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A university, medical school, and science center along with numerous K-12 public schools, university departments, local businesses, funded grant projects, and federal, state and private grants all work in concert to produce a unique partnership focusing on outreach to public school teachers and students. This article shares the history, work, vision, and future expectations of this partnership and proposes this model as one which can be replicated elsewhere. (Contains 1 figure.)

A community engaged research (CER) approach was used to provide an exposure assessment of poly- and perfluorinated (PFAS) compounds in North Carolina residential drinking water. Working in concert with community partners, who acted as liaisons to local residents, samples were collected by North Carolina residents from three different locations along the Cape Fear River basin: upper, middle, and lower areas of the river. Residents collected either drinking water samples from their homes or recreational water samples from near their residence that were then submitted by the community partners for PFAS analysis. All samples were processed using weak anion exchange (WAX) solid phase extraction and analyzed using a non-targeted suspect screening approach as well as a quantitative approach that included a panel of 45 PFAS analytes, several of which are specific to chemical industries near the collection site locations. The non-targeted approach, which utilized a suspect screening list (obtained from EPA CompTox database) identified several PFAS compounds at a level two confidence rating (Schymanski scale); compounds identified included a fluorinated insecticide, a fluorinated herbicide, a PFAS used in polymer chemistry, and another that is used in battery production. Notably, at several locations, PFOA (39.8 ng/L) and PFOS (205.3 ng/L) were at levels that exceeded the mandatory EPA maximum contaminant level (MCL) of 4 ng/L. Additionally, several sites had detectable levels of PFAS that are unique to a local chemical manufacturer. These findings were communicated back to the community partners who then disseminated this information to the local residents to help empower and aid in making decisions for reducing their PFAS exposure. [ABSTRACT FROM AUTHOR]

Leatherback sea turtles (Dermochelys coriacea) migrate along the east coast of the United States, traversing the South and Mid-Atlantic Bights (SAB and MAB) while traveling to and from well-known northern foraging areas off Southern New England (SNE) and Nova Scotia. However, there is limited information on leatherback movement behavior in these regions. To identify leatherback movement patterns, we fit hidden Markov models (HMMs) to satellite transmitter data from 52 leatherbacks tagged between 2017 and 2022 off the coasts of Massachusetts and North Carolina to estimate locations of area restricted searching (ARS) and transient behaviors. Depth-temperature profiles were then paired to locations associated with ARS behavior to understand the vertical use of the water column. We observed leatherbacks displaying ARS behavior in SNE as expected, but also in the MAB and SAB. The HMM results indicated that leatherbacks were primarily foraging in SNE between Nantucket and Long Island Sound and depth-temperature plots from ARS behavior on Nantucket Shoals implied turtles foraging throughout the entire water column. In the MAB, ARS behavior was concentrated between Cape Hatteras, North Carolina, and the mouth of Delaware Bay during the summer. Turtles were closely associated with a well-defined thermocline, but still appeared to dive to deeper cooler waters, which may be a sign of thermoregulatory behavior. There was evidence of foraging in the SAB along the coast as well as along the continental shelf edge. The ARS behavior we documented within the MAB and SAB is the first published empirical evidence that both areas may be important foraging grounds. Our results lay a path for future research to understand how leatherbacks use these areas and the potential anthropogenic threats encountered while moving through these regions. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Achilles tendon repairs and reconstructions have historically been associated with high wound infection rates due to poor vascularity in this region. The risk of postoperative infection, a potentially devastating complication, has led surgeons to pursue non-operative treatment when possible for a range of Achilles tendon pathology. However, new surgical techniques have allowed for smaller incisions and modern, aggressive infection control strategies have limited the morbidity associated with these complications. The present study will review a large case series of Achilles infections, evaluating treatment strategies and outcomes for patients who developed a postoperative infection following treatment for Achilles pathology. Methods: This is a retrospective case series including all patients who experienced a postoperative Achilles tendon infection at a single hospital. Cases from 11 surgeons performed between 2011 and 2020 were reviewed for infection requiring a return to the operating room for irrigation, debridement, and any other necessary interventions. Cases that presented to our institution with an existing infection were also included. Thorough chart review was performed for all patients to determine pathology and initial treatment method, infection management, and clinical outcomes. For patients undergoing Achilles reconstruction with a graft, operative notes were reviewed to determine whether the graft was infected and thus removed during debridement. Clinical follow-up was performed and Patient-Reported Outcomes Measurement Information System (PROMIS) surveys were sent to all patients who were over 1 year out from surgery. Results: 33 patients experienced a postoperative Achilles infection, including 10 who developed infection after surgery at an outside hospital. For patients treated initially at our institution, 8 presented with an acute rupture and 15 with chronic pathology. 12 of 15 chronic cases underwent reconstruction with a graft. For 3 reconstructions and 1 acute repair (12%) the entire Achilles was infected and removed. The graft was partially removed in 2 reconstruction cases (6%) and remained fully intact in the remaining 27 cases (82%). In 2/4 cases in which the Achilles was removed, it ultimately reconstituted as confirmed on MRI. A skin graft or flap was required in 5 of 33 cases (15%) for adequate soft-tissue coverage. In 14 cases (42%), the infection was controlled after a single debridement, 17 cases (52%) required a second debridement, and 2 cases (6%) a third. Postoperative PROMIS scores were available for 17 patients (Table 1). Conclusion: To our knowledge, this case series represents the largest number of postoperative infections analyzed following Achilles tendon surgery. Relatively high postoperative PROMIS scores indicate that infected patients can ultimately reach high levels of physical function with minimal pain when managed appropriately. In many cases the Achilles or graft could be salvaged and in those where it was not, the tendon did at times reconstitute. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Post-operative infections can be a devastating complication after Achilles tendon surgery. While Achilles infection rates have decreased with the development of less invasive surgical techniques, these infections remain a challenging complication for patients and clinicians due to the relative lack of vasculature in the Achilles tendon region. This study aimed to analyze rates of postoperative Achilles tendon infection based on the type of Achilles pathology and surgical approach. We hypothesized that procedures with smaller incisions that avoided the critical zone would be associated with lower infection rates than those that require larger incisions, such as reconstructions. Methods: All patients undergoing Achilles tendon surgery at a single, multi-surgeon center between 2011 and 2020 were identified. Charts were reviewed for infection, pathology, surgical approach, incision size, and risk factors such as body mass index (BMI), smoking status, and diabetes. Rates of infection were compared between groups based on pathology and operative technique. These groups included acute rupture treated immediately, chronic pathology treated with debridement and repair, and chronic pathology treated with graft reconstruction. For patients treated for an acute rupture, minimally invasive and open approach sub-groups were compared. Further, prevalence of risk factors was compared between patients with and without postoperative infections. Statistical comparisons were performed between groups using a student's t-test or Fisher's exact test. Results: A total of 1,148 cases were identified, 23 of which involved a post-operative infection requiring a return to the operating room for irrigation and debridement. The overall infection rate was 2.00%. Cases involving chronic pathology treated with graft reconstruction were associated with an infection rate of 8.96%. Acute repairs had an infection rate of 1.32% and other chronic pathologies treated without graft reconstruction had an infection rate of 0.73%. Statistical comparisons of infection rates for these sub-groups are displayed in Table 1 alongside comparisons of risk factor prevalence between the infection and non-infection groups. The comparison of risk factors between groups did not identify any significant differences. No infections were observed following the use of a distal lateral incision to treat chronic tendon pathology (179 cases) or the use of a windows incision technique for reconstructions (8 cases). Conclusion: Analysis of infection rates indicated that treatment options requiring large incisions, such as reconstruction with a graft, pose a significantly greater risk of post-operative Achilles infection. Both minimally invasive treatments and measured open incisions were associated with similarly low infection rates for primary repair of acute ruptures. Comparison of risk factors between patients with and without infection did not reveal any significant differences. Given low infection rates for chronic pathology treated with distal lateral incisions and windows-type incisions, we recommend these whenever possible. [ABSTRACT FROM AUTHOR]

Natural and anthropogenic environmental impacts can introduce contaminants into sensitive habitats, threatening ecosystems and human health. Consistent monitoring of coastal areas provides critical environmental assessment data. Sediments and Eastern Oyster (Crassostrea virginica) tissues were collected at fourteen South Carolina (SC) and four North Carolina (NC) sites as part of the National Oceanic and Atmospheric Administration's Mussel Watch environmental monitoring program. Cellular and molecular techniques were employed to measure C. virginica stress response, specifically, Lipid Peroxidation (LPx), Glutathione (GSH), and qPCR techniques. Gene specific primers targeted for detecting oxidative stress and cellular death were developed in C. virginica to gauge response to current environmental conditions using gill and hepatopancreas (HP) tissue. In order to validate gene specific markers as additional assessment tools, a 96 h zinc (Zn) laboratory exposure was performed. Cellular biomarker data revealed tissue specific responses. Hepatopancreas data showed C. virginica exhibited stress through the lipid peroxidation assay amongst sampling sites, however, response was managed through glutathione detoxification. Gill tissue data had significantly lower levels of cellular biomarker response compared to hepatopancreas. Molecular biomarkers targeting these cellular stress pathways through qPCR analysis show upregulation of Metallothionein in hepatopancreas and gill tissue with a concurrent > 2-fold upregulation in the detoxification marker Superoxide Dismutase (SOD) at three NC sites. SC sites displayed higher stress levels through LPx assays and down-regulation in GPx gene activity. Laboratory zinc exposure revealed no significance in cellular biomarker results, however, molecular data showed gills responding to zinc treatment through upregulation of Metallothionein, SOD and Cathepsin L, indicating an acute response in gills. Collectively, chemical, cellular and molecular methods clarify sentinel stress response of biological impacts and aid in evaluating environmental health in coastal ecosystems. This combined methodological approach provides a detailed analysis of environmental conditions and improves land-use management decisions. [Display omitted] • Cellular, molecular and chemical methods enhance monitoring shoreline communities • Genetic markers are valuable in providing supporting data for sentinel health • Quantitative PCR clarifies biomarker data by detecting stress pathway fluctuations • Acute zinc exposure effects are observed in C. virginica gill apoptosis gene, CathL • There were no regions of chemical concern within the Carolinas sites analyzed [ABSTRACT FROM AUTHOR]