The University of Sudbury (French: Université de Sudbury) is a bilingual and tri-cultural university in Sudbury, Ontario, Canada. It provides undergraduate programming in both French and English in Religious Studies, Philosophy, Indigenous Studies, and in French in Journalism and Folklore. It was a federated school of Laurentian University until May 1, 2021, when Laurentian terminated its relationships with all of its federated schools as part of the 2021 Laurentian University financial crisis; it was subsequently announced that the University of Sudbury will continue operations as an independent French-language university.The university is a member of Association des collèges et universités de la francophonie canadienne (Association of Colleges and Universities of the Canadian Francophonie), a network of academic institutions of the Canadian Francophonie.Founded as a Roman Catholic institution, the university became officially secular in 2021.
BACKGROUND:Whether a hospital policy of tranexamic acid administration for patients undergoing major noncardiac surgery safely reduces the need for red-cell transfusion is uncertain. METHODS:We conducted a multicenter, double-blind, cluster-randomized, placebo-controlled trial involving patients undergoing noncardiac surgery who were at high risk for red-cell transfusion. Hospitals were randomly assigned at 4-week intervals to a hospital-wide policy of intraoperative tranexamic acid or placebo. The coprimary effectiveness and safety outcomes were transfusion of red cells during the index hospitalization and diagnosis of venous thromboembolism within 90 days, respectively. The safety outcome was assessed for noninferiority, with a prespecified noninferiority margin defined as an upper boundary of 1.46 for the 95% confidence interval of the relative risk. Analyses used mixed-effects models that accounted for the cluster-crossover design. RESULTS:A total of 8273 patients enrolled across 10 Canadian hospitals could be evaluated for the coprimary outcomes. Oncologic surgery accounted for 60.5% of the surgical procedures (5002 of 8273). The percentage of patients who received a red-cell transfusion during hospitalization was 7.4% (306 of 4156) in the tranexamic acid group and 9.8% (403 of 4117) in the placebo group (relative risk, 0.73; 95% confidence interval [CI], 0.61 to 0.86; adjusted difference, -2.7 percentage points; 95% CI, -4.2 to -1.4). Venous thromboembolism within 90 days occurred in 2.1% of patients (86 of 4128) in the tranexamic acid group and 2.1% of patients (85 of 4052) in the placebo group (relative risk, 0.96; 95% CI, 0.65 to 1.38; adjusted difference, -0.1 percentage points; 95% CI, -0.9 to 0.7), which met the criterion for noninferiority. CONCLUSIONS:Among patients undergoing major noncardiac surgery, a hospital policy of tranexamic acid administration resulted in a lower incidence of red-cell transfusion than placebo administration, and tranexamic acid was noninferior to placebo with regard to diagnosis of venous thromboembolism. (Funded by the Canadian Institutes of Health Research and others; TRACTION ClinicalTrials.gov number, NCT04803747.).
Urbanization exerts profound impacts on wildlife, often leading to morphological adaptation. However, species-specific effects of urbanization on amphibian populations remain poorly understood. American toads ( Anaxyrus americanus ) are the most widely distributed toad species in Ontario and are considered good indicators of environmental health due to their permeable skin and dual life strategy, which increase vulnerability to environmental change. American toad populations were expected to exhibit differences in morphological traits between urban and rural sites due to selective pressures imposed by urbanization. Based on previous literature, urban populations were predicted to show decreased parotoid gland size, increased limb size, increased tympanum diameter, reduced melanistic patterning, and increased body condition. Adult toads were sampled from seven sites in Lambton County, Ontario, with varying levels of urbanization estimated using the proportion of impervious surface area. Mass, snout–vent length, limb size, tympanum diameter, and parotoid area were measured, while melanistic patterning and body condition were calculated after sampling. Morphological traits were analyzed in relation to urban and rural site types using linear mixed-effects models. Toads in urban sites exhibited significantly less dorsal melanism than those in rural sites, with females more affected than males. Male toads in urban sites were also found to be in better body condition. These findings suggest that urbanization may drive morphological differences between urban and rural American toad populations and highlight the need for further research on the ecological and evolutionary consequences of urban environments on amphibians.
ABSTRACT Background Individually, sodium–glucose co‐transporter‐2 inhibitors (SGLT2i) and glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) have been shown to reduce major kidney and cardiovascular events in patients with chronic kidney disease (CKD). However, evidence supporting combined GLP‐1RA and SGLT2i therapy in this population remains limited. Methods We conducted a retrospective cohort study using the TriNetX Global Collaborative Network, including adults with CKD treated with SGLT2i alone or SGLT2i with subsequent initiation of GLP‐1RA between June 2020 and December 2023. Propensity score matching (1:1) adjusted for demographics, comorbidities, medications, and laboratory values. The primary outcome was major adverse kidney events (MAKE); secondary outcomes included all‐cause mortality and major adverse cardiovascular events (MACE). Time‐to‐event analyses were performed using Cox proportional hazards models. Results Among 112 596 patients with CKD, 16460 received SGLT2i and GLP‐1RA combination therapy, and 96 136 received SGLT2i monotherapy. The matched cohort included 32 448 patients (16 224 per group). Over a median follow‐up of 12 months, the addition of a GLP‐1RA was associated with lower rates of the primary outcome of MAKE (HR 0.70; 95% CI 0.65–0.74; p < 0.001) compared with SGLT2i monotherapy. Combination therapy was also associated with lower risks of MACE (HR 0.83; 95% CI 0.78–0.87) and all‐cause mortality (HR 0.55; 95% CI 0.50–0.61). Benefits were consistent across CKD stages and diabetes status, with significantly more pronounced effects observed in patients with obesity, heart failure, and ischemic heart disease. Combination therapy was associated with increased gastrointestinal symptoms, genital infections, and retinopathy progression, but lower risks of volume‐depletion events and acute kidney injury. Conclusions In this real‐world CKD cohort, GLP‐1RA added to SGLT2i therapy was associated with substantial incremental reductions in kidney disease progression and cardiovascular events. These findings suggest an additive cardiorenal benefit, particularly in patients with obesity, supporting the evaluation of combination therapy in future randomised trials.
Global spread of animal pathogens has contributed to species declines and extinctions. In regions where a particular disease is enzootic, pathogen inhibition may arise through protection provided by host-associated microbiomes. Amphibians skin microbiomes can inhibit growth of the fungal pathogen Batrachochytrium dendrobatidis (Bd), preventing emergence of disease through a range of microbe-mediated antifungal mechanisms, allowing hosts to resist Bd infection. However, it remains unclear how skin microbiomes may shift in community composition or structure following infection by different Bd strain types. We assessed infection dynamics of Bd-resistant amphibians (Ambystoma maculatum) following experimental exposure to enzootic and epizootic strains of Bd-GPL and tracking pathogen load and bacterial skin microbiome community responses from exposure through to recovery, using 16S rRNA metabarcoding. We found that microbiome communities shifted post-exposure, with increasing diversity, dominance, abundance and total proportion of known Bd-inhibitory microbes, indicating microbial rescue effects during infection. We also observed lower intra-host variation in diversity during recovery, indicating a shared functional response across the host population and broadly indicative of microbial community resilience. Salamanders exposed to enzootic Bd had greater pathogen loads over time and demonstrated more prolonged community changes and more putatively protective microbiomes, whereas epizootic Bd infection was more rapidly cleared following temporary increase in inhibitory microbes. Collectively, these results indicate that skin microbiomes may offer a crucial barrier to fungal disease in Bd-resistant amphibians, with exposure to pathogens inducing changes in microbial community structure that benefit hosts, possibly driven by localized coevolutionary changes in infection dynamics. Our work illustrates how complex host-pathogen interactions are mediated by skin microbiomes through changes in microbial community dynamics that favour pathogen resistant microbes.
Aerial insectivores have experienced steep population declines in North America, with an estimated loss of nearly 160 million individuals since the 1970s. Agricultural intensification, habitat loss, pesticide use, extreme climatic events, and loss of high-quality insect prey are all threats to aerial insectivore populations worldwide. Several species within the guild breed sympatrically or co-occur in agricultural areas, and thus aerial insectivores can act as indicators of ecosystem health within agricultural landscapes. Here, we highlight the valuable contributions of new research published as part of a Special Feature series on “Aerial Insectivores Breeding in Agricultural Landscapes”. In reviewing this research and the broader literature on aerial insectivores, we developed the hypothesis that habitat heterogeneity, and especially wetlands, support aerial insectivores breeding in agricultural landscapes. Importantly, wetlands are a source of emergent aquatic insects, and these high-quality prey items have been found in the diets of several species, including those of conservation concern. We provide evidence that (1) aerial insectivores use wetland habitats for foraging and roosting while breeding in agricultural landscapes; (2) wetlands improve the health, reproductive success, or fitness prospects of aerial insectivores; and, importantly, (3) wetlands may offset the negative effects of agricultural intensification. While evidence for the benefits of wetlands to aerial insectivores is biased toward breeding swallows in the Canadian Prairies, the higher nutritional value of insects emerging from wetlands and other aquatic sources points to the widespread value of wetlands for aerial insectivores in North America. Overall, protecting wetland habitat may be critically important for the conservation of healthy aerial insectivore populations in agricultural landscapes.
