Flying along the supply chain: accounting for emissions from student air travel in the higher education sector

Higher education institutions (HEIs) can play a key role in facilitating the transition to a low carbon economy, where reporting greenhouse gas emissions is an important step in this process. While most UK HEIs are required to report estate emissions, engagement with supply chain emissions has been inconsistent. This research examined emissions arising from the air travel of international and study-abroad students and their visiting friends and relatives (VFR). Survey results demonstrated that flight frequencies were substantially higher than those assumed in sector guidance. An analysis of 25 UK HEIs found student and VFR flight emissions were significant, each being greater than other Scope 3 travel and comparable to Scope 2 emissions. Scenario analysis suggests that by 2020/2021, increases in flight emissions are likely to exceed reductions in estate emissions unless HEIs reinvigorate efforts to achieve reduction targets, and/or there is close to zero growth in inbound and outbound student numbers. It is thus imperative that HEIs develop an accurate picture of these emissions in order to inform their carbon management and internationalization strategies. In doing so, the risk of a rebound-type effect must also be considered, where if action is taken to reduce student flights, VFR flights may increase

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Air-sea fluxes of biogenic bromine from the tropical and North Atlantic Ocean

Air-sea fluxes and bulk seawater and atmospheric concentrations of bromoform (CHBr3) and dibromomethane (CH2Br2) were measured during two research cruises in the northeast Atlantic (53-59° N, June-July 2006) and tropical eastern Atlantic Ocean including over the African coastal upwelling system (16-35° N May-June 2007). Saturations and sea-air fluxes of these compounds generally decreased in the order coastal > upwelling > shelf > open ocean, and outside of coastal regions, a broad trend of elevated surface seawater concentrations with high chlorophyll-a was observed. We show that upwelling regions (coastal and equatorial) represent regional hot spots of bromocarbons, but are probably not of major significance globally, contributing at most a few percent of the total global emissions of CHBr3 and CH2Br2. From limited data from eastern Atlantic coastlines, we tentatively suggest that globally, coastal oceans (dept

Low carbon futures: assessing the status of decarbonisation efforts at universities within a 2050 perspective

Background: The implementation of sustainability at universities means that they can also play a key role in the transition to a low carbon economy, and in assisting global efforts towards decarbonisation. Yet, not all of them have so far fully engaged in this area. This paper reviews the state of the art on trends in decarbonisation, and outlines the need for decarbonisation efforts at universities. It also reports on a survey aimed at ascertaining the extent to which universities in a sample of 40 countries across the various geographical regions are engaged in carbon reduction efforts, identifying the challenges faced. Results: The study has shown that the literature on the topic has been evolving over time and that increasing a given university’s energy supply from renewable energy sources has been the cornerstone of university-based climate action plans. The study also indicates that even though several universities are concerned with their carbon footprint and actively seeking ways to reduce it, there are some institutional obstacles that need to be overcome. Conclusions: A first conclusion which can be drawn is that efforts on decarbonisation are becoming more popular, with a special focus being placed on the use of renewable energy. Also, the study has shown that, from the range of efforts being made towards decarbonisation, many universities are setting up a team with carbon management responsibilities, have Carbon Management Policy Statements, and review them. The paper points towards some measures which may be deployed, so as to allow universities to take better advantage of the many opportunities an engagement in decarbonisation initiatives offers to them

Chronicling the Journey of the Society for the Advancement in Biology Education Research (SABER) in its Effort to Become Antiracist: From Acknowledgement to Action

The tragic murder of Mr. George Floyd brought to the head long-standing issues of racial justice and equity in the United States and beyond. This prompted many institutions of higher education, including professional organizations and societies, to engage in long-overdue conversations about the role of scientific institutions in perpetuating racism. Similar to many professional societies and organizations, the Society for the Advancement of Biology Education Research (SABER), a leading international professional organization for discipline-based biology education researchers, has long struggled with a lack of representation of People of Color (POC) at all levels within the organization. The events surrounding Mr. Floyd’s death prompted the members of SABER to engage in conversations to promote self-reflection and discussion on how the society could become more antiracist and inclusive. These, in turn, resulted in several initiatives that led to concrete actions to support POC, increase their representation, and amplify their voices within SABER. These initiatives included: a self-study of SABER to determine challenges and identify ways to address them, a year-long seminar series focused on issues of social justice and inclusion, a special interest group to provide networking opportunities for POC and to center their voices, and an increase in the diversity of keynote speakers and seminar topics at SABER conferences. In this article, we chronicle the journey of SABER in its efforts to become more inclusive and antiracist. We are interested in increasing POC representation within our community and seek to bring our resources and scholarship to reimagine professional societies as catalyst agents towards an equitable antiracist experience. Specifically, we describe the 12 concrete actions that SABER enacted over a period of a year and the results from these actions so far. In addition, we discuss remaining challenges and future steps to continue to build a more welcoming, inclusive, and equitable space for all biology education researchers, especially our POC members. Ultimately, we hope that the steps undertaken by SABER will enable many more professional societies to embark on their reflection journeys to further broaden scientific communities