Search Results (224)

This study assessed the baseline indoor environmental quality (IEQ) of secondary school classrooms in Tanzania by measuring temperature, relative humidity, noise, lighting, and indoor air quality. Objective measurements were conducted using calibrated sensors in 14 classrooms across five schools, with data collected during occupied school hours and additional noise measurements during unoccupied periods. All classrooms are naturally ventilated through operable windows and doors. The findings reveal a pattern of cumulative IEQ deficiencies: classroom temperatures frequently exceeded the recommended 20–24 °C range, reaching means as high as 30.4 °C, while relative humidity varied widely, with levels occasionally surpassing 65%. Noise levels consistently exceeded the World Health Organization (WHO)’s recommended 35 dBA threshold, with significant differences observed between occupied and unoccupied periods (p = 0.02). Light distribution was uneven, with significantly higher lux levels near windows than at classroom centers (p < 0.001), and artificial lighting was generally insufficient due to infrastructure limitations. Although CO₂ concentrations remained below the 1000 ppm threshold, indicating adequate ventilation, particulate matter levels were often elevated, with PM2.5 reaching up to 58.80 µg/m³ and PM10 up to 96.90 µg/m³, exceeding health-based guidelines. Together, these findings suggest that students are exposed to multiple environmental stressors that may impair health, comfort, and academic performance. This study provides a critical baseline for future research and context-specific interventions aimed at improving learning environments in Tanzanian schools and similar settings in East Africa. Full article

Background/Objectives: Iron stores accrued in utero are critical for fetal and infant neurodevelopment. Low neonatal hemoglobin (Hb) may indicate inadequate iron capture and storage. Prior studies differ on whether and under what conditions maternal anemia predicts neonatal Hb; whether sex differences are present is unknown. Methods: Maternal and neonatal Hb and sociodemographic and health characteristics were abstracted from electronic medical records for biorepository participants at a tertiary academic medical center. Maternal anemia was defined as Hb < 11 g/dL in trimesters T1 and T3 and Hb < 10.5 g/dL in T2. Adjusted linear regression models were used to estimate associations of maternal anemia with neonatal Hb. Sex differences were evaluated with product terms and stratification. Results: In 228 participants with maternal Hb measured, the prevalence of prenatal (pre-delivery) and delivery anemia was 54% and 44%, respectively. Maternal race and ethnicity but no other sociodemographic characteristics were associated with maternal anemia. Neonatal hematology was available for 114 newborns < 7 days old (50%; 52% male). The median (IQR) neonatal Hb was 16.7 g/dL (14.9, 18.0) and did not differ by sex, but it was lower among infants of mothers with vs. without delivery anemia (15.9 vs. 17.1, p = 0.032) and those identifying as Black vs. Hispanic or other (16.0, 17.9, 17.0, respectively; p = 0.003). Independent associations of maternal anemia and race and ethnicity with neonatal Hb were stronger in males and attenuated to null in females. Conclusions: Maternal anemia was highly prevalent and associated sex-specifically with neonatal Hb independent of maternal race and ethnicity. Future studies to replicate these findings with a more comprehensive panel of iron biomarkers are needed. Functional consequences of greater susceptibility to risk factors for low neonatal Hb in male infants need to be further investigated. Full article

Artificial Intelligence (AI) is reshaping mental healthcare by enabling new forms of diagnosis, therapy, and patient monitoring. Yet this digital transformation raises complex policy and ethical questions that remain insufficiently addressed. In this paper, we critically examine how AI-driven innovations are being integrated into mental health systems across different global contexts, with particular attention to governance, regulation, and social justice. The study follows the PRISMA-ScR methodology to ensure transparency and methodological rigor, while also acknowledging its inherent limitations, such as the emphasis on breadth over depth and the exclusion of non-English sources. Drawing on international guidelines, academic literature, and emerging national strategies, it identifies both opportunities, such as improved access and personalized care, and threats, including algorithmic bias, data privacy risks, and diminished human oversight. Special attention is given to underrepresented populations and the risks of digital exclusion. The paper argues for a value-driven approach that centers equity, transparency, and informed consent in the deployment of AI tools. It concludes with actionable policy recommendations to support the ethical implementation of AI in mental health, emphasizing the need for cross-sectoral collaboration and global accountability mechanisms. Full article

Background/Objectives: Mental disorders that emerge during adolescence frequently extend into adulthood, predicting poor academic and employment outcomes and heavy societal burdens. Novel efforts to improve youth mental health have transitioned from clinical recovery, typically focused on a cure, to a strength-based approach to wellbeing in supporting youth within mental health services. Mental health scholars have appealed for interventions to adopt an ecological system of care approach that integrates the principal caregivers in a young person’s life. Despite preliminary literature indicating the importance of caregivers, little research has focused on the caregiver’s role in supporting personal recovery in youth. Methods: This study sought to understand the role of caregivers in youth recovery by employing a qualitative design to inductively analyze the narratives from nine semi-structured interviews with caregivers. Additionally, deductive analysis explored the core five underpinnings of personal recovery connectedness, hope, identity, meaning, and empowerment (CHIME). Results: A thematic analysis of the literature identified five themes: providing unconditional love and positive regard; encouraging connection with peers; co-creating a sense of purpose, meaning, and hope; supporting assertiveness and advocacy; and promoting strength and opportunity for mastery aligning with the CHIME framework. The findings will allow health services to understand caregivers’ roles better, thus providing information to guide recovery-oriented and family-centered care. Full article

Community-Engaged Research (CER) arose as a means of increasing the democratic participation of communities that study outcomes directly impact. CER has been identified as a recommended approach for conducting biomedical and behavioral health research with Black communities, a population that has been excluded from and exploited by academic health research for centuries. However, solely increasing community participation without identifying and redressing racialized power imbalances within community–academic partnerships involving Black populations can stall progress towards racial health equity. The purpose of this study was to explore how power can be redistributed equitably in community–academic health research partnerships involving Black populations. Utilizing the qualitative methodological approach of critical narrative inquiry, counter-stories from 12 Black individuals who have served as community partners on U.S.-based academic health research teams were collected via in-depth semi-structured narrative interviews. A reflexive thematic analysis approach was utilized to identify and analyze strategies expressed by study participants for increasing community agency, efficacy, and solidarity in health research. By centering the voices of Black community members who have directly engaged with academic health research institutions, this study sought to amplify the desires and aspirations of Black communities regarding shifting power in health research processes and outcomes. Full article

Background/Objectives: Necrotizing pneumonia (NP) is an uncommon, severe complication of community-acquired pneumonia (CAP) associated with increased hospital length of stay and high morbidity and mortality. Although this entity was described several decades ago, there is no consensus on radiological criteria for diagnosis, optimal antibiotic duration, or data on clinical outcomes in adults. Given the paucity of data on this entity, a retrospective cohort study was conducted at our institution to evaluate factors associated with all-cause mortality, hospital length of stay, and duration of antibiotics. Methods: An IRB-approved retrospective cohort analysis was conducted through electronic health record review at a tertiary academic center at the University of Florida—Jacksonville. The electronic health record was queried for a list of all hospitalizations from 1 January 2016 to 31 December 2023 with an International Classification of Diseases, 10th revision diagnosis code of J85.0 (gangrene and necrosis of the lung). The primary outcome was all-cause mortality, and secondary outcomes were hospital length of stay and duration of antibiotics. Results: A total of 57 patients met the definition of necrotizing pneumonia and were included in our study. Fourteen (24.6%) patients died while hospitalized. The mean length of hospital stay was 26.6 days, and the median duration of antibiotics was 28 days. The only statistically significant predictor in the model of all-cause mortality was the requirement of mechanical ventilation, with mortality being 27 times more likely in patients requiring mechanical ventilation (OR 27.6 (95% CI (2.6924, 671.9648)); p = 0.011). Conclusions: To our knowledge, this is the largest cohort of adult patients with NP in the literature. We found that mortality was 24.6%, with the requirement of mechanical ventilation associated with 27 times higher risk of mortality on multivariable logistic regression analysis. Full article

The Global Virus Network (GVN) is a voluntary consortium of virology laboratories and affiliated scientists that seek to prevent and control global viral threats. The meetings of the GVN are characterized by academic, health center, government, and industry participation, sharing information that is designed to further the mutual mission. In September 2024, the meeting in Durban, South Africa, highlighted diseases and investigators from Africa, and paid special attention to pandemic preparedness. Selected highlights from the meeting are presented here, along with a call-to-action in defense of global partnerships for research in the origins of human and animal viruses, the risk to humans from other animal sources, the pathogenesis of given viruses, and their prevention and treatment. Discussions of laboratory discovery science are juxtaposed with development of vaccines, antiviral drugs, immunotherapies, and innovative field strategies for control of viral diseases. Full article

Background/Objectives: Psychological vulnerability in individuals with obesity represents a significant concern in the context of bariatric surgery. This study aimed to assess psychosocial functioning and identify the psychological, clinical, and sociodemographic predictors of impairment among patients undergoing preoperative evaluation. Methods: A retrospective observational study was conducted on patients referred for bariatric surgery at a single academic medical center. Data were collected through clinical interviews and validated psychometric tools: the Clinical Impairment Assessment (CIA), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Robust multiple regression analysis determined associations between CIA scores and psychological and demographic factors. Results: A total of 688 patients were evaluated (median age: 46 years; 70.3% female). Most had a high school education (56.9%) and were employed (69%). Elevated scores on the Clinical Impairment Assessment (CIA) were significantly associated with female gender (β = 1.075, p = 0.029), moderate anxiety (GAD-7 ≥ 10; β = 3.85, p < 0.001), and severe depressive symptoms (PHQ-9 ≥ 15; β = 16.67, p < 0.001). Other significant predictors included prior psychotherapy (β = 1.18, p = 0.044), aesthetic motivation for surgery (β = 0.92, p = 0.120), and expectations that weight loss would improve self-esteem (β = 2.11, p = 0.001) or social relationships (β = 1.98, p = 0.002). Conversely, physical activity was associated with lower CIA scores (β = –1.23, p = 0.050). The regression model showed strong explanatory power (McFadden R² = 0.529). Conclusions: This study highlights key predictors of psychosocial distress in bariatric candidates, underscoring the importance of comprehensive psychological assessment before surgery. The CIA appears to be a valuable screening and monitoring tool. Future research should explore the longitudinal evolution of psychosocial functioning and support the integration of psychological care into multidisciplinary bariatric programs. Full article

Objective: Current good manufacturing practice (cGMP) guidance for positron emission tomography (PET) drugs has been established in Europe and the United States. In Japan, the Pharmaceuticals and Medical Devices Agency (PMDA) approved the use of radiosynthesizers as medical devices for the in-house manufacturing of PET drugs in hospitals and clinics, regardless of the cGMP environment. Without adequate facilities, equipment, and personnel required by cGMP regulations, the quality assurance (QA) and clinical effectiveness of PET drugs largely depend on the radiosynthesizers themselves. To bridge the gap between radiochemistry standardization and site qualification, the Japanese Society of Nuclear Medicine (JSNM) has issued guidance for the in-house manufacturing of small-scale PET drugs under academic GMP (a-GMP) environments. The goals of cGMP and a-GMP are different: cGMP focuses on process optimization, certification, and commercialization, while a-GMP facilitates the small-scale, in-house production of PET drugs for clinical trials and patient-specific standard of care. Among PET isotopes, N-13 has a short half-life (10 min) and must be synthesized on site. [¹³N]Ammonia ([¹³N]NH₃) is used for myocardial perfusion imaging under the Japan Health Insurance System (JHIS) and was thus selected as a working example for the manufacturing of PET drugs in an a-GMP environment. Methods: A [¹³N]NH₃-radiosynthesizer was installed in a hot cell within an a-GMP-compliant radiopharmacy unit. To comply with a-GMP regulations, the air flow was adjusted through HEPA filters. All cabinets and cells were disinfected to ensure sterility once a month. Standard operating procedures (SOPs) were applied, including analytical methods. Batch records, QA data, and radiation exposure to staff in the synthesis of [¹³N]NH₃ were measured and documented. Results: 2.52 GBq of [¹³N]NH₃ end-of-synthesis (EOS) was obtained in an average of 13.5 min in 15 production runs. The radiochemical purity was more than 99%. Exposure doses were 11 µSv for one production run and 22 µSv for two production runs. The pre-irradiation background dose rate was 0.12 µSv/h. After irradiation, the exposed dosage in the front of the hot cell was 0.15 µSv/h. The leakage dosage measured at the bench was 0.16 µSv/h. The exposure and leakage dosages in the manufacturing of [¹³N]NH₃ were similar to the background level as measured by radiation monitoring systems in an a-GMP environments. All QAs, environmental data, bacteria assays, and particulates met a-GMP compliance standards. Conclusions: In-house a-GMP environments require dedicated radiosynthesizers, documentation for batch records, validation schedules, radiation protection monitoring, air and particulate systems, and accountable personnel. In this study, the in-house manufacturing of [¹³N]NH₃ under a-GMP conditions was successfully demonstrated. These findings support the international harmonization of small-scale PET drug manufacturing in hospitals and clinics for future multi-center clinical trials and the development of a standard of care. Full article

With the growing demand for mobility fueled by global population expansion and rapid urbanization, the intricate interplay between public transport and land use, along with their economic, environmental, and social externalities, has emerged as a critical concern for policymakers and the public alike. This study assembles publicly available academic literature, including papers, reports, books, and news articles, to construct a comprehensive database. Using CiteSpace 5.8.R3 software, this study conducts a visualized analysis of 10,470 scholarly works on public transport and land use published since 1932, identifying and synthesizing the researcher, research stages, research theories, research models, and research hotspots. Findings reveal that since Mitchell and Rapkin first introduced the transport–land use relationship in 1954, research in this field has steadily gained traction, particularly after the 1973 oil embargo crisis. The Journal of Transport and Land Use and institutions such as the University of Minnesota’s Transportation Research Center have played pivotal roles, particularly with the establishment of the World Society for Transport and Land Use Research (WSTLUR). In recent years, China’s high-speed rail expansion has further revitalized interest in this field. Prominent scholars in this domain include Robert Cervero, Reid Ewing, Michael Duncan, and Peter Calthorpe. Major theoretical frameworks encompass utility theory, urban economic theory, and the human–land system theory. Key modeling approaches include the spatial interaction model, the stochastic utility model, and urban economic models. Current research hotspots center on safety and public health, equity and valuation, environmental sustainability and energy efficiency, as well as transit-oriented development (TOD) and accessibility. This systematic literature review offers valuable insights to inform land use planning, enhance spatial structure, guide transportation project decision making, and optimize transport infrastructure and service provision. Full article

Academic success in medical education is shaped by a complex interaction of biological predispositions, lifestyle choices, and mental health status. Understanding these factors is essential for student-centered educational reform and well-being support systems. This study investigates the association between biological traits, lifestyle behaviors, psychological stress, and academic outcomes among Vietnamese medical students. A cross-sectional survey of 1227 students from a Vietnamese medical university was conducted, with valid GPA data from 1038 participants. Data on biological (age, sex, BMI, blood group), lifestyle (diet, sleep, exercise, screen time, self-study), stress-related (DASS-21 scores, life domain-specific stressors), and social–academic factors (major, year, roommates) were collected. Linear regression models were applied to explore relationships with GPA. Lifestyle factors (R² = 0.032, p = 0.001) such as eating dinner (p = 0.001), self-study hours (p = 0.005), and having breakfast (p = 0.046) were positively associated with GPA. Biological variables had a smaller impact (R² = 0.013), with age showing a modest positive association (p = 0.001). Mental health scores (DASS-21) explained 1.2% of GPA variance (p = 0.007), with depression positively and stress negatively influencing performance. Academic year was a consistent predictor across models (p = 0.001), and multivariate regression combining all categories (R² = 0.048, p < 0.001) confirmed these relationships. In conclusion, regular mealtime patterns, particularly having breakfast and dinner, and consistent self-study routines are stronger predictors of GPA than biological or general stress markers. Educational institutions should promote healthy daily routines and academic mentoring. Full article

Background: The COVID-19 pandemic had a significant impact on nursing students by intertwining academic demands with health concerns, a situation that had effects on their emotional well-being and academic engagement. Factors such as sociodemographic characteristics and health status determined their experiences. Understanding these dynamics is crucial, especially in the context of the Spanish health and education systems. The present study aimed to adapt and assess the psychometric properties of the AMICO scale in the context of nursing students in Spain. Methods: Cross-sectional descriptive study. The study was carried out in University Nursing Centers in Spain using a non-probabilistic snowball sampling method. The total sample consisted of 1197 nursing students. Sociodemographic variables were included, as well as questions related to general health and some more specific questions about COVID-19. For the reliability study, Cronbach’s alpha was calculated. An exploratory factor analysis using principal components and varimax rotation was applied, excluding items with loadings below 0.05. Results: In this study, 1197 nursing students residing in Spain participated, of whom 85% were female, with a mean age of 22.35 years. Despite 73.9% of the students being isolated due to exposure to COVID-19, they rated their general health positively (7.86). Females reported higher levels of anxiety. The AMICO scale revealed significant differences according to gender, health, and vaccination history, showing high reliability (Cronbach’s alpha = 0.913). Conclusions: The two-factor structure of the AMICO scale was validated, confirming its suitability for assessing anxiety and fear among nursing students in Spain. The study revealed significant emotional distress during the COVID-19 pandemic, particularly among women, high-risk individuals, and those fully vaccinated. These findings accentuate the need for higher education institutions to implement targeted mental health interventions during public health emergencies. Future longitudinal research should examine the evolving psychological impact of such crises and the mitigating roles of quality of life, sleep, and physical activity. Full article

Introduction: The World Health Organization has identified dementia as a growing global health concern with 10 million new cases diagnosed every year. The growing number of people living with dementia (PLWD) heightens the need for effective interventions that support PLWD and their caregivers. The most effective interventions supporting PLWD and caregivers combine education, care, and services to increase knowledge, decrease stigma, improve care, heighten empathy, and increase engagement of PLWD in their communities. Dementia Friendly America (DFA), administered by USAging, promotes a Dementia Friendly Community (DFC) initiative designed to engage multiple sectors (e.g., business, healthcare, community services) and engage PLWD in a comprehensive community change process. A center for healthy aging and wellness at a midwestern public university developed a network approach in its regional support of eight DFCs, as a part of its Geriatric Workforce Enhancement Program funded by the U.S. Health Resources and Services Administration. Objective: This article documents a mid-size university’s approach to establishing a regional DFC network of urban and rural communities surrounding the university, describing the support the university provided as well as how communities implemented the four-phase DFC process and emulated guiding principles. Results: A retrospective evaluation found engagement with the DFA guiding principles and varying levels of adherence to DFC phases. Discussion: The project team suggests that there are unique roles that universities can play in supporting the DFC movement and that developing a network of communities is a helpful strategy to use in providing this support. Additionally, the authors propose the integration of a community change model to guide future DFC work. Conclusions: This article helps to fill an existing research gap concerning DFC implementation and explores the unique role academic partners can play in cultivating regional hubs of DFC activity. Full article

Background: Resistance to vaccinations continues to pose a considerable challenge to attaining widespread vaccination, especially among the college student demographic, who are pivotal in championing public health initiatives. This systematic review investigates the elements that influence reluctance to receive the COVID-19 vaccine among university students globally. Utilizing the WHO’s 3C model, which encompasses confidence, complacency, and convenience, this review seeks to pinpoint the main factors and suggest focused strategies to address them. Methods: Following the PRISMA guidelines, we conducted a systematic search in PubMed, Medline, Web of Science, Scopus, Embase, and Global Health. Eligible studies were cross-sectional, peer-reviewed, and examined COVID-19 vaccine hesitancy among college students. Covidence was used for screening, and data were synthesized narratively using the 3C model. Results: Sixty-seven studies (n = 88,345 participants) from 25 countries were included in this study. Confidence factors were the most influential, with fear of side effects (87.18%) and doubts about efficacy (72.4%) as primary concerns. Complacency factors included a low perceived risk of infection (34.9%) and a preference for alternative preventive measures (52.3%). Convenience barriers involved financial costs (58.1%) and difficulty accessing vaccination centers (40.3%). Subgroup analyses revealed variations by academic discipline and geographic region, with medical students showing hesitancy despite their health knowledge. Conclusions: COVID-19 vaccine hesitancy among college students is primarily driven by safety concerns, misinformation, and accessibility barriers. Addressing hesitancy requires transparent risk communication, policy-driven accessibility improvements, and tailored educational interventions. These findings can inform strategies to enhance vaccine uptake among young adults and contribute to broader efforts in pandemic preparedness. Full article

Background: Medical imaging and therapeutic tools are used on a daily basis. Some of these technologies bear potential risk of harm due to exposure to ionizing radiation. Previous research has shown a lack of knowledge and awareness surrounding ionizing radiation among a wide range of medical staff. Objectives: This study aimed to evaluate the knowledge and awareness of ionizing radiation in a large tertiary medical center and compare the knowledge and awareness among types of hospital employees. Methods: A cross-sectional study based on an anonymous 32-question questionnaire was conducted. Participants were categorized by employee type, including physicians, nurses, allied health professionals, and ancillary and administrative staff. The questionnaire was divided into demographic profile, professional characteristics related to ionizing radiation, and knowledge and awareness. Knowledge and awareness scores were analyzed as standard scores (Z-scores). Univariate and multivariable analyses were performed. Results: The study included 479 participants. Physicians received the highest scores compared to other employee types, participants who had received ionizing radiation training received higher scores, and similar trends were observed for employees working in departments with higher potential for radiation exposure. Conclusions: This research underscores the need to enhance ionizing radiation knowledge and awareness among hospital staff. Achieving this may involve training sessions, workshops, and academic courses. Full article