Search Results (1,581)

Background and Objectives: E-cigarette use among middle and high school students steadily increased in the last decade, raising significant public health concerns. It is argued that e-cigarettes contain a lower level of toxicants than combustible tobacco cigarettes. This perception has contributed to the growing popularity of e-cigarettes among youth. However, lower level of toxicants does not mean addiction is less likely. In this study, we examine trends in the usage of electronic cigarettes among middle and high school students in the U.S. from 2018 to 2023, compare these patterns with traditional cigarette use over the same period and population, and explore the underlying reasons driving e-cigarette use within this demographic. Understanding patterns and motivations are essential for developing effective prevention and intervention strategies. Materials and Methods: Data were derived from the National Youth Tobacco Survey (NYTS), administered by the Centers for Disease Control and Prevention (CDC). Population-level estimates and standard errors were calculated to facilitate comparisons across subgroups and time points. Results: A declining trend in e-cigarette use was observed over the study period. The proportion of students who reported exclusive e-cigarette use was significantly higher than that of those who used combustible cigarettes exclusively. Among reported motivations, anxiety consistently ranked among the top three reasons for vaping for current users. Conclusions: The downward trend in youth e-cigarette experimentation is encouraging. However, the period from 2020 to 2023, which includes the COVID-19 pandemic (2020 and 2021) era, may have impacted usage patterns. Alarmingly, the number of students who vape exclusively is approximately five times greater than that of those who smoke only cigarettes. This finding contradicts claims by e-cigarette manufacturers that their products facilitate smoking cessation. Further rising e-cigarette smoking exclusively is of public health concern, which warrants targeted intervention. Full article

The COVID-19 pandemic and subsequent non-pharmaceutical interventions (NPIs) significantly disrupted the epidemiology of pediatric respiratory viruses. This study compared infection patterns among 3658 hospitalized children in South Korea during the pandemic (2020–2022) and the post-emergency phase (2023–2024), following the relaxation of mandatory NPIs. Of 4419 eligible tests, the most frequently detected viruses overall were rhinovirus/enterovirus (HRV/HEV) (27.9%), influenza (14.5%), and respiratory syncytial virus (RSV, 11.9%). The post-emergency phase was marked by a dramatic surge in influenza virus (IFV), which surged dramatically (5.5% → 28.2%), and a more than two-fold increase in adenovirus (ADV) (5.7% → 12.5%) (p < 0.001). (p < 0.001). Conversely, parainfluenza virus (PIV) detection rates declined significantly (15.4% → 11.3%, p < 0.001). Demographically, post-emergency phase patients were significantly older (mean 4.9 vs. 3.5 years) and experienced a shorter hospital stays (3.2 vs. 4.3 days) (p < 0.001). Crucially, age-specific susceptibility shifts were evident. IFV rebounded across all pediatric ages but spiked severely in school-aged children and adolescents, while HRV/HEV demonstrated a clear proportional shift towards older age groups. These results demonstrate a substantial reconfiguration of the pediatric respiratory landscape, necessitating age-stratified surveillance and flexible public health strategies to mitigate the future infectious disease burden. Full article

Background: Dementia is an increasing public health challenge in Mexico, yet recent national data on mortality patterns remain limited. This study examines temporal trends in dementia-related mortality and its sociodemographic and ecological characteristics among adults aged ≥65 years from 2017 to 2023. Methods: National mortality records from the General Directorate of Health Information were analyzed. Annual dementia-related mortality rates were calculated based on mid-year population estimates from CONAPO. Trends were assessed with regression analysis, including population offsets, and individual- and state-level characteristics were evaluated. Results: Between 2017 and 2023, dementia-related deaths increased from 761 to 1425, corresponding to an observed rise from 7.9 to 14.6 deaths per 100,000 inhabitants aged ≥65 years. Period trend indicated an average annual expected increase of 18.6% in dementia related mortality. A transient decline occurred in 2020–2021, coinciding with the COVID-19 pandemic. At the individual level, higher education was associated with greater odds of dementia certification, whereas Indigenous ethnicity appeared protective, which may reflect patterns consistent with diagnostic and reporting disparities. Higher state-level life expectancy correlated with higher dementia mortality, while greater population aging was inversely associated. Conclusions: Dementia-related mortality in Mexico shows a sustained upward trend with regional heterogeneity and apparent inequities in diagnosis and reporting. Strengthening mortality surveillance, improving certification quality, and integrating dementia indicators into national non-communicable disease registries are essential to guide equitable policy responses. Full article

Respiratory syncytial virus (RSV) is among leading global causes of lower respiratory tract infections, yet data from Russia and other states of the Former Soviet Union (FSU) remain fragmented and structurally inconsistent. This systematic review aims to map and synthesize existing evidence on RSV epidemiology and genotypic distribution across the FSU. Published studies from eLIBRARY and PubMed databases queried for RSV prevalence data, together with public health surveillance datasets, were used to summarize RSV prevalence research across eight FSU countries. Random-effects meta-analysis across age strata showed high prevalence in children before 6 (21%) and a progressive decline with age, which is in agreement with global data. Prevalence estimates showed a high degree of variability partially explained by study scope and clinical presentation. We observed COVID-19-related seasonal disruptions of RSV seasonality, followed by gradual post-pandemic stabilization. Genotypic data reflects global trends with two cosmopolitan clades, A.D and B.D, and their descendants, dominating in the region. The review is limited by uneven geographical and temporal coverage, and scarce data on adults. The review provides the first integrated summary of RSV epidemiology across the FSU and underscores the need for expanded regional surveillance and genomic reporting. Full article

Complete or partial loss of smell (anosmia), sometimes in association with distorted olfactory perceptions (parosmia), is a common neurological symptom affecting nearly 60% of patients suffering from post-acute neurological sequelae of COronaVIrus Disease of 2019 (COVID-19) syndrome, called long COVID. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) may gain access from the nasal cavity to the brain (neurotropism), and the olfactory route has been proposed as a peripheral site of virus entry. COVID-19 is a risk factor for developing Alzheimer’s Disease (AD), an age-dependent and progressive neurodegenerative disorder characterized in affected patients by early olfaction dysfunction that precedes signs of cognitive decline associated with neurodegeneration in vulnerable brain regions of their limbic system. Here, we summarize the recent literature data supporting the causal correlation between the persistent olfactory deterioration following SARS-CoV-2 infection and the long-delayed manifestation of AD-like memory impairment. SARS-CoV-2 infection of the olfactory neuroepithelium is likely to trigger a pattern of detrimental events that, directly and/or indirectly, affect the anatomically interconnected hippocampal and cortical areas, thus resulting in tardive clinical dementia. We also delineate future advancement on pharmacological and rehabilitative treatments to improve the olfactory dysfunction in patients recovering even from the acute/mild phase of COVID-19. Collectively, the present review aims at highlighting the physiopathological nexus between COVID-19 anosmia and post-pandemic mental health to favor the development of best-targeted and more effective therapeutic strategies in the fight against the long-term neurological complications associated with SARS-CoV-2 infection. Full article

The abrupt COVID-19 lockdown in early 2020 offered a unique natural experiment to examine vegetation productivity responses to sudden declines in human activity. Although vegetation often responds to environmental changes with time lags, how such lags operate under short-term, intensive disturbances remains unclear. This study combined multi-source environmental data with an interpretable machine learning framework (XGBoost-SHAP) to analyze spatiotemporal variations in net primary productivity (NPP) across the Beijing-Tianjin-Hebei region during the strict lockdown (March–May) and recovery (June–August) periods, using 2017–2019 as a baseline. Results indicate that: (1) NPP showed a significant increase during lockdown, with 88.4% of pixels showing positive changes, especially in central urban areas. During recovery, vegetation responses weakened (65.31% positive) and became more spatially heterogeneous. (2) Integrating lagged environmental variables improved model performance (R² increased by an average of 0.071). SHAP analysis identified climatic factors (temperature, precipitation, radiation) as dominant drivers of NPP, while aerosol optical depth (AOD) and nighttime light (NTL) had minimal influence and weak lagged effects. Importantly, under lockdown, vegetation exhibited stronger immediate responses to concurrent temperature, precipitation, and radiation (SHAP contribution increased by approximately 7.05% compared to the baseline), whereas lagged effects seen in baseline conditions were substantially reduced. Compared to the lockdown period, anthropogenic disturbances during the recovery phase showed a direct weakening of their impact (decreasing by 6.01%). However, the air quality improvements resulting from the spring lockdown exhibited a significant cross-seasonal lag effect. (3) Spatially, NPP response times showed an “urban-immediate, mountainous-delayed” pattern, reflecting both the ecological memory of mountain systems and the rapid adjustment capacity of urban vegetation. These findings demonstrate that short-term removal of anthropogenic disturbances shifted vegetation responses toward greater immediacy and sensitivity to environmental conditions. This offers new insights into a “green window period” for ecological management and supports evidence-based, adaptive regional climate and ecosystem policies. Full article

The COVID-19 pandemic led to an unprecedented slowdown in global economic and transportation activities, offering a unique opportunity to assess the relationship between human activity and atmospheric pollution. This study analyzes global variations in major air pollutants and meteorological conditions during the pandemic period using multi-satellite and reanalysis datasets. Nitrogen dioxide (NO₂) data were obtained from the OMI sensor aboard NASA’s Aura satellite, while carbon monoxide (CO) observations were taken from the MOPITT instrument on Terra. Reanalysis products from MERRA-2 were used to assess CO, sulfur dioxide (SO₂), black carbon (BC), organic carbon (OC), and key meteorological variables, including temperature, precipitation, evaporation, wind speed, and direction. Average concentrations of pollutants for April, May, and June 2020, representing the lockdown phase, were compared with the average values of the same months during 2017–2019, representing pre-pandemic conditions. The difference between these multi-year means was used to quantify spatial changes in pollutant levels. Results reveal widespread reductions in NO₂, CO, SO₂, and BC concentrations across major industrial and urban regions worldwide, consistent with decreased anthropogenic activity during lockdowns. Meteorological analysis indicates that the observed reductions were not primarily driven by short-term weather variability, confirming that the declines are largely attributable to reduced emissions. Unlike most previous studies, which examined local or regional air-quality changes, this work provides a consistent global-scale assessment using harmonized multi-sensor datasets and uniform temporal baselines. These findings highlight the strong influence of human activities on atmospheric composition and demonstrate how large-scale behavioral and economic shifts can rapidly alter air quality on a global scale. The results also provide valuable baseline information for understanding emission–climate interactions and for guiding post-pandemic strategies aimed at sustainable air-quality management. Full article

Background/Objectives: Post-COVID-19 condition (PCC) remains poorly characterized beyond two years, particularly among intensive care unit (ICU) survivors. We aimed to describe the prevalence, persistence, and late consequences of PCC up to 32 months after discharge in an ICU cohort. Methods: This single-center longitudinal cohort included 170 adults with confirmed SARS-CoV-2 infection admitted to an ICU in Cáceres (Spain) between March 2020 and March 2021. 94 survivors entered follow-up at discharge and 3, 6, 12, 18, 24, and 32 months. PCC manifestations were grouped into five organ system domains (respiratory, cardiovascular, renal, infectious, and musculoskeletal/neuromuscular) and recorded only when supported by clinician-confirmed diagnoses or diagnostic tests. Prevalence at each visit, persistence, and new onset of manifestations between 3 and 6 months, and the cumulative incidence of new chronic diseases between 18 and 32 months were estimated with 95% confidence intervals. Results: Any PCC manifestation was almost universal at discharge (96.8% [95% CI, 91.1–98.9]) and remained high at 12 months (85.2% [95% CI, 76.3–91.2]), declining to 48.6% at 24 months and 25.7% at 32 months. Respiratory manifestations predominated early and were largely resolved by 32 months, whereas musculoskeletal/neuromuscular involvement remained relatively stable. From 18 to 32 months, 36.5% (95% CI, 26.4–47.9) of survivors developed at least one chronic condition, most frequently cardiovascular disease (14.9% [95% CI, 8.5–24.7]). Conclusions: Long-term PCC manifestations and incident chronic diseases are common among ICU COVID-19 survivors, underscoring the need for prolonged follow-up and post-ICU care. Full article

Excess commuting reflects the inefficiency of urban land resource allocation, generating additional greenhouse gas emissions and social costs, and has therefore become a central concern in the pursuit of sustainable cities. While exogenous shocks inevitably alter the efficiency of land resource allocation, it remains unclear how such shocks affect overall urban efficiency. To address this gap, this paper proposes a generalized framework for measuring excess commuting that accounts for imbalances between the numbers of jobs and residences. Drawing on mobile signaling big data, we trace the daily commuting patterns of more than 900,000 residents in Beijing, comparing the pre-pandemic period (March–October 2019) with the pandemic period (March–October 2020). The results show that: (1) Excess commuting increased significantly after the outbreak of COVID-19, with the observed average commuting distance (Tact) of the full sample rising from 6267 m to 10,058 m (an increase of 59%), indicating a decline in urban land resource allocation efficiency; (2) A more pronounced center-periphery pattern emerged at the metropolitan scale: the average Jobs–Housing Ratio (JHR) increased from 1.08 to 1.11, and its standard deviation rose from 0.54 to 0.70, with the JHR of central urban areas decreasing by 3% and that of suburban areas increasing by 20%—suggesting a marked increase in commuting distances; (3) Heterogeneous impacts were observed across age groups: the Difference-in-Differences (DID) regression confirmed a significant negative interaction term (Group × COVID-19 = −0.2991 **, p < 0.05), indicating that older adults experienced a greater increase in commuting inefficiency than younger adults. These findings reveal the dynamic mechanisms linking exogenous shocks, jobs–housing mismatch, and urban land resource allocation efficiency and provide policy implications for improving spatial resource allocation in the post-pandemic era. Full article

Climate change is the most significant socio-environmental challenges of our time, and education has been recognized as a fundamental strategy to confront it. Yet research efforts have focused more on students than on teachers, despite the latter’s key role in mediating between scientific and curricular knowledge and classroom practice. This study set out to characterize the field of educational research on climate change from the perspective of secondary school teachers. To this end, we conducted a systematic review and bibliometric analysis of 50 peer-reviewed studies from 15 countries (2010–2023). The results show a growing interest over time, with increases associated with international milestones such as the IPCC reports and the Paris Agreement, while declines are observed in connection with political shifts and the COVID-19 pandemic. Consolidated academic reference points were identified, including Eric Plutzer and Maria Ojala, alongside influential international organizations such as the IPCC and UNESCO, suggesting the presence of schools of thought and institutional frameworks that structure the field. Methodologically, descriptive and exploratory studies predominate, with a notable reliance on qualitative and mixed-methods designs using small samples, reinforcing the difficulty of accessing teachers as a research population. Overall, this review highlights significant gaps, particularly the geographical bias toward the Global North, and underscores the urgency of broader, more inclusive, and critically engaged research that positions teachers as essential agents of transformative educational responses to the climate crisis. Full article

Objectives: This pilot study examined telerehabilitation, which has emerged as a crucial modality in light of recent global challenges such as the COVID-19 pandemic. We examined the effectiveness of a mobile health telerehabilitation intervention developed for older adults with frailty. Methods: Six participants received a telerehabilitation intervention (Rehab Studio) that included exercise training videos. The participants were aged ≥65 years, had no history of dementia or psychiatric disorders, and had mild-to-moderate care needs. For 1 month, the participants received 1 h live online rehabilitation sessions with real-time communication with rehabilitation specialists (physical therapists and occupational therapists: PTs/OTs). The quality of life (QoL) (EuroQol 5 dimensions 5-level [EQ-5D-5L] questionnaire) and self-rated health scores were recorded before and after the intervention, and the data were analyzed using paired t-tests to determine whether the service was effective. Results: Significant differences were found in the total EQ-5D-5L and self-rated health scores (p < 0.05). The mean EQ-5D-5L score increased from 0.63 ± 0.13 before the intervention to 0.77 ± 0.14 after the intervention (p = 0.010), while the mean self-rated health score increased from 66.0 ± 18.0 to 83.3 ± 10.3, respectively (p = 0.019). Conclusions: This study revealed that the mobile health telerehabilitation intervention is safe and can improve QoL for older adults with frailty. However, the effectiveness of the intervention needs to be further investigated in patients with poor performance in daily living activities. Telerehabilitation could help to reduce the burden of nursing care in aging societies with declining birthrates. However, given the extremely small sample size (N = 6), these p-values should be interpreted with considerable caution. Statistical significance in such a small sample does not provide strong evidence for population-level effects, and our findings should be regarded as hypothesis-generating rather than confirmatory. Full article

Influenza D virus (IDV), an emerging orthomyxovirus with zoonotic potential, infects diverse hosts, causes respiratory disease, and remains poorly characterized in China despite its global expansion. From October 2023 to January 2025, we collected 563 nasal swabs from cattle across 28 farms in Jilin Province, Northeast China, and identified seven IDV-positive samples (1.2%), recovering two viable isolates (JL/YB2024 and JL/CC2024). Full-genome sequencing revealed complete, stable seven-segment genomes with high nucleotide identity (up to 99.9%) to contemporary Chinese D/Yamagata/2019 strains and no evidence of reassortment. Maximum-likelihood and time-resolved Bayesian phylogenies of 231 global hemagglutinin-esterase-fusion (HEF) sequences placed the Jilin isolates within the East Asian D/Yamagata/2019 clade and traced their most recent common ancestor to approximately 2017 (95% highest posterior density: 2016–2018), suggesting a cross-border introduction likely associated with regional cattle movement. No IDV was detected in parallel surveillance of swine, underscoring cattle as the principal reservoir and amplifying host. Bayesian skyline analysis demonstrated a marked decline in global IDV genetic diversity during 2020–2022, coinciding with livestock-movement restrictions imposed during the COVID-19 pandemic. Collectively, these findings indicate that IDV circulation in China is sporadic and geographically localized, dominated by the D/Yamagata/2019 lineage, and shaped by multiple independent incursions rather than a single emergence. Both the incorporation of IDV diagnostics into routine bovine respiratory disease surveillance and cattle-import quarantine programs, and the adoption of a One Health framework to monitor potential human spillover and future viral evolution, were recommend. Full article

Background/Objectives: Alcohol-based handrub (ABHR) consumption is commonly used as an indirect proxy for hand hygiene practices. Hand hygiene compliance increased significantly during COVID-19, but sustainability remains uncertain. This study assessed ABHR consumption trends from 2022 to 2024 and compared them with pre-pandemic and pandemic-era rates. Methods: We conducted a follow-up observational study tracking quarterly ABHR consumption in a surgical department and hospital-wide (2022–2024). Consumption was normalized as mL per patient-day and compared with 2019–2020 data. Time-series regression with Newey–West standard errors assessed temporal trends. Results: Surgical department consumption declined 27.5% (55.9 to 40.5 mL/patient-day), returning to 2019 pre-pandemic levels. Hospital-wide consumption increased 36% (36.4 to 49.6 mL/patient-day). Neither trend reached statistical significance (p > 0.05). The 2024 surgical rate remained substantially below the 2020 pandemic peak (320 mL/patient-day). Conclusions: Pandemic-era ABHR consumption gains were not sustained in the surgical department despite maintained educational infrastructure, accessible dispensers, and consistent staffing. The critical missing element was systematic monitoring and feedback. Institutions relying solely on passive education may experience erosion of hand hygiene compliance post-crisis, highlighting the need for active surveillance programs to maintain behavioral gains. Full article

Objective: The aim of this study was to systematically map evidence to inform best practices for sexual and reproductive healthcare delivered via telehealth (TeleSRH) in United States-based Title X-funded clinics. Methods: We searched three databases (2017–2025) for studies evaluating effectiveness, harms, patient and provider experiences, barriers/facilitators, and engagement strategies encompassing TeleSRH for sexually transmitted infections (STIs), contraceptive care/family planning (CC/FP), and sexual wellness, in countries with a human development index of ≥0.8. Results: From 5963 references and 436 articles, we included 142 eligible publications. TeleSRH use declined since the COVID-19 pandemic’s peak but remains higher than pre-pandemic. Evidence comes mostly from poor-quality studies. TeleSRH increases access and adherence to STI prevention (e.g., pre-exposure prophylaxis for HIV). Tele-follow-up may safely facilitate HIV care continuity. For CC/FP, TeleSRH is comparable to in-person care for patient satisfaction and uptake; patients are less likely to select long-acting reversible contraception but post-initiation tele-follow-up may increase its continuation rates. Vasectomy completion rates may be similar between pre-procedural counseling via telehealth versus in-person. TeleSRH’s potential benefits might include reduced travel time, wait times, no-show rates, and clinic human resource burden (via tele-triaging) and increased preventative screening rates for STIs and non-communicable diseases, prescription refill rates, ability to receive confidential care in preferred settings, and rural/marginalized community outreach. Implementation challenges span technological and capital constraints, provider availability, staff capability building, restrictive policies, language incompatibility, and patient mistrust. Supplementing synchronous TeleSRH with asynchronous communication (e.g., mobile application) may improve continued patient engagement. Conclusions: Preventive, diagnostic, and therapeutic TeleSRH can be effective, with high patient acceptability; however, effectiveness and adoption hinge on contextual factors outlined in this review. Full article

During the Coronavirus Disease 2019 (COVID-19) pandemic, global awareness of infectious diseases increased markedly. Many infectious diseases are transmitted through direct or indirect contact with biological fluids containing pathogens such as viruses and bacteria. This risk is particularly pronounced in environments used by large numbers of unspecified individuals. Public restrooms, therefore, raise significant hygienic concerns, as toilet seats may serve as vectors for indirect transmission. To mitigate this risk, this study proposes a novel toilet seat equipped with an automatic cleaning function. Specifically, after use, the seat surface is automatically wiped by a cleaning cloth, eliminating the need for manual cleaning by staff. A fundamental operational concept is established, emphasizing the determination of an appropriate cleaning initiation timing that allows the cleaning sequence to be completed without compromising user convenience. Based on this concept, a belt–pulley type prototype is developed, and the effectiveness of the proposed cleaning sequence is verified. Subsequently, the prototype is further improved through the introduction of a flexible-rack mechanism. The control methodology, including the design of the electronic circuitry, is described in detail. Using the improved prototype, extensive simulations and experimental evaluations were conducted. The results showed that battery capacity declined at an approximately constant rate of 3% per 10 cycles, with about 70% remaining after 100 cycles. In addition, a single reciprocating cleaning cycle removed over 95% of artificially applied stains across the entire toilet seat. Additional evaluation results are presented in detail. Full article