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Despite the increasing awareness that sustainability is an issue needing ongoing attention, and despite millions of dollars spent yearly at universities to promote sustainable behaviors, previous research has found college students have primarily a unidimensional understanding of what sustainability encompasses. The current research sought to understand the depth of students' sustainability knowledge at one of the nation's "greenest" campuses and what implications this finding may have on future educational efforts. A representative sample of 779 students at a public liberal arts university were asked to define the term "sustainability" via an open-ended survey question. The survey also assessed students' knowledge of a dedicated on-campus sustainability office and preferred information sources and message channels. Definitions encompassing maintaining the status quo were the most prevalent, followed by definitions stating that sustainability had an environmental component. The least mentioned concepts were those encompassing the social or economic factors of sustainability--despite these factors being often-cited key components of sustainability. About one-third did not know their university had a Student Office of Sustainability. In addition, about 81% did not know that student fees had been supporting that office's $200,000 annual budget since its inception in 2011. Students' preferred source and message channels for receiving sustainability information (i.e., a mix of interpersonal sources and mass media channels) highlight the need for interdisciplinary collaboration and a multidimensional approach in sustainability education. Improvements in message branding and an increase in learning opportunities both inside and outside the classroom are recommended for advancing sustainability education on college campuses.

Biological applications of microfluidics technology is beginning to expand beyond the original focus of diagnostics, analytics and organ-on-chip devices. There is a growing interest in the development of microfluidic devices for therapeutic treatments, such as extra-corporeal haemodialysis and oxygenation. However, the great potential in this area comes with great challenges. Haemocompatibility of materials has long been a concern for blood-contacting medical devices, and microfluidic devices are no exception. The small channel size, high surface area to volume ratio and dynamic conditions integral to microchannels contribute to the blood-material interactions. This review will begin by describing features of microfluidic technology with a focus on blood-contacting applications. Material haemocompatibility will be discussed in the context of interactions with blood components, from the initial absorption of plasma proteins to the activation of cells and factors, and the contribution of these interactions to the coagulation cascade and thrombogenesis. Reference will be made to the testing requirements for medical devices in contact with blood, set out by International Standards in ISO 10993-4. Finally, we will review the techniques for improving microfluidic channel haemocompatibility through material surface modifications—including bioactive and biopassive coatings—and future directions.

Objectives To examine correlates of Neisseria gonorrhoeae antimicrobial resistance (AMR) to first-line antimicrobials (azithromycin, cefixime and ceftriaxone).Design and setting The sentinel surveillance network is an open cohort of gonococcal infection cases from Québec, Canada. Cross-sectional results are reported herein.Participants Between 1 January 2016 and 31 December 2019, data from 886 individuals accounting for 941 gonorrhoea cases were included.Methods Epidemiological and clinical data were collected using an auto-administered questionnaire, direct case interviews and chart reviews. Antimicrobial susceptibility testing was performed using the agar dilution method. Generalised estimating equations were used for regression.Results The prevalence of azithromycin resistance with a minimal inhibitory concentration (MIC) of ≥2 mg/L was 21.3%. In 2016, men who have sex with men were more likely to be infected with an azithromycin-resistant N. gonorrhoeae isolate (adjusted prevalence ratio (aPR)=4.73, 95% CI 1.48 to 15.19) or with an isolate with increased third-generation cephalosporin (3GC) MIC (aPR=5.32, 95% CI 1.17 to 24.11 for cefixime (MIC≥0.06 mg/L) and aPR=4.38, 95% CI 1.53 to 12.54 for ceftriaxone (MIC≥0.03 mg/L)). However, these associations were not maintained between 2017 and 2019, with increased MIC observed in men who have sex exclusively with women and women. Overall, azithromycin resistance was significantly more likely in cases who self-reported HIV infection (aPR=1.65, 95% CI 1.00 to 2.71). Cefixime increased MIC were more likely in individuals 25–34 years old (aPR=2.23, 95% CI 1.18 to 4.21). Cefixime and ceftriaxone increased MIC were both more likely in cases who reported ≥5 sexual partners (cefixime: aPR=2.10, 95% CI 1.34 to 3.27 and ceftriaxone: aPR=1.62, 95% CI 1.14 to 2.30).Conclusion Significant correlates of N. gonorrhoeae AMR to first-line antimicrobials were observed. Antimicrobial stewardship may be particularly important for 3GC. Active monitoring and interventions are critical for 3GC non-susceptible strains, especially considering the very low prevalence in Québec.

This review summarizes the current understanding of how brevetoxins, produced by Karenia brevis during harmful algal blooms, impact sea turtle health. Sea turtles may be exposed to brevetoxins through ingestion, inhalation, maternal transfer, and potentially absorption through the skin. Brevetoxins bind to voltage-gated sodium channels in the central nervous system, disrupting cellular function and inducing neurological symptoms in affected sea turtles. Moreover, the current evidence suggests a broader and longer-term impact on sea turtle health beyond what is seen during stranding events. Diagnosis relies on the detection of brevetoxins in tissues and plasma from stranded turtles. The current treatment of choice, intravenous lipid emulsion therapy, may rapidly reduce symptoms and brevetoxin concentrations, improving survival rates. Monitoring, prevention, and control strategies for harmful algal blooms are discussed. However, as the frequency and severity of blooms are expected to increase due to climate change and increased environmental pollution, continued research is needed to better understand the sublethal effects of brevetoxins on sea turtles and the impact on hatchlings, as well as the pharmacokinetic mechanisms underlying brevetoxicosis. Moreover, research into the optimization of treatments may help to protect endangered sea turtle populations in the face of this growing threat.

Academic Medical Centers (AMCs) offer patient care and perform research. Increasingly, AMCs advertise to the public in order to garner income that can support these dual missions. In what follows, we raise concerns about the ways that advertising blurs important distinctions between them. Such blurring is detrimental to AMC efforts to fulfill critically important ethical responsibilities pertaining both to science communication and clinical research, because marketing campaigns can employ hype that weakens research integrity and contributes to therapeutic misconception and misestimation, undermining the informed consent process that is essential to the ethical conduct of research. We offer ethical analysis of common advertising practices that justify these concerns. We also suggest the need for a deliberative body convened by the Association of American Medical Colleges and others to develop a set of voluntary guidelines that AMCs can use to avoid in the future, the problems found in many current AMC advertising practices.

BackgroundDuodenal biopsies are commonly obtained during esophagogastroduodenoscopy (EGD) but are very often histopathologically normal. Therefore, a more strategic method for evaluating the duodenal mucosa and avoiding unnecessary biopsies is needed.AimTo examine the clinical utility of narrow band imaging (NBI) for evaluating duodenal villous morphology.MethodsWe performed a prospective cohort study of adult patients at Mayo Clinic Rochester from 2013-2014 who were referred for EGD with duodenal biopsies. A staff endoscopist scored, in real-time, the NBI-based appearance of duodenal villi into one of three categories (normal, partial villous atrophy, or complete villous atrophy), captured ≥ 2 representative duodenal NBI images, and obtained mucosal biopsies therein. Images were then scored by an advanced endoscopist and gastroenterology fellow, and biopsies (gold standard) by a pathologist, in a masked fashion using the same three-category classification. Performing endoscopist, advanced endoscopist, and fellow NBI scores were compared to histopathology to calculate performance characteristics [sensitivity, specificity, positive and negative, negative predictive value (NPV), and accuracy]. Inter-rater agreement was assessed with Cohen's kappa.Results112 patients were included. The most common referring indications were dyspepsia (47%), nausea (23%), and suspected celiac disease (14%). Duodenal histopathology scores were: 84% normal, 11% partial atrophy, and 5% complete atrophy. Performing endoscopist NBI scores were 79% normal, 14% partial atrophy, and 6% complete atrophy compared to 91%, 5%, and 4% and 70%, 24%, and 6% for advanced endoscopist and fellow, respectively. NBI performed favorably for all raters, with a notably high (92%-100%) NPV. NBI score agreement was best between performing endoscopist and fellow (κ = 0.65).ConclusionNBI facilitates accurate, non-invasive evaluation of duodenal villi. Its high NPV renders it especially useful for foregoing biopsies of histopathologically normal duodenal mucosa.

Abstract Our understanding of the importance of microbiomes on large aquatic animals—such as whales, sea turtles and manatees—has advanced considerably in recent years. The latest observations indicate that epibiotic diatom communities constitute diverse, polyphyletic, and compositionally stable assemblages that include both putatively obligate epizoic and generalist species. Here, we outline a successful approach to culture putatively obligate epizoic diatoms without their hosts. That some taxa can be cultured independently from their epizoic habitat raises several questions about the nature of the interaction between these animals and their epibionts. This insight allows us to propose further applications and research avenues in this growing area of study. Analyzing the DNA sequences of these cultured strains, we found that several unique diatom taxa have evolved independently to occupy epibiotic habitats. We created a library of reference sequence data for use in metabarcoding surveys of sea turtle and manatee microbiomes that will further facilitate the use of environmental DNA for studying host specificity in epizoic diatoms and the utility of diatoms as indicators of host ecology and health. We encourage the interdisciplinary community working with marine megafauna to consider including diatom sampling and diatom analysis into their routine practices.

Assessments of health variables in wild animal populations have evolved into important tools for characterizing spatiotemporal population trends and fitness, effects of stressors, diseases, and ecosystem health. Blood as a sample matrix can be obtained fairly non-invasively in the field, with preservation and sample processing techniques that allow for readily available routine and advanced diagnostic testing of blood. For wild-caught hawksbill sea turtles (Eretmochelys imbricata) foraging in southeastern Florida, USA, the objectives of this study were to (1) establish reference intervals for hematological and 24 plasma biochemical analytes, (2) determine length-and body condition-specific relationships with blood analytes, and (3) determine how water temperature influenced plasma biochemical analytes. Reference intervals were established for clinically normal juvenile (n = 26) and subadult (n = 39) hawksbills, with descriptive data reported for adult turtles (n = 3). Although subadults (mainly captured at Palm Beach County) were heavier and larger with greater body depth, juveniles (mainly captured at Monroe County) had a higher body condition index. Positive length-specific correlations were identified for packed cell volume, eosinophils, aspartate aminotransferase, phosphorus, cholesterol, glutamate dehydrogenase, total protein, albumin, and globulins, with negative correlations including alkaline phosphatase, creatine kinase, calcium, calcium to phosphorus ratio, and glucose. Subadults had less frequent morphological features of red blood cell regeneration compared to juveniles. These findings provide insight into life-stage class differences regarding hematopoiesis, antigenic stimulation, somatic growth, dietary shifts, nutritional status, osmoregulation, metabolism, physical activity or stress levels, and possible habitat differences. Life-stage class is the likely driver for the observed blood analyte differences, in addition to influences from water temperature. The data herein offer baseline information for a snapshot in time for critically endangered hawksbills inhabiting the Florida reef system and for answering individual-and population-relevant questions of relevance to conservation and population management.

Summary Introduction Methods Results Discussion Iron deficiency, with or without anaemia, is common during the peri‐operative period. It has been hypothesised that pre‐operative iron deficiency is associated with an increased incidence of postoperative infection. We designed the CARIPO prospective observational study to assess the incidence of postoperative infection in patients with and without iron deficiency undergoing a variety of major surgeries.We conducted a single‐centre study in a tertiary, university‐affiliated hospital in France. Iron deficiency was defined as a ferritin < 100 μg.l‐1 or < 300 μg.l‐1 with a transferrin saturation < 20%. The primary outcome was incidence of any postoperative infectious complication measured at 90 days after surgery. Secondary endpoints included the incidence of individual infectious complications: surgical site infection; bacteraemia; pneumonia; urinary tract infection; peripheral line‐associated bacterial infection; and all‐cause postoperative complication.We recruited 390 patients. Of these, 170 (44%) had pre‐operative iron deficiency and 220 (66%) were iron replete; 27 (16%) patients in the iron deficient group developed a postoperative infection compared with 26 (12%) in the iron replete group (p = 0.25). Surgical site infections occurred in 11 (7%) iron deficient patients and 3 (1%) iron replete patients (p = 0.01). Other types of infectious complication and all‐cause postoperative complication were similar between groups.Iron deficiency was not associated with a higher rate of postoperative infection relative to an iron replete state. While iron deficiency was associated with a higher rate of surgical site infection, this result is hypothesis‐generating, and further prospective studies are required. [ABSTRACT FROM AUTHOR]

Digital citizen participation tools revolutionize how residents engage with urban issues, enabling unprecedented levels of collective discourse and large-scale involvement. These tools are essential for advancing urban design and planning through individual and asynchronous contributions. However, their inherent complexity often poses significant challenges for users. To mitigate this, developers and practitioners equip these platforms with user instructions aimed at simplifying navigation. Despite these efforts, the strategies for communicating the functionality and objectives of these tools, as well as their impact on participation processes, are not well understood. Accordingly, this study investigates the influence of different types of user instructions—descriptive versus non-descriptive—on users’ perceived reliability of digital participation platforms. Conducted in three phases—pre-participation, participation, and post-participation—the research involved modifying a digital tool and testing it with 47 university students engaged in a campus transformation project in Singapore using the Consul Project digital platform. The evaluation, carried out through surveys and semi-structured interviews in the post-participation phase, reveals that well-crafted descriptive instructions, which contain clear objectives, step-by-step guidance, and contextual information, significantly boost participants’ trust and engagement levels. Consequently, our findings underscore the importance of carefully designed user instructions in enhancing the effectiveness of digital citizen participation in urban design and planning. [ABSTRACT FROM AUTHOR]

Objective To describe Neisseria gonorrhoeae treatment failure to the recommended antimicrobial regimens (azithromycin, cefixime and ceftriaxone). Methods Our study was a longitudinal analysis of treatment failures from an observational open cohort of gonococcal infection cases collected in Québec, Canada (n  = 2547) between September 2015 and December 2019. Epidemiological and clinical data were collected using a self-administered questionnaire, direct case interviews and chart reviews. Antimicrobial susceptibility testing was performed using the agar dilution method. To be retained as a treatment failure, cases must have had (i) a laboratory-confirmed gonococcal infection; (ii) a documented treatment; (iii) a positive test of cure (TOC) performed within a defined period and (iv) no sexual contact (vaginal, oral or anal), even protected with a condom, between the beginning of treatment and the positive TOC. A broader definition, including suspected cases, was also examined. Results Among 1593 cases where a TOC was performed, 83 had a positive TOC: 11 were retained as treatment failure, and 6 were considered suspected cases (overall = 17/1593; 1.1%). Possible explanations for retained or suspected treatment failure included resistance to the antibiotics used for treatment (n  = 1), pharyngeal infection (n  = 9, of which 5 had been treated with ceftriaxone and 4 with other regimens); and azithromycin monotherapy (n  = 1). Some cases had more than one potential explanation. Conclusions Treatment failure occurred in 1.1% of cases of Neisseria gonorrhoeae infection for which a TOC was performed, including some cases of pharyngeal infection treated with ceftriaxone. [ABSTRACT FROM AUTHOR]