a large city in the Midwest of the United States. Language proficiency in English and Spanish was assessed using the Woodcock-Muñoz Language Survey-Revised and depressive symptoms were assessed using the Children's Depression Inventory. Paired samples t-tests showed lower than expected growth in English vocabulary and higher than expected growth in the ability to reason using lexical knowledge in Spanish over a one-year period. Cross-lagged panel analyses (χ2 (99) = 211.19, p < .001, CFI = .93, TLI = .92, RMSEA = .07 (90% CI [.06, .09])) indicated that growth in English language proficiency is predictive of decreased depressive symptoms. Likewise, increases in depressive symptoms are predictive of decreased English language proficiency. Results have important implications for the design of appropriate psychological interventions and sensible educational policies for students of linguistic minority backgrounds.

Confidence-weighted Testing as an Impactful Education Intervention within a Pediatric Sepsis Quality Improvement Initiative.

INTRODUCTION: Confidence-weighted testing assesses learners' beliefs about their knowledge and skills. As part of a hospital-wide quality improvement initiative to enhance care for pediatric patients with suspected sepsis, we developed a novel intervention using confidence-weighted testing to identify institutional areas of misinformation and knowledge gaps while also providing real-time feedback to individual learners. METHODS: We developed pediatric sepsis eLearning modules incorporating confidence-weighted testing. We distributed them to nurses, advanced practitioners, and physicians in emergency departments and acute care/non-intensive care unit inpatient settings in our hospital system. We analyzed completion and response data over 2 years following module distribution. Our outcomes included completion, confidently held misinformation (CHM; when a learner answers a question confidently but incorrectly), struggle (when a learner repeatedly answers a question incorrectly or with low confidence), and mastery (when a learner initially answers a question correctly and confidently). RESULTS: Eighty-three percent of assigned learners completed the modules (1,463/1,754). Although nurses had significantly more misinformation and struggled more than physicians and advanced practitioners, learners of all roles achieved 100% mastery as part of module completion. The greatest CHM and struggle were found in serum lactate interpretation's nuances and the hemodynamic shock states commonly seen in sepsis. CONCLUSIONS: Our novel application of confidence-weighted testing enhanced learning by correcting learners' misinformation. It also identified systems issues and institutional knowledge gaps as targets for future improvement.

An Acute Care Sepsis Response System Targeting Improved Antibiotic Administration.

BACKGROUND AND OBJECTIVES: Pediatric sepsis quality improvement in emergency departments has been well described and associated with improved survival. Acute care (non-ICU inpatient) units differ in important ways, and optimal approaches to improving sepsis processes and outcomes in this setting are not yet known. Our objective was to increase the proportion of acute care sepsis cases in our health system with initial antibiotic order-to-administration time ≤60 minutes by 20% from a baseline of 43% to 52% by December 2020. METHODS: Employing the Model for Improvement with broad stakeholder engagement, we developed and implemented interventions aimed at effective intervention for sepsis cases on acute care units. We analyzed process and outcome metrics over time using statistical process control charts. We used descriptive statistics to explore differences in antibiotic order-to-administration time and inform ongoing improvement. RESULTS: We cared for 187 patients with sepsis over the course of our initiative. The proportion within our goal antibiotic order-to-administration time rose from 43% to 64% with evidence of special cause variation after our interventions. Of all patients, 66% experienced ICU transfer and 4% died. CONCLUSIONS: We successfully decreased antibiotic order-to-administration time. We also introduced a novel model for sepsis response systems that integrates interventions designed for the complexities of acute care settings. We demonstrated impactful local improvements in the acute care setting where quality improvement reports and success have previously been limited.

Challenges and opportunities for sustaining coastal wetlands and oyster reefs in the southeastern United States.

Formed at the confluence of marine and fresh waters, estuaries experience both the seaside pressures of rising sea levels and increasing storm severity, and watershed and precipitation changes that are shifting the quality and quantity of freshwater and sediments delivered from upstream sources. Boating, shoreline hardening, harvesting pressure, and other signatures of human activity are also increasing as populations swell in coastal regions. Given this shifting landscape of pressures, the factors most threatening to estuary health and stability are often uncertain. To identify the greatest contemporary threats to coastal wetlands and oyster reefs across the southeastern United States (Mississippi to North Carolina), we summarized recent population growth and land-cover change and surveyed estuarine management and science experts. From 1996 to 2019, human population growth in the region varied from a 17% decrease to a 171% increase (mean = +43%) with only 5 of the 72 SE US counties losing population, and nearly half growing by more than 40%. Individual counties experienced between 999 and 19,253 km2 of new development (mean: 5725 km2), with 1-5% (mean: 2.6%) of undeveloped lands undergoing development over this period across the region. Correspondingly, our survey of 169 coastal experts highlighted development, shoreline hardening, and upstream modifications to freshwater flow as the most important local threats facing coastal wetlands. Similarly, experts identified development, upstream modifications to freshwater flow, and overharvesting as the most important local threats to oyster reefs. With regards to global threats, experts categorized sea level rise as the most pressing to wetlands, and acidification and precipitation changes as the most pressing to oyster reefs. Survey respondents further identified that more research, driven by collaboration among scientists, engineers, industry professionals, and managers, is needed to assess how precipitation changes, shoreline hardening, and sea level rise are affecting coastal ecosystem stability and function. Due to the profound role of humans in shaping estuarine health, this work highlights that engaging property owners, recreators, and municipalities to implement strategies to improve estuarine health will be vital for sustaining coastal systems in the face of global change.

Smartphone-Enhanced Training, QA, Monitoring, and Evaluation of a Platform for Secondary Prevention of Cervical Cancer: Opportunities and Challenges to Implementation in Tanzania.

PURPOSE: Until human papillomavirus (HPV)-based cervical screening is more affordable and widely available, visual inspection with acetic acid (VIA) is recommended by the WHO for screening in lower-resource settings. Visual inspection will still be required to assess the cervix for women whose screening is positive for high-risk HPV. However, the quality of VIA can vary widely, and it is difficult to maintain a well-trained cadre of providers. We developed a smartphone-enhanced VIA platform (SEVIA) for real-time secure sharing of cervical images for remote supportive supervision, data monitoring, and evaluation. METHODS: We assessed programmatic outcomes so that findings could be translated into routine care in the Tanzania National Cervical Cancer Prevention Program. We compared VIA positivity rates (for HIV-positive and HIV-negative women) before and after implementation. We collected demographic, diagnostic, treatment, and loss-to-follow-up data. RESULTS: From July 2016 to June 2017, 10,545 women were screened using SEVIA at 24 health facilities across 5 regions of Tanzania. In the first 6 months of implementation, screening quality increased significantly from the baseline rate in the prior year, with a well-trained cadre of more than 50 health providers who "graduated" from the supportive-supervision training model. However, losses to follow-up for women referred for further evaluation or to a higher level of care were considerable. CONCLUSION: The SEVIA platform is a feasible, quality improvement, mobile health intervention that can be integrated into a national cervical screening program. Our model demonstrates potential for scalability. As HPV screening becomes more affordable, the platform can be used for visual assessment of the cervix to determine amenability for same-day ablative therapy and/or as a secondary triage step, if needed.

Implementation barriers for mHealth for non-communicable diseases management in low and middle income countries: a scoping review and field-based views from implementers.

Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMIC). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMIC is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMIC were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 16 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies did not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients' characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowed linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMIC. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage.

Field Experiments and Meta-analysis Reveal Wetland Vegetation as a Crucial Element in the Coastal Protection Paradigm.

Increasing rates of sea-level rise and wave action threaten coastal populations. Defense of shorelines by protection and restoration of wetlands has been invoked as a win-win strategy for humans and nature, yet evidence from field experiments supporting the wetland protection function is uncommon, as is the understanding of its context dependency. Here we provide evidence from field manipulations showing that the loss of wetland vegetation, regardless of disturbance size, increases the rate of erosion on wave-stressed shorelines. Vegetation removal (simulated disturbance) along the edge of salt marshes reveals that loss of wetland plants elevates the rate of lateral erosion and that extensive root systems, rather than aboveground biomass, are primarily responsible for protection against edge erosion in marshes. Meta-analysis further shows that disturbances that generate plant die-off on salt marsh edges generally hasten edge erosion in coastal marshes and that the erosion protection function of wetlands relates more to lateral than vertical edge-erosional processes and is positively correlated with the amount of belowground plant biomass lost. Collectively, our findings substantiate a coastal protection paradigm that incorporates preservation of shoreline vegetation, illuminate key context dependencies in this theory, and highlight local disturbances (e.g., oil spills) that kill wetland plants as agents that can accelerate coastal erosion.

Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases.

Task-shifting to non-physician health workers (NPHWs) has been an effective model for managing infectious diseases and improving maternal and child health. There is inadequate evidence to show the effectiveness of NPHWs to manage cardiovascular diseases (CVDs). In 2012, the Global Alliance for Chronic Diseases funded eight studies which focused on task-shifting to NPHWs for the management of hypertension. We report the lessons learnt from the field. From each of the studies, we obtained information on the types of tasks shifted, the professional level from which the task was shifted, the training provided and the challenges faced. Additionally, we collected more granular data on 'lessons learnt ' throughout the implementation process and 'design to implementation' changes that emerged in each project. The tasks shifted to NPHWs included screening of individuals, referral to physicians for diagnosis and management, patient education for lifestyle improvement, follow-up and reminders for medication adherence and appointments. In four studies, tasks were shifted from physicians to NPHWs and in four studies tasks were shared between two different levels of NPHWs. Training programmes ranged between 3 and 7 days with regular refresher training. Two studies used clinical decision support tools and mobile health components. Challenges faced included system level barriers such as inability to prescribe medicines, varying skill sets of NPHWs, high workload and staff turnover. With the acute shortage of the health workforce in low-income and middle-income countries (LMICs), achieving better health outcomes for the prevention and control of CVD is a major challenge. Task-shifting or sharing provides a practical model for the management of CVD in LMICs.

Oyster aquaculture impacts Zostera marina epibiont community composition in Akkeshi-ko estuary, Japan.

Coastal fisheries are in decline worldwide, and aquaculture has become an increasingly popular way to meet seafood demand. While finfish aquaculture can have substantial adverse effects on coastal ecosystems due mostly to necessary feed inputs, bivalves graze on natural phytoplankton and are often considered for their positive ecosystem services. We conducted two independent studies to investigate the effects of long-line Crassostrea gigas oyster aquaculture on Zostera marina seagrass beds and associated epibiont communities in Akkeshi-ko estuary, Japan. Results from both studies yielded no evidence of an effect of oyster aquaculture on the morphology, density, or biomass of Z. marina, but significant differences were apparent in the epibiont community. Reference seagrass beds located away from aquaculture had higher seagrass epiphyte loads and higher abundances of amphipods. Conversely, seagrass beds below aquaculture lines had higher sessile polychaete biomass and higher isopod abundances. Our results suggest that the presence of oyster aquaculture may have indirect effects on seagrass by changing epibiont community composition and relative abundances of species. One proposed mechanism is that cultured oysters feed on epiphytic diatoms and epiphyte propagules before they can settle on the seagrass, which reduces epiphyte loads and influences subsequent faunal settlement. If carefully implemented and monitored, long-line oyster aquaculture may be a sustainable option to consider as bivalve aquaculture expands to meet global seafood demand, but further work is needed to fully assess and generalize the community-level effects on seagrass epibionts.

Living shorelines enhanced the resilience of saltmarshes to Hurricane Matthew (2016).

Nature-based solutions, such as living shorelines, have the potential to restore critical ecosystems, enhance coastal sustainability, and increase resilience to natural disasters; however, their efficacy during storm events compared to traditional hardened shorelines is largely untested. This is a major impediment to their implementation and promotion to policy-makers and homeowners. To address this knowledge gap, we evaluated rock sill living shorelines as compared to natural marshes and hardened shorelines (i.e., bulkheads) in North Carolina, USA for changes in surface elevation, Spartina alterniflora stem density, and structural damage from 2015 to 2017, including before and after Hurricane Matthew (2016). Our results show that living shorelines exhibited better resistance to landward erosion during Hurricane Matthew than bulkheads and natural marshes. Additionally, living shorelines were more resilient than hardened shorelines, as they maintained landward elevation over the two-year study period without requiring any repair. Finally, rock sill living shorelines were able to enhance S. alterniflora stem densities over time when compared to natural marshes. Our results suggest that living shorelines have the potential to improve coastal resilience while supporting important coastal ecosystems.