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Most anthropogenic nitrogen (N) reaches coastal waters via rivers carrying increasing loads of sewage, fertilizer, and sediments. To understand anthropogenic N impacts, we need to understand historical N-dynamics before human influence. Stable isotope ratios of N preserved in carbonates are one way to create temporal N records. However, records that span periods of human occupation are scarce, limiting our ability to contextualize modern N dynamics. Here, we produce a fossil-bound N-record using coral subfossils, spanning 6700 years in China's Greater Bay Area (GBA). We found that during the mid-to-late Holocene, the GBA's coastal N was dominated by fluvial sources. The weakening of the Asia monsoon throughout the late-Holocene decreased river outflow, leading to a relative increase of marine nitrate. This source shift from riverine-to-ocean dominance was overprinted by anthropogenic N. During the late 1980s to early 1990s, human development and associated effluent inundated the coastal system, contributing to the decline of coral communities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Atmospheric deposition of nitrogen (N) from rain and aerosols can be a significant non-point source - particularly in urbanized coastal areas and contribute to coastal eutrophication and hypoxia. Here, we present geochemical and isotopic data from surface waters coupled with an 18-month time series of geochemical and isotopic data measured on wet and dry deposition over Hong Kong from June 2018. Dual stable isotopes of nitrate (δ 15 N-NO 3 - and δ 18 O-NO 3 - ) of rain and total suspended particulates (TSP) were analyzed to trace the sources and understand seasonal pattern of atmospheric nitrate. The δ 15 N of TSP, δ 15 N-NO 3 in rain and TSP ranged from +0.94 to +17.6‰, -4.1 to +3.0‰ and -1.3 to +9.0‰ respectively. δ 15 N varied seasonally with higher values in winter and lower values in summer. This variation can be explained by a change in the sources of atmospheric NO x driven by the East Asian Monsoon. It was found that most NO x comes from coal burning in winter and a mix of vehicle emissions, fossil fuel combustion and lightning in summer. Moreover, the estimated dry and wet deposition of nitrate and ammonium in Hong Kong is around 18 kg N ha -1 annually, which is of the same order of magnitude as N released by sewage effluents and groundwater. This implies that atmospheric N deposition over the N-limited waters of the eastern side of Hong Kong could contribute significantly to the N budget. Therefore, atmospheric N deposition may alter the local N marine cycling, thus monitoring its impact is crucial for water quality in Southern China., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

We present geochemical analysis of 75 surface water samples collected in 2016 in Hong Kong coastal waters. We found that nitrogen distribution around Hong Kong can be characterized by two regimes driven by the influence of the Pearl River: 1) a regime where nitrate is the dominant species of nitrogen, associated with lower salinity and more faecal coliform and 2) a regime where dissolved organic nitrogen is dominant, associated with higher salinity and fewer faecal coliform. While the impact of the Pearl River on Hong Kong coastal waters is well characterized, we used the sharp contrast between the nitrogen regimes to produce new evidence about the role of the Pearl River on the generation of local hypoxia in Hong Kong. The impact of nitrate originating from the Pearl River on the generation of hypoxia in Hong Kong might be less important than previously thought, as no sign of eutrophication was found within the zones dominated by dissolved organic nitrogen and an historical decoupling of surface processes and bottom water oxygenation was observed. Moreover, we measured elevated ammonium levels and rapid cycling of ammonium and dissolved organic nitrogen in Victoria Harbour suggesting local sources, such as wastewater, might be rapidly oxidized and thus play an important role in the consumption of oxygen locally. A first-order calculation highlighted the potential for wastewater to drive the observed seasonal decline in oxygen. Taken together, these evidences suggest that eutrophication might not be the primary driver in the generation of seasonal hypoxia and that oxidation of ammonium released locally might play a bigger role than initially thought., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Symbiotic corals receive energy not only by ingesting food (e.g. plankton, inorganic/organic matter, i.e. heterotrophy), but also by endosymbiosis, which supplies photosynthates (dissolved inorganic carbon, i.e. autotrophy). These two sources of energy have distinct fatty acid (FA) profiles, which can be used to differentiate corals by their primary feeding mode. FA profiles have been applied as biomarkers to evaluate the quality of nutrition in the midst of environmental change. However, species-specific responses of coral FA profiles and biosynthetic pathway under cultural eutrophication are still unknown. We collected two coral species (Acropora samoensis, Platygyra carnosa) from sites with different levels of eutrophication to test for variations in FA profiles. Gas Chromatography-Mass Spectrometry (GC-MS) was performed to identify FA profiles and quantify their concentration. Our main findings are threefold: 1) chronic eutrophication inhibits corals' ability to synthesize essential FA; 2) PUFA:SFA ratio and certain FA biomarkers or their pathway can be successfully utilized to determine the relative degree of autotrophy and heterotrophy in corals; 3) under eutrophication, different FA profiles of coral host tissue are attributed to different feeding strategies. Thus, our research provides significant new insights into the roles of FA as a risk assessment tool in coral reef ecosystems under the pressure of eutrophication., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Pulau Redang and Pulau Tioman have experienced huge tourism growth over the last two decades, but minimal sewage treatment may threaten the resilience of their coral reefs. This study uses stable isotope techniques to identify suitable bioindicators of sewage nutrients (δ 15 N) at these islands by measuring macroalgae (Lobophora spp.), gastropods (Drupella spp.), scleractinian coral (Acropora spp.), and leather coral (Sinularia spp.). At tourist hubs using seepage septic tank systems, enrichment of Acropora δ 15 N (Redang, +0.7‰) and Sinularia δ 15 N (Tioman, +0.4‰) compared to pristine background levels indicate enhanced sewage nutrient discharge. Carbon isotopes and survey data suggest that sedimentation did not confound these δ 15 N trends. Potential damaging effects of sewage discharge on the coral reef communities at both islands are highlighted by strong correlations between Acropora δ 15 N and regional variation in coral reef community structure, and exclusive occurrence of degraded reefs at regions of high sewage influence., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: The objective of this project was to develop valid and reliable course and instructor student evaluation tools (SETs) of teaching for utilization by a college of pharmacy., Methods: A collection of 119 course and instructor evaluation items was compiled from a review of the primary literature and grouped into six different themes (subscales): organization, communication, motivation, rapport, fairness, and learning. Input was sought from the college of pharmacy faculty to reduce the list of items to a more manageable pilot tool (27 for course evaluations; 29 for instructor evaluations) for developing pilot SETs. The results were analyzed for internal consistency and reliability using Cronbach's alpha, and whether factor structures aligned with the content structure using Confirmatory Factor Analysis (CFA)., Results: The Cronbach's alpha for all six subscales in the designed instructor evaluation and for three of the six subscales in the designed course evaluation were above 0.9, indicating high internal consistency and reliability. The CFA results indicated a moderate model fit with factor loadings for all items above 0.6. The correlation coefficients between each dimension were about 0.8, indicating high correlations among dimensions. Those data items found to be valid were then used to construct new course and instructor evaluation instruments, both consisting of three validated items in each of the six themes (subscales)., Conclusion: This report describes the process that one college of pharmacy employed to develop a valid and reliable SET. The methodology can inform other colleges and schools of pharmacy who wish to design, revise, or develop their own SETs., (Copyright © 2018 Elsevier Inc. All rights reserved.)

We investigated the potential of coral skeleton δ 15 N (CS-δ 15 N) records for tracking anthropogenic-N sources in coral reef ecosystems. We produced a 56yr-long CS-δ 15 N record (1958-2014) from a reef flat in Guam that has been exposed to varying 1) levels of sewage treatment 2) population density, and 3) land use. Increasing population density (from <30 to 300ind·km -2 ) and land use changes in the watershed resulted in a ~1‰ enrichment of the CS-δ 15 N record until a sewage treatment plant (STP) started operation in 1975. Then, CS-δ 15 N stabilized, despite continued population density and land use changes. Based on population and other considerations, a continued increase in the sewage footprint might have been expected over this time. The stability of CS-δ 15 N, either contradicts this expectation, or indicates that the impacts on the outer reef at the coring site were buffered by the mixing of reef water with the open ocean., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background and Purpose: The purpose of this project was to design and develop a health care communications course built around practice-like simulations and active learning in the first year of a professional pharmacy program., Educational Activity and Setting: A three-credit health care communications course was divided into one didactic (two hours per week) and three simulation components (one hour per week). The simulation components consisted of one written patient education pamphlet, three group presentations, and three one-on-one patient counseling sessions. This was accomplished by breaking the class of approximately 75 students into eight separate sections, each consisting of 8-10 students and one instructor. Each week four sections were devoted to counseling role-plays: half in the role of pharmacists and half as patients. The other four sections were devoted to hour-long professional group presentations-half in the presenting group and half as audience. The students' performance in the simulated counseling sessions and group presentations has been tracked and analyzed to determine if the simulated exercises had a positive impact on the students' active communications skills., Findings: Consistently, over the first four years of the implementation of the course, students' communications skills, as measured by faculty assessments, in both professional group presentations and one-on-one counseling sessions significantly improved., Discussion and Summary: Incorporation of active-learning simulation exercises into a healthcare communications course has a positive impact on the development of students' communications skills. This creates a foundation upon which students can build over the remainder of the professional program and into their future careers., (Copyright © 2017 Elsevier Inc. All rights reserved.)

For centuries, Bermuda has been challenged with wastewater management for the protection of human and environmental health. By quantifying the δ 15 N of the common sea fan Gorgonia ventalina sampled from 30 sites throughout Bermuda we show that sewage-derived nitrogen is detectable on nearshore coral reefs and declines across the lagoon to the outer rim. We also sampled gorgonians from two museum collections representing a 50y time-series (1958-2008). These samples revealed an increase in δ 15 N of >4.0‰ until the mid-1970s, after which δ 15 N values slowly declined by ~2.0‰. A δ 15 N chronology from a gorgonian skeleton exhibited a similar decline over the last 30-40years of approximately 0.6‰. We conclude that policies have been effective in reducing sewage impacts to Bermudian reefs. However, significant sources of sewage pollution persist and are likely have a strong impact on harbor and nearshore coral communities and human health., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Stable isotopes (δ(15)N, δ(18)O) can serve as tracers for sources of nitrogen in the receiving environment. Hong Kong discharges ~3×10(6)m(3)d(-1) of treated wastewater into the ocean from 68 facilities implementing preliminary to tertiary treatment. We sampled treated sewage from 18 plants across 5 treatment types and examined receiving seawater from northeast Hong Kong. We analyzed nitrate and nitrite (NO3(-)+NO2(-), hereafter NOx) ammonium (NH4(+)), phosphate (PO4(+)) concentrations and δ(15)NNOx, δ(18)ONOx. Sewage effluents contained high mean nutrient concentrations (NO3(-)=260μmolL(-1), NH4(+)=1400μmolL(-1), PO4(+)=50μmolL(-1)) with some indication of nitrogen removal in advanced treatment types. Mean δ(15)NNOx of sewage effluents from all plants and treatment types (12‰) was higher than natural sources and varied spatially and seasonally. There was no overall effect of sewage treatment type on δ(15)NNOx. A mass balance model indicated that sewage (>68%) remains a dominant source of nitrate pollution in seawater in Tolo Harbor., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The USEPA and the WHO now advocate the use of enterococci as indicators for marine water quality. This study investigated the outcomes for Hong Kong beach water quality assessment by comparing enterococcus measures with data from the HKEPD's monitoring programme. Six beaches were tested once every 2-3 months from November 2013 to June 2014 in order to identify the most contaminated sites, followed by intensive water sampling in sites found to have the highest enterococci densities (Clear Water Bay Second and Golden) every five to six days for six sampling events over a 30-day period in 2014. The geometric means of enterococci were found to be 124 and 41 cfu/100 mL at Clear Water Bay Second and Golden respectively, indicating that there may be higher risks of illness associated with swimming at both beaches than previously known. Moreover, beach sediments contained higher concentrations of enterococci than water, and warrant further study., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The goals of this study were to evaluate the contribution of sewage-derived N to reef flat communities in Guam and to assess the impact of N inputs on coral disease. We used stable isotope analysis of macroalgae and a soft coral, sampled bimonthly, as a proxy for N dynamics, and surveyed Porites spp., a dominant coral taxon on Guam's reefs, for white syndrome disease severity. Results showed a strong influence of sewage-derived N in nearshore waters, with δ(15)N values varying as a function of species sampled, site, and sampling date. Increases in sewage-derived N correlated significantly with increases in the severity of disease among Porites spp., with δ(15)N values accounting for more than 48% of the variation in changes in disease severity. The anticipated military realignment and related population increase in Guam are expected to lead to increased white syndrome infections and other coral diseases., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

In Stone Town, Zanzibar, sewage treatment is minimal, with a biological oxygen demand reduction to 60% and no removal of bacteria or nutrients. Here, Stone Town's sewage pollution was studied by measuring Enterococci and NH(4)(+) concentrations in seawater and δ(15)N of benthic organisms; samples were collected along the Stone Town shoreline and from offshore coral reefs. Public perceptions of sewage pollution were investigated via interviews. Enterococci from the Stone Town shoreline exceeded USEPA guidelines for recreational use. Benthic organisms from two of the four reefs were relatively enriched (δ(15)N>10 ‰), indicative of sewage derived N. δ(15)N values of organisms from Stone Town exceeded 16 ‰. A strong correlation was found between Enterococci and δ(15)N across sites, while step-wise regression indicated rainfall and tidal stage as important predictors for bacterial concentrations. These data provide an important impact assessment from which the efficacy of future policy and management change can be assessed., (Copyright © 2012 Elsevier Ltd. All rights reserved.)