Georgia Urology

Over the past three years, the University of North Georgia (UNG) has advanced the goals of the National Science Foundation’s GEOPAths:IN program by strengthening geoscience education for grades 9–12 STEM and Special Education teachers and their students through sustained, hand-on professional development and outreach. Central to this effort was GeoEd, a week-long professional development workshop designed to increase exposure to the geosciences,and build teacher confidence and capacity for the years 2022, 2023 and 2024. GeoEd engaged teachers through hands-on field experiences, laboratory investigations, and the use of geospatial technologies, all framed within Project/Problem-Based Learning (PBL) and aligned with Georgia state science standards in Biology, Physics, Chemistry, and Environmental Science. In-person workshops and student programs have demonstrated clear gains in teacher confidence, instructional capacity, and student engagement. However, a critical challenge in educational outreach initiatives such as GeoEd, include long-term sustainability beyond the funding period. To address this challenge, UNG developed a centralized, open-access website that curates and hosts all instructional materials created and developed through the GeoEd workshops and related GEOPAths activities. These resources include standards-aligned PBL modules, lesson plans, GIS and Google Earth exercises, datasets, assessment tools, and implementation guides designed for classroom use. By making these materials freely available, the website removes financial, geographic, and institutional barriers to professional development and enables teachers to revisit, adapt, and share resources as their instructional needs evolve.A defining feature of the hosted materials is their emphasis on inclusive and accessible geoscience instruction. Several activities include accessible versions intentionally designed to support students with a wide range of learning abilities. This approach empowers both STEM and Special Education teachers to integrate Earth Science concepts into inclusive classrooms while maintaining academic rigor and alignment with required state standards. Teachers report increased confidence in adapting geoscience content for diverse learners, expanded use of geospatial technologies, and greater student engagement with real-world Earth system challenges such as climate change, resource management, and environmental hazards.This presentation highlights the design, implementation, and early impacts of this open-access resource hub as a sustainable model for scaling Earth Science education. By extending the reach of professional development well beyond in-person participation, the website supports thousands of students indirectly through teacher use and adaptation of materials. This work demonstrates how partnerships between university departments and K–12 teachers, combined with freely available, high-quality teaching resources, can strengthen the visibility, relevance, and inclusivity of Earth Science in school curricula. Ultimately, this model contributes to building long-term geoscience capacity, fostering scientific literacy, and supporting a more diverse and informed next generation of Earth scientists, educators and citizens capable of addressing global sustainability challenges.

Ebola virus disease (EVD) survivors develop post-acute ophthalmic sequelae, including a high prevalence of uveitis that may be complicated by vision-threatening cataract. After the non-detection of Ebola virus (EBOV) RNA in sampled ocular fluid, vision impairment due to cataract can be treated safely and effectively via manual small incision cataract surgery (MSICS). However, the long-term ocular visual outcomes and assessment of ocular tissues, including for genomic RNA, have been infrequently or not reported in Western African survivors. A cohort of EVD survivors with visually significant cataract, in whom EBOV RNA was not detected by RT-PCR testing of ocular fluid sampled prior to MSICS, were followed for a year after intraocular lens replacement. Ophthalmic outcomes, including visual acuity (VA), adverse events, and follow-up examinations, were recorded. Ocular tissue specimens obtained at MSICS underwent histopathologic examination and in-situ hybridization (ISH) targeting EBOV genomic RNA. Thirty-four EVD survivors underwent MSICS and were included for analysis. The median age of EVD survivors who underwent surgery at enrollment was 22.5 years (Interquartile range, IQR: 16.5-33) and the cohort was comprised of 20 females (58.8%). Median logMAR VA at preoperative baseline was 3 (IQR: 1-3) which improved to 0.4 (IQR: 0-0.6; n = 10; p = 0.002) and 0.6 (IQR: 0.18-0.78; n = 18; p < 0.0001) at 6- and 12-months following surgery, respectively. EBOV RNA was not detected in 7 cataract and capsular tissue specimens obtained at the time of MSICS. After MSICS, meaningful improvement in vision was maintained in EVD survivors at long-term follow-up. EBOV RNA was not detected in cataract and lens capsule specimens, providing additional reassurance of the low risk of EBOV RNA exposure during cataract surgery. Further study is needed to understand long-term ocular outcomes, including adverse events, in this population. Ebola virus disease (EVD) survivors may develop several ophthalmic sequelae including uveitis and cataract that may lead to severe vision loss if left untreated. Manual small incision cataract surgery (MSICS) has been utilized to treat cataract in EVD survivors with encouraging short-term outcomes, but the long-term visual acuity outcomes and the potential for Ebola virus RNA to reside in cataract material is unknown. In this study, we reported long-term visual acuity outcomes following MSICS in a cohort of EVD survivors along with histopathology findings from materials collected during surgery. Visual acuity improved over 12-month follow-up with encouraging safety measures. Ebola virus RNA was not detected in cataract and lens capsular tissue analyzed from EVD survivors. This study provides additional assurance regarding the safety and efficacy of cataract surgery, with potential for improved vision for EVD survivors.

After he learned that his congenital bicuspid aortic valve needed replacement, a urologic oncologist describes, in this narrative medicine essay, the pain and helplessness he felt while recovering from surgery.

Mohs micrographic surgery (MMS) offers high cure rates for nonmelanoma skin cancer (NMSC) but relies on precise margin assessment, traditionally initiated by the naked eye. Dermoscopy has emerged as a potential tool to improve margin delineation. To compare the efficacy of dermoscopic versus naked eye evaluation in marking initial MMS margins for NMSC. A multicenter, prospective study on patients with NMSC undergoing MMS was conducted. Patients were randomized into dermoscopy and naked eye groups. Statistical analysis was performed using statistical package for social sciences. A total of 127 patients were enrolled, with 63 in the naked eye group and 64 in the dermoscopy group. No significant differences in age, sex distribution, or histological subtype were found. The average number of MMS stages and accuracy of initial margins were comparable between groups. Despite its potential, the authors' study found no significant reduction in total MMS stages using dermoscopy. Novel imaging modalities or standardized dermoscopic criteria should be explored to enhance margin assessment accuracy and improve outcomes in NMSC treatment. Dermoscopic evaluation of presurgical margins does not effectively assess lateral/deep margins nor contribute to a reduction in total MMS stages. Improving the authors' understanding of presurgical margin assessment techniques can lead to better treatment outcomes for NMSC.

Fecal microbiota transplantation (FMT) is recommended for the treatment of recurrent Clostridioides difficile infection (rCDI). In the current study, we evaluated rates of rCDI and subsequent FMT in a large metropolitan area. We compared demographic and clinical differences in FMT recipients and nonrecipients and quantified differences in outcomes based on treatment modality. A retrospective community-wide cohort study was conducted using surveillance data from the Georgia Emerging Infections Program, the Georgia Discharge Data System, and locally maintained lists of FMTs completed across multiple institutions to evaluate all episodes of C. difficile infection (CDI) in this region between 2016 and 2019. Cases were limited to patients with rCDI and ≥1 documented hospitalization. A propensity-matched cohort was created to compare rates of recurrence and mortality among matched patients based on FMT receipt. A total of 3038 (22%) of 13 852 patients with CDI had rCDI during this period. In a propensity-matched cohort, patients who received an FMT had lower rates of rCDI (odds ratio, 0.6 [95% confidence interval, .38-.96) and a lower mortality rate (0.26 [.08-.82]). Of patients with rCDI, only 6% had received FMT. Recipients were more likely to be young, white, and female and less likely to have renal disease, diabetes, or liver disease, though these chronic illnesses were associated with higher rates of rCDI. These data suggest FMT has been underused in a population-based assessment and that FMT substantially reduced risk of recurrence and death.

The authors declare no conflict of interest.

Chemical agents have been utilized for centuries in warfare and pose a health threat to civilians and military personnel during armed conflict. Despite treaties and regulations against their use, chemical agent exposure remains a threat and measures to understand their effects and countermeasures for systemic and organ-specific health are needed. Many of these agents have ocular complications, both acute and chronic. This mini-review focuses on key chemical agents including vesicants (mustards, lewisite), nerve agents (sarin, VX), knockdown gasses (hydrogen cyanide), and caustics (hydrofluoric acid). Their ophthalmic manifestations and appropriate treatment are emphasized. Acute interventions include removal of the source and meticulous decontamination, as well as normalization of pH to 7.2–7.4 if alteration of the ocular pH is observed. Besides vigorous lavage, acute therapies may include topical corticosteroids and non-steroid anti-inflammatory therapies. Appropriate personal protective equipment (PPE) and strict donning and doffing protocols to avoid healthcare provider exposure are also paramount in the acute setting. For more severe disease, corneal transplantation, amniotic membrane graft, and limbal stem cell transplantation may be needed. Orbital surgery may be required in patients in whom cicatricial changes of the ocular surface have developed, leading to eyelid malposition. Multidisciplinary care teams are often required to handle the full spectrum of findings and consequences associated with emerging chemical threats.