Search Results (231)

Nephrogenic diabetes insipidus (NDI) is a rare hereditary disorder characterized by renal resistance to arginine vasopressin (AVP), resulting in the kidneys’ inability to concentrate urine. Approximately 90% of NDI cases follow an X-linked inheritance pattern and are associated with pathogenic variants in the AVPR2 gene, which encodes the vasopressin receptor type 2. The remaining 10% are attributed to mutations in the AQP2 gene, which encodes aquaporin-2, and may follow either autosomal dominant or recessive inheritance patterns. We present the case of a male infant, younger than nine months of age, who was clinically diagnosed with NDI at six months. The patient presented recurrent episodes of polydipsia, polyuria, dehydration, hypernatremia, and persistently low urine osmolality. Despite adjustments in pharmacologic treatment and strict monitoring of urinary output, the clinical response remained suboptimal. Given the lack of improvement and the radiological finding of an absent posterior pituitary (neurohypophysis), the possibility of coexistent central diabetes insipidus (CDI) was raised, prompting a therapeutic trial with desmopressin. Nevertheless, in the absence of clinical improvement, desmopressin was discontinued. The patient’s management was continued with hydrochlorothiazide, ibuprofen, and a high-calorie diet restricted in sodium and protein, resulting in progressive clinical stabilization. Whole-exome sequencing identified a novel homozygous missense variant in the AQP2 gene (c.398T > A; p.Val133Glu), classified as likely pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria: PM2 (absent from population databases), PP2 (missense variant in a gene with a low rate of benign missense variation), and PP3 (multiple lines of computational evidence supporting a deleterious effect)]. NDI is typically diagnosed during early infancy due to the early onset of symptoms and the potential for severe complications if left untreated. In this case, although initial clinical suspicion included concomitant CDI, the timely initiation of supportive management and the subsequent incorporation of molecular diagnostics facilitated a definitive diagnosis. The identification of a previously unreported homozygous variant in AQP2 contributed to diagnostic confirmation and therapeutic decision-making. The diagnosis and comprehensive management of NDI within the context of polyuria-polydipsia syndrome necessitates a multidisciplinary approach, integrating clinical evaluation with advanced molecular diagnostics. The novel AQP2 c.398T > A (p.Val133Glu) variant described herein was associated with early and severe clinical manifestations, underscoring the importance of genetic testing in atypical or treatment-refractory presentations of diabetes insipidus. Full article

Background: As COVID-19 transitions to an endemic phase, long COVID symptoms remain a significant public health issue affecting both physical and mental health. A notable proportion of college students report symptoms such as fatigue, cough, and brain fog persisting for weeks or months post-infection. Objectives: This study explored the prevalence and contributing factors of long COVID symptoms among both infected and uninfected students in medicine-related departments. Methods: A cross-sectional study was conducted using online self-reported questionnaires completed by 1523 undergraduate and graduate students in medicine-related departments at a medical university. Participants who had tested positive for COVID-19 within the past three months were excluded. The survey assessed long COVID symptoms, with comparisons conducted between infected and uninfected groups. Multivariate logistic regression identified risk factors associated with long COVID symptoms. Results: Of the 1118 participants, 47.5% of those with a prior COVID-19 diagnosis reported long COVID symptoms within the past month. Significant differences between the infected and uninfected groups were observed in physical, cognitive, and psychological health. Logistic regression identified that prior COVID-19 diagnosis had an association with the presence of long COVID symptoms (odds ratio = 1.48, p = 0.024) after adjusted model analysis. Meanwhile, higher anxiety levels (odds ratio = 1.09, p < 0.001) and a BMI ≥ 24 (odds ratio = 4.50, p < 0.01) were identified as significant risk factors for post-infection syndrome among previously infected students. Sex and exercise habits also influenced symptom prevalence. Conclusions: Since late 2023, with those experiencing cumulative infections surpassing half of Taiwan’s population, long COVID symptoms have persisted as a widespread concern affecting both physical and mental health, continuing into 2025. This study underscores critical risk factors and symptom patterns among students in medicine-related departments, reinforcing the urgency of sustained surveillance and targeted interventions to facilitate comprehensive recovery. Full article

Bias and fairness issues in artificial intelligence (AI) algorithms are major concerns, as people do not want to use software they cannot trust. Because these issues are intrinsically subjective and context-dependent, creating trustworthy software requires human input and feedback. (1) Introduction: This work introduces an interactive method for mitigating the bias introduced by machine learning models by allowing the user to adjust bias and fairness metrics iteratively to make the model more fair in the context of undergraduate student admissions. (2) Related Work: The social implications of bias in AI systems used in education are nuanced and can affect university reputation and student retention rates motivating a need for the development of fair AI systems. (3) Methods and Dataset: Admissions data over six years from a large urban research university was used to create AI models to predict admissions decisions. These AI models were analyzed to detect biases they may carry with respect to three variables chosen to represent sensitive populations: gender, race, and first-generation college students. We then describe a method for bias mitigation that uses a combination of machine learning and user interaction. (4) Results and Discussion: We use three scenarios to demonstrate that this interactive bias mitigation approach can successfully decrease the biases towards sensitive populations. (5) Conclusion: Our approach allows the user to examine a model and then iteratively and incrementally adjust bias and fairness metrics to change the training dataset and generate a modified AI model that is more fair, according to the user’s own determination of fairness. Full article

Background: Individuals with ADHD may perform poorly on tasks targeting executive functioning skills such as the ImPACT, which requires the test-taker to employ judgement in non-routine situations Objective: To determine whether ADHD serves as a mediating variable for increasing the likelihood of an invalid score. Materials and Methods: A total of 39,140 collegiate athletes and United States military cadets consented to the Concussion Assessment, Research, and Education (CARE) Consortium study. Participants completed the CARE Baseline Packet which included various sections through which study participants provide self-report data, including demographic, personal, and family history sections. The personal history portion of the CARE Baseline Packet addressed the participant’s neurological history, including self-reported diagnosis of ADHD and history of traumatic brain injury. Variables utilized for the current study included age, gender, race, ethnicity, the participant’s primary college sport, use of mouthguards for athletes competing in sports requiring them, and the presence of an ADHD diagnosis. Participants responded to a question, inquiring if they had ever been diagnosed by a medical professional with ADHD, ultimately producing a dichotomous yes/no response. Results: We found that participants with ADHD were more likely to produce invalid baseline scores (ß = −0.884; p < 0.001). Similar results were found when controlling for sex, race, age, sport played, mouthguard use, and number of previous concussions (ß = −0.786; p < 0.001). Sex, race, sport played, and mouthguard use each played a significant role in determining profile validity, independent of ADHD diagnosis. With ADHD removed from the model, age negatively affected the likelihood of a valid score (ß = −0.052; p = 0.048). Conclusions: Our study suggests that the relationship between age and ImPACT validity is explained by the presence of ADHD. Results support adjusting ImPACT’s validity thresholds for individuals with ADHD. Full article

Background/Objectives: Lower extremity non-contact injuries (LE-NCIs) pose a significant burden on the National Football League (NFL), with ongoing debates regarding playing surface safety. The stressful college-to-professional transition period for rookies, which can include adapting to new playing surfaces, may influence injury susceptibility. This study aimed to determine whether the transition in a home stadium turf type (natural grass, artificial, and hybrid) from the final college season to the rookie NFL season impacts LE-NCI likelihood. Methods: A retrospective cohort study analyzed 826 first and second-round NFL draft picks from 2012 to 2024. Data on college/NFL home surfaces (defining six transition types), position group, college training surface access, and rookie season LE-NCIs were collected from public sources. Competing risk analysis was used to estimate the cumulative LE-NCI incidence. Multivariable logistic regression assessed the association between turf transition and LE-NCI risk, adjusting for position, draft cohort, and college training access. Results: During their rookie season, 21.2% (175/826) of players sustained an LE-NCI. Skill position players had significantly higher adjusted odds of LE-NCI compared to hybrid players (AOR = 1.88; 95% CI: 1.20–2.97; p = 0.006). No specific turf transition category showed a statistically significant association with LE-NCI risk compared to the Grass-to-Grass reference in adjusted models. College training surface access was also not significantly associated with risk (AOR = 0.97; 95% CI: 0.65–1.45; p = 0.874). Cumulative LE-NCI incidence reached 33.1% by season end, with risk accelerating between weeks 4 and 10. Conclusions: Home stadium turf-type transition from college to the NFL was not significantly associated with LE-NCI risk in this rookie cohort, suggesting that surface transitions may not be a primary risk factor during the professional transition period. However, our analysis revealed significant position-dependent injury patterns (skill players: AOR = 1.88) and a temporal clustering of injuries between weeks 4 and 10, indicating that rookie LE-NCI prevention strategies should prioritize position-specific interventions and enhanced monitoring during the early- to mid-season high-risk period rather than surface transition-based approaches. Full article

Emerging but limited evidence suggests that HIV infection does not affect in-hospital COVID-19 mortality, regardless of the prevalence of HIV infection in most parts of sub-Saharan Africa, especially the southern Africa region, and Zambia, Lusaka District in particular, is not an exception. Therefore, this study aimed to determine the effect of HIV infection, demographics, and clinical factors on mortality among hospitalized COVID-19 patients at Levy Mwanawasa University Teaching Hospital (LMUTH). A cross-sectional study was conducted with a sample size of 698 adults admitted for COVID-19 at LMUTH from 18 March 2020 to 31 December 2021. For all statistical analysis of data, STATA statistical software, version 15 MP (College Station, TX 77845, USA) was used—ensuring that appropriate statistical techniques were applied to the data. Unadjusted and adjusted logistic regressions were conducted to model COVID-19 mortality among COVID-19 patients based on their HIV status while controlling for five predictor variables. Based on the results, the best predictors of in-hospital COVID-19 mortality were HIV status, number of comorbidities, age in years, smoking, and alcohol intake. The results suggest that COVID-19 mortality among those with HIV and those without HIV infection was different. People living with HIV infection had increased odds of COVID-19 mortality compared to those without HIV. The results further suggested that a unit increase in age was associated with increased odds of COVID-19 mortality. Furthermore, drinking alcohol and having two or more comorbidities increased the odds of COVID-19 mortality compared to not drinking alcohol, having no comorbidity, or having a comorbidity. This study, therefore, concludes that HIV infection has a significant effect on COVID-19 mortality among patients hospitalized at LMUTH and that the proportion of COVID-19 mortality in the HIV-infected group is relatively higher than in the uninfected group. Therefore, there is a need for close monitoring of COVID-19 patients with HIV infection. Full article

Matching problems arise in various settings where two or more entities need to be matched—such as job applicants to positions, students to colleges, organ donors to recipients, and advertisers to ads slots in web advertising platforms. This study introduces the preference adjustment matching algorithm (PAMA), a novel matching framework that pairs elements, which conceptually represent a bipartite graph structure, based on rankings and preferences. In particular, this algorithm is applied to tutor–module assignment in academic settings, and the methodology is built on four key assumptions where each module must receive its required number of candidates, candidates can only be assigned to a module once, eligible candidates based on ranking and module capacity must be assigned, and priority is given to mutual first-preference matches with institutional policies guiding alternative strategies when needed. PAMA operates in iterative rounds, dynamically adjusting modules and tutors’ preferences while addressing capacity and eligibility constraints. The distinctive innovative element of PAMA is that it combines concepts of maximal and stable matching, pending status and deadlock resolution into a single process for matching tutors to modules to meet the specific requirements of academic institutions and their constraints. This approach achieves balanced assignments by adhering to ranking order and considering preferences on both sides (tutors and institution). PAMA was applied to a real dataset provided by the Hellenic Open University (HOU), in which 3982 tutors competed for 1906 positions within 620 modules. Its performance was tested through various scenarios and proved capable of effectively handling both single-round and multi-round assignments. PAMA effectively handles complex cases, allowing policy-based resolution of deadlocks. While it may lose maximality in such instances, it converges to stability, offering a flexible solution for matching-related problems. Full article

Background and Objectives: Contraceptive education may influence reproductive health outcomes, foster greater sexual autonomy, and improve mental well-being. The current study investigated the efficacy of a structured contraceptive counseling program on reproductive health knowledge, sexual autonomy, anxiety, and depressive symptoms among Romanian college women. Materials and Methods: A prospective study was conducted during the 2021–2024 academic years, enrolling 240 female students aged 18–26 from the “Victor Babes” University of Medicine and Pharmacy in Timisoara. The participants were divided into two arms: (1) Intervention Group (IG, n = 115), which was provided counseling materials, and (2) Control Group (CG, n = 116), which received no additional counseling. Baseline and post-intervention data were collected using a contraceptive knowledge quiz (CKQ), a sexual autonomy scale (SAS), the WHOQOL-BREF, GAD-7, and PHQ-9. Results: After the 12-week intervention, the IG demonstrated significant improvements in contraceptive knowledge (mean CKQ score: 25.5 ± 3.1 vs. 20.1 ± 4.3 in CG, p < 0.001), sexual autonomy (SAS: 82.6 ± 9.2 vs. 75.7 ± 10.1, p < 0.001), and psychological well-being indicators: lower anxiety (GAD-7: 3.1 ± 2.0 vs. 5.2 ± 2.3, p < 0.001) and depression scores (PHQ-9: 4.8 ± 2.0 vs. 7.1 ± 2.2, p < 0.001). Multiple regression analysis showed that membership in the IG was the most significant predictor of improved post-intervention contraceptive knowledge and reduced mental distress, even after adjusting for confounders such as age, socioeconomic status, and relationship status. Conclusions: A structured contraceptive counseling program can significantly enhance reproductive health knowledge, strengthen sexual autonomy, and reduce depressive and anxiety symptoms among Romanian college women. The findings emphasize the importance of developing systematic, multi-faceted interventions for improving students’ reproductive well-being and mental health outcomes within university settings. Full article

In recent years, some college graduates in China have chosen to postpone or avoid employment due to the disparity between their career expectations and the reality of the job market, leading to the emergence of a group of graduates not in employment, education, or training (NEETs). As the number of individuals in this group continues to grow, exploring effective strategies to mitigate such behavior has become increasingly important. Based on self-determination theory, this study conducted an empirical analysis using a multi-wave questionnaire survey with a sample of 226 graduate NEETs in Shanghai, China. The findings indicate that (1) career expectations do not directly reduce social withdrawal behavior; (2) the mere accumulation of human capital is insufficient to decrease social withdrawal—only when knowledge and skills are further transformed into problem-solving ability does an individual’s tendency toward social withdrawal significantly decline; and (3) human capital and problem-solving ability serve as a sequential mediating mechanism between career expectations and social withdrawal behavior. This study expands the research on the formation mechanisms of social withdrawal behavior and elucidates the proactive adaptation pathways in individuals’ career adjustment processes. The findings provide theoretical insights for higher education institutions to shift from traditional knowledge transmission models toward a greater emphasis on problem-solving ability development. Full article

Background/Objectives: We examined the association between bean consumption and the risk of gestational diabetes mellitus (GDM). Methods: We analyzed data from 1397 U.S. pregnant women from Infant Feeding Practices Study II. By using a Diet History Questionnaire, pregnant women were asked about the frequency of consumption and portion size of dried beans, chili, and bean soup over the previous month. They also reported the status of GDM. We used multivariable logistic regression models to examine associations between maternal bean consumption and the risk of GDM, adjusting for socio-demographic and pregnancy-related confounders. Results: Mean bean consumption was low among pregnant women: 0.31 cups/week of dried beans, 0.16 cups/week of chili, and 0.10 cups/week of bean soup. Dried bean consumption was relatively high in Hispanic mothers (mean, 0.65 cups/week) and mothers from the East South Central region (0.44). Chili consumption was relatively high in mothers who were Black (0.33), who did not attend college (0.18), who had a household size of 4+ (0.19), whose household income was <USD 25,000/year (0.20), who were WIC recipients (0.18), or who lived in the East South Central region (0.26). Pregnant women who consumed chili one time per month had a lower risk of GDM, compared with never consumers (3.5% vs. 7.4%; confounder-adjusted odds ratio or OR, 0.37 [95% confidence interval or CI, 0.17–0.79]; p = 0.011). However, there was no significant association between dried bean (6.6% for one time per week or more vs. 7.0% for never; confounder-adjusted OR, 0.82 [95% CI, 0.41–1.62]; p-value = 0.569) or bean soup (4.9% for two–three times per month or more vs. 6.6% for never; confounder-adjusted OR, 0.40 [95% CI, 0.05–3.08]; p-value = 0.382) consumption and GDM. Conclusions: Bean consumption during pregnancy is low and varies by socio-demographics in the U.S. A moderate frequency of chili consumption may offer some protection against GDM. Replication is needed in larger cohorts with more diverse populations, detailed measures of bean consumption, gold standards of GDM diagnosis, and experimental design. Research in this field can potentially inform dietary approaches to addressing GDM and related morbidities. Full article

This study aimed to increase the understanding of academic stress and coping strategies of third culture kids (TCKs) in South Korean colleges. For this aim, six Korean college students who are TCKs were interviewed. For analyzing the interview data, consensual qualitative research was used. As a result, participants’ academic stressors were related to language, interpersonal relationships, learning strategies, career issues, and financial difficulties. As their coping strategies, they reported preparation and review, help-seeking, group study, goal orientation, self-efficacy, and control belief. The results of this study can help South Korean TCK college students with academic stressors, reducing their related stress and allowing them to adjust well in college. We also discussed how educational institutions can help those students overcome academic stress and find their coping strategies. Full article

Objective: This work aimed to develop and validate a scale to assess motivations for alcohol drinking among Mexican college students. Methods: The scale design consisted of applying a stimulus phrase to assess motivations for moderate alcohol drinking (up to three drinks per occasion) and severe alcohol consumption (four or more drinks) in 130 college students. The semantic network technique was applied to identify 15 defining motivations (with more considerable semantic weight) for each drinking level, constituting the pilot scale. The pilot scale was validated on 307 students from a public university in Mexico (255 with moderate drinking and 82 with severe consumption). Results: The final number of items per level of drinking was 10 (moderate drinking) and 13 (severe consumption). Internal reliability (Cronbach’s alpha) for the first one was 0.886 with three factors that explain 57.5% of the total variance; the second had an alpha of 0.884 with four factors that explain 70.5% of the total variance. All the factors had positive correlations with the risk perception for alcohol drinking, and there was a positive correlation between severe consumption motivation and the risk perception for consumption of other substances. The confirmatory factor analysis showed that the proposed theoretical models adjust to the data with an error of approximately zero (i.e., RMSEA of 0.088 for moderate consumption and 0.074 for severe consumption), which also carefully measures the motivation for moderate and severe alcohol consumption among college students. Conclusions: The new scale is valid and reliable for assessing motivations for moderate and severe alcohol consumption in Mexican college students. This may be a valuable tool to design and evaluate interventions for the prevention of alcohol use among college students. Full article

U.S. Latino/a college students face distinct stressors, including acculturative stress and enculturative stress, impacting their capacity to engage in prosocial behaviors (voluntary actions benefiting others). Cultural stress can deplete resources essential to engaging in altruistic acts (selflessly motivated helping), yet it can also stimulate selfishly motivated prosocial behaviors. The present study examines how cultural adjustment stressors and cultural identity relate to prosocial behaviors among U.S. Latino/a college students. A sample of 1450 U.S. Latino/a college students (M age = 19.7 years; SD = 1.61; 75.4% women) completed an online survey assessing their levels of enculturative and acculturative stress, ethnic and U.S. identity, and altruistic and public prosocial behaviors. A path analysis revealed that higher enculturative stress is associated with lower ethnic identity, which, in turn, predicts increased public prosocial behaviors. Conversely, acculturative stress is linked with higher ethnic identity, leading to elevated public prosocial behaviors. The discussion underscores the importance of mitigating culture-related stress that can stem from home and U.S. society to enhance the well-being of U.S. Latino/as. Full article

With the current downturn in the real estate and construction industries, the construction job market is saturated, and architects are facing an urgent employment crisis. Architectural education should understand the skill requirements of individuals in the labor market and make adjustments accordingly. This study examines the evaluation of and demand for skills from the perspective of employers. A research questionnaire was constructed based on the Kano theoretical model and distributed to 810 practitioners, and the results were analyzed. The results of the data analysis of demand attributes, importance, and group differences showed that the construction industry pays the most attention to strengthening professional soft abilities, while improving personal comprehensive abilities and maintaining professional hard abilities can support architects in maintaining strong competitiveness in the job market. Furthermore, different groups and regions have different needs for architectural skills. The cultivation of skills in colleges and universities must be targeted. This study provides an adjusted direction for architectural education and training and also provides guidance for architectural practitioners in improving their skills and expanding their career development with the trend of industry saturation. Full article

Background/Objectives: Antibiotic resistance (ABR) is a global crisis leading to increased mortality and economic burden. Antimicrobial stewardship (AMS) promotes responsible antibiotic use and prescribing practices to combat ABR. This study assessed the knowledge, awareness, and perceptions of final-year medical and pharmacy students in Saudi Arabia regarding antibiotic use, ABR, and AMS. Methods: A national cross-sectional survey was conducted from January to April 2024 using a 49-item questionnaire. The survey assessed knowledge of antibiotic use, ABR, and AMS using predefined scoring, while perceptions were evaluated with a 5-point Likert scale. Data were analyzed using descriptive statistics and Chi-square tests to explore associations between independent variables and outcomes. A logistic regression analysis identified factors associated with good knowledge, and results were reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Among 197 participants from 26 Saudi universities, pharmacy students comprised 73.1% of the sample. Good knowledge was observed in 44.7% for antibiotic use, 47.7% for ABR, and 52.8% for AMS. However, 28.4% lacked awareness of AMS, and 5.6% were unaware of ABR. Pharmacy students demonstrated significantly higher knowledge and confidence in AMS and antibiotic handling compared to medical students (p < 0.001). Higher knowledge was also associated with the university’s region and prior education on resistance or AMS during college. Conclusions: This study highlights significant gaps in knowledge and awareness of antibiotic use, ABR, and AMS among final-year medical and pharmacy students in Saudi Arabia. The findings emphasize the need for targeted educational strategies, standardized curricula, and enhanced AMS training to better prepare future healthcare professionals to combat ABR effectively. Full article