Search Results (3,444)

Background/Objective: Lifestyle behaviors evolve with age and are driven by biological requirements (e.g., growth and development) and environmental changes (e.g., living and working situations), and they interact bidirectionally with health. Few studies have tracked these behaviors from emerging adulthood into later adulthood. This study examines changes in lifestyle behavior patterns from precollege to adulthood and their association with weight trajectories. Methods: Between 1998 and 2007, 4783 incoming undergraduate students at a northeastern US university completed a health survey. In 2018, 970 completed a follow-up alumni survey. Latent class analysis (LCA) was used to categorize respondents into five lifestyle patterns: stable healthy, stable moderately healthy, stable minimally healthy, worsened, or improved. BMI trajectories were similarly classified into five weight status patterns. Associations between LCA lifestyle patterns and weight were examined using ANCOVA. Results: The most common lifestyle pattern was stable moderately healthy (36.7%). Over 11–20 years, 31.7% of respondents experienced a decline in lifestyle behaviors, and 18.6% improved. During this period, the prevalence of overweight more than doubled (12% to 26%), and obesity quadrupled (2% to 8%). Transitioning to a higher BMI category was noted in 34.9% of those with a stable minimally healthy lifestyle compared with 15.9% among those with a stable healthy lifestyle. Conclusions: Early lifestyle behaviors have long-term implications for weight status. Initiatives that promote the adoption and maintenance of healthy behaviors from precollege through adulthood might reduce obesity risk. Full article

The rapid advancement of Artificial Intelligence (AI) technologies has significantly transformed teaching, learning, and research practices within higher education institutions (HEIs). Although a growing body of literature has examined the application of AI in higher education, existing studies remain fragmented, often focusing on isolated tools or outcomes, with limited synthesis of best practices, core functionalities, and implementation challenges across diverse contexts. To address this gap, this systematic review aims to comprehensively examine the best practices, functionalities, and challenges associated with the integration of AI in HEIs. A comprehensive literature search was conducted across major academic databases, including Google Scholar, Scopus, Taylor & Francis, and Web of Science, resulting in the inclusion of 35 peer-reviewed studies published between 2014 and 2024. The findings suggest that effective AI integration is supported by best practices, including promoting student engagement and interaction, providing language support, facilitating collaborative projects, and fostering creativity and idea generation. Key AI functionalities identified include adaptive learning systems that personalize educational experiences, predictive analytics for identifying at-risk students, and automated grading tools that improve assessment efficiency and accuracy. Despite these benefits, significant challenges persist, including limited knowledge and skills, ethical concerns, inadequate infrastructure, insufficient institutional and management support, data privacy risks, inequitable access to technology, and the absence of standardized evaluation metrics. This review provides evidence-based insights to inform educators, institutional leaders, and policymakers on strategies for leveraging AI to enhance teaching, learning, and research in higher education. Full article

Background: Awake carotid endarterectomy (CEA) under local anesthesia demands an optimal sedation strategy that ensures patient comfort while preserving the ability for real-time neurological assessment. Dexmedetomidine (DEX) and remifentanil (REMI) are widely used agents, but direct comparisons in this setting remain scarce. Methods: Exploratory, retrospective, single-center study of awake CEA (March–July 2019). DEX or REMI infusions were titrated to a Richmond Agitation–Sedation Scale (RASS) of −1 to −2. Outcomes were sedation failure (RASS ≥ +2 despite maximum infusion rate), bradycardia, hypotension, and neurologic events. Statistical analyses used χ² test (categorical variables) and Student’s t-test or Mann–Whitney test (continuous variables). Associations were assessed with Firth’s logistic regression (univariable and bivariate models), reporting odds ratios (OR) with 95% confidence intervals (CI_95%). Trends in the Bispectral Index (BIS), hemodynamic, and respiratory parameters were assessed using two-way repeated-measures Analysis of Variance (ANOVA). A p-value < 0.05 was considered significant. Results: Fifty-two patients were included (DEX = 25; REMI = 27). DEX group showed more frequent sedation failure (32.0% vs. 3.7%; p = 0.020), bradycardia (36.0% vs. 3.7%; p = 0.009), and hypotension (28.0% vs. 0%; p = 0.011). DEX was associated with increased risk in sedation failure (OR 8.58, CI_95% 1.70–85.81), bradycardia (OR 10.17, CI_95% 2.05–101.21), and hypotension (OR 22.30, CI_95% 2.46–2959.60); the direction of associations remained consistent in bivariate models adjusted for baseline confounders. ANOVA showed group-by-time interactions for BIS, heart rate, mean arterial pressure, and end-tidal CO₂. No intraoperative complications or adverse outcomes were observed. Conclusions: In this retrospective cohort of awake CEA, DEX was associated with higher rates of sedation failure and hemodynamic adverse events compared with REMI, without an apparent impact on procedural success. Given non-random allocation and baseline imbalances, these findings are hypothesis-generating and warrant confirmation in larger, robust, and prospective studies. Full article

Background: Food allergy [FA] is a growing public health concern among school-age children, with schools and childcare/daycare settings representing high-risk environments for accidental exposure and anaphylaxis. Objective: To systematically review evidence on digital health interventions supporting FA education, prevention, and management in school settings. Methods: A systematic search of PubMed, Scopus, Web of Science, and CINAHL was conducted to identify studies published between January 2015 and December 2025 [PROSPERO CRD420251185553]. Eligible studies evaluated e-learning, mHealth, or web-based programs targeting school staff, parents, or students. Results: Sixteen studies met inclusion criteria. Digital health emerged as a catalyst for professional development, interprofessional communication, and health equity within school communities. Interventions consistently improved knowledge, preparedness, and self-efficacy in anaphylaxis management among school staff, strengthened parental empowerment and communication with schools, and supported coping and inclusion among allergic children. Evidence on clinical outcomes; however, remains limited. Conclusions: Digital health can meaningfully enhance school preparedness and reduce inequalities in allergy management. Integrating digital tools into national school health frameworks—particularly where school nursing is not yet institutionalized—may represent a pivotal step toward safer, more equitable inclusion of children with food allergy. Full article

Prescription drug misuse among youth is a significant public health problem that can lead to negative consequences, including addiction and overdose deaths. This study examined the effectiveness of an evidence-based hybrid approach in preventing prescription drug misuse outcomes in high school students. The prevention program used a combination of e-learning modules and classroom activities to enhance social and personal competence skills and refusal skills to deter prescription drug misuse and other types of substance misuse. Findings indicated that prescription sedative misuse was lower among students who received the hybrid prevention program compared to students in the control group. Perceived risk of using prescription sedatives, painkillers, and stimulants prescribed for someone else was higher in the intervention group relative to the control group students. These findings indicate that a comprehensive, universal school-based hybrid prevention program can produce positive impacts on sedative use and perceived risks of prescription drug misuse. Full article

In the face of increasing global temperatures, this study aims to explore ventilation strategies that could provide passive cooling to mitigate overheating in studied low-energy school buildings, in particular those that use ventilative cooling. This study utilises building modelling calibrated with field data to tackle the challenge of maintaining indoor thermal comfort and cognitive performance levels during increasingly warm seasons. The calibrated building model is used to evaluate the vulnerability of classrooms, identifying and addressing risks based on standardised overheating and resilience criteria. Two primary school classrooms were simulated in three main cities across Ireland to assess the possibility of natural ventilative cooling for maintaining indoor thermal conditions without sacrificing energy efficiency. The study highlights the critical need to enhance natural ventilation strategies to protect against projected future overheating, with peak indoor temperatures reaching 29 °C to 31 °C during May, June, and September. Implementing a maximum natural ventilation strategy during occupied times, with a 9.6% opening-to-floor area ratio, can reduce peak indoor temperatures by up to 2.5 °C. Findings show Irish classrooms in low-energy buildings equipped with hybrid ventilative cooling can act as potential climate shelters during July and August under extreme weather conditions, underlining their capacity to provide a comfortable environment for vulnerable people during heatwaves and reduce overheating risk by 42–48% compared to natural ventilation. Additionally, projections show that cognitive performance loss in students may rise to 23% by 2071 due to raised indoor temperatures; however, this can be reduced to below 10% in 2021 and 2041 with maximum natural ventilation. The novelty of this work lies in its systematic evaluation of ventilative cooling resilience under future climate scenarios across multiple Irish city contexts, providing a robust evidence base for designing climate-resilient, energy-efficient learning environments. Full article

Background/Objectives: The increasing prevalence of overweight and obesity in adolescents represents a major global health concern. Adolescent weight gain frequently shows additional metabolic risk factors, including insulin resistance, hypertension, and dyslipidemia, whose co-occurrence defines the metabolic syndrome (MetS). Adherence to a healthy dietary pattern, such as the Mediterranean Diet (MD), has been shown to reduce the metabolic risk among adolescents. Skin carotenoid score has emerged as an objective and non-invasive indicator of MD adherence; however, its relationship with a cluster of metabolic parameters which characterize the MetS, including the triglyceride levels, diastolic blood pressure, and waist circumference, remains poorly explored. Here, we investigated the role of skin carotenoid score as an early biomarker of metabolic syndrome risk in adolescents. Methods: A sample of 634 healthy adolescents underwent anthropometric and clinical measurements, blood sample collection, and evaluation of the MD adherence by the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) questionnaire and the skin carotenoid levels by the Veggie Meter^®. Student’s t-test, chi-square test, Pearson correlation, and the multivariable linear regression model were used for analyses. Results: Participants had a mean BMI Z-score of 0.02 ± 1.01; the metabolic serum profile and the cardiovascular parameters were within the normal range. Mean KIDMED and skin carotenoid scores were 5.21 ± 2.56 and 357 ± 96.58, respectively. Skin carotenoids were positively associated with height (p = 0.02), while they were inversely associated with weight (p = 0.008), BMI Z-score (p < 0.0001), diastolic blood pressure (p = 0.013), and triglycerides (p = 0.003). Moreover, the carotenoid score was positively associated with male gender and KIDMED score and negatively associated with waist circumference and triglyceride levels in multivariable regression analyses. Conclusions: Our results suggested the potential application of skin carotenoid score as a complementary biomarker for the early identification of adolescents at increased metabolic risk. Full article

(1) Background: The purpose of this study was to investigate the associations between perceived stress and anxiety in high school senior students, taking into account the possible influence from lifestyle (physical activity, nicotine dependence, and alcohol use) and social support. (2) Methods: A representative sample of high school senior students (N = 405; mean age: 18.2 ± 0.4), reflecting the overall geographic distribution of Lithuania’s student population, was investigated using anonymous questionnaires on perceived stress (Perceived Stress Scale, PSS-10), anxiety (Generalized Anxiety Disorder Scale, GAD-7), perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS), lifestyle (Fagerström Test for Nicotine Dependence), alcohol use (Alcohol Use Disorders Identification Test, AUDIT), and physical activity (International Physical Activity Questionnaire, IPAQ). Hierarchical multiple regression analysis was employed, investigating mediating and moderating effects. (3) Results: The direct effect of perceived stress on anxiety was significant (B = 0.364; SE = 0.0486; 95% CI [0.268, 0.459]; p < 0.001). Furthermore, the analysis revealed a significant indirect effect via social support (B = 0.387; SE = 0.0525; 95% CI [0.284, 0.490]), indicating that a portion of the relationship between perceived stress and anxiety was mediated by social support. Physical inactivity, alcohol use, and nicotine dependence served as moderators. Our findings confirmed that all three moderators showed significant interaction effects, with standardized β = −0.124, p = 0.002, for physical inactivity, β = 0.073, p = 0.016, for alcohol dependence, and β = 0.119, p = 0.001, for nicotine dependence, in the relationship between perceived stress and anxiety among high school senior students. (4) Conclusions: These findings have practical insights for educators who implement physical activity and alcohol and nicotine usage programs for high school senior students to help reduce their stress and anxiety. Full article

An early indicator of future cardiovascular risk is lower levels of nighttime blood pressure (BP) dipping from day to night. Prior work has been limited to identifying health behaviors that can promote greater dipping. This pilot study proposes that one possible set of behaviors may be engagement in self-selected leisure activities (SSLAs, or freely chosen non-work activities that are performed with the purpose of relaxation and/or mental escape), which have been linked with reduced daily stress and general daily BP control. Healthy young adult college students [N = 32; 78.1% (n = 25) female, 71.9% (n = 23) white, with an average body mass index (BMI) of 26.31 (SD = 2.46)] visited our laboratory twice within approximately one week. At each visit, the participants were fitted with an ambulatory monitor to collect BP over 24 h. On each day, participants were randomly assigned to either engage in an agreed-upon SSLA or go about their day as usual, except to refrain from engaging in assigned SSLAs; compliance was verified by daily diaries. When accounting for BMI and race/ethnicity, the results showed a higher percentage of BP dipping on the SSLA versus control day for diastolic BP (d = 0.54). SSLAs may be associated with reduced future cardiovascular disease through a nighttime BP dipping effect. Full article

The integration of AI tools like ChatGPT into educational assessments, particularly in the context of Multivariable Calculus, represents a transformative approach to personalized and scalable learning. This study examines the Exams as a Service (EaaS)-Flipped Chatbot Test (FCT) framework, implemented through the AIQuest platform, to explore how chatbots can support assessment processes while addressing risks related to automation and academic integrity. The methodology combines static and dynamic assessment modes within a cloud-based environment that generates, evaluates, and provides feedback on student responses. Quantitative survey data and qualitative written reflections were analyzed using a mixed-methods approach, incorporating Grounded Theory to identify emerging cognitive patterns. The results reveal differences in students’ engagement, performance, and reasoning patterns between AI-assisted and non-AI assessment conditions, highlighting the role of structured AI-generated feedback in supporting reflective and metacognitive processes. Quantitative results indicate higher and more homogeneous performance under the reverse evaluation, while survey responses show generally positive perceptions of feedback usefulness and task appropriateness. This study contributes integrated quantitative and qualitative evidence on the design of AI-assisted evaluation frameworks as formative and diagnostic tools, offering guidance for educators to implement AI-based evaluation systems. Full article

Background/Objectives: Adolescents and young adults (AYAs) with cancer often begin their careers later in life and are at risk of negative work-related outcomes. Research into and tailored support programs for AYAs diagnosed during higher education remain limited. An improved understanding of AYAs’ experiences is essential in guiding the development of age-appropriate support programs. This study explored the impact of cancer and the challenges AYAs face in educational participation and the transition to work. Methods: A qualitative study was conducted with thirteen AYAs diagnosed with cancer during higher education. Participants were interviewed using a semi-structured guide. In collaboration with patient experts as co-researchers, data were analyzed via thematic analysis. Results: Eight analytically derived themes reflected AYA students’ experiences: (1) Meaning and importance of education, (2) Reduced performance, (3) Recovery and expectations, (4) Interruption and delay, (5) Transition to work, (6) Disclosure, (7) Challenges related to the context of students, and (8) Experienced lack of support. The themes were clustered into four overarching thematic categories: Meaningful participation, Impact on performance, Academic progress and career transition, and Challenges in navigation. Conclusions: Our findings provide greater insight into the significance of educational participation for AYAs. AYA students encounter challenges stemming from both diagnosis-related changes in functioning and from contextual factors tied to their roles as students and new starters in the labor market. Navigating the healthcare, education, and social systems is complex and AYAs often lack adequate support when resuming their education or transitioning to work. Tailored support programs in healthcare and educational settings should be developed to help AYAs harness their strong motivation to resume studies, enter the labor market, and achieve their full potential. Full article

Objective: Additional preoperative risk factors may influence the prognosis of patients diagnosed with HBV. This study aims to compare the effects of cirrhosis patients with HBV with and without risk factors on post-transplant follow-ups and postoperative complications. Materials and Method: The study included patients with HBV who underwent living donor liver transplantation (LDLT) at Demiroğlu Bilim University, Şişli Liver Transplant Center, Istanbul, Türkiye, between 2004 and 2019. The data from 319 patients were retrospectively analyzed. Those without preoperative risk factors were classified as group 1 (n = 214), and those with risk factors were classified as group 2 (n = 105). These patients were compared in terms of complications during their postoperative follow-up. The Student’s t-test, ANOVA test, Mann–Whitney U test, Kruskal–Wallis test, chi-squared test, and Fisher’s exact test were used, and p < 0.05 was considered statistically significant. Results: When group 1 and group 2 were compared in terms of postoperative mortality, infections, bleeding complications, and biliary system complications, no statistically significant difference was found [(8.87% vs. 9.52% p = 0.62), (28.80% vs. 20.24%, p = 0.95), (6.10% vs. 8.70%, p = 0.35), (12.7% vs. 9.60% p = 0.19, respectively)]. Although bleeding complications were numerically found more frequent in patients with obesity, this difference did not reach statistical significance (23.02% vs. 6.10% p = 0.08). Conclusions: Obesity was not significantly associated with postoperative complications and may be influenced by accompanying comorbidities. Full article

Objective: The impact of underweight or low-BMI donors on heart transplantation (HTx) outcomes remains poorly understood. This study aims to investigate the effect of underweight donors on post-transplant outcomes. Methods: We retrospectively analyzed 574 patients divided into 2 groups based on donor BMI: underweight donors (BMI < 20 kg/m², n = 101, 17.6%) and normal-weight donors (BMI 20–25 kg/m², n = 473, 82.4%). Baseline variables and postoperative outcomes were compared using the Student’s t-test for continuous variables and the chi-squared test for categorical variables. Propensity score matching (PSM) was performed to balance baseline differences and control for confounders. Survival analysis was performed using the Kaplan–Meier method. Results: The matched cohort included 71 patients per group, with balanced baseline characteristics. Compared to the normal-weight group, recipients of underweight donors had significantly higher rates of respiratory complications (64.8% vs. 47.9%, p = 0.042), neurological complications (15.9% vs. 4.2%, p = 0.021), renal complications (17.4% vs. 5.6%, p = 0.029), and longer postoperative hospital stay (37.2 vs. 28.4 days, p < 0.001). No significant difference was observed in hospital mortality (2.8 vs. 4.2%, p = 0.649). The overall follow-up time was 72.2 ± 1.9 months (range 68.5 to 75.8). The 1-, 3-, and 5-year survival rates for the underweight and normal-weight donor BMI groups were 83.1% vs. 85.9% (p = 0.624), 75.6% vs. 80.2% (p = 0.527), and 72.0% vs. 77.3% (p = 0.468), respectively. Conclusions: Patients receiving hearts from underweight donors demonstrate comparable long-term survival to those from normal-weight donors but have a higher risk of postoperative complications. These findings suggest that underweight donors could be cautiously utilized to expand the donor pool, offering lifesaving opportunities to recipients who might otherwise experience adverse outcomes due to donor scarcity, albeit with an increased risk of postoperative complications. Full article

Despite the extensive application of machine learning (ML) methods to educational datasets, few studies have provided a systematic benchmarking of the available algorithms with respect to both predictive performance and interpretability of the resulting models. In this work, we address this gap by comparing a range of supervised learning methods on a freely available dataset concerning two high schools, where the goal is to predict student performance by modeling it as a binary classification task. Given the high feature-to-sample ratio, the problem falls within the small-data learning regime, which often challenges ML models by diluting informative features among many irrelevant ones. The experimental results show that several algorithms can achieve robust predictive performance, even in this scenario and in the presence of class imbalance. Moreover, we show how the output of ML algorithms can be interpreted and used to identify the most relevant predictors, without any a priori assumption about their impact. Finally, we perform additional experiments by removing the two most dominant features, revealing that ML models can still uncover alternative predictive patterns, thus demonstrating their adaptability and capacity for knowledge extraction under small-data conditions. Future work could benefit from richer datasets, including longitudinal data and psychological features, to better profile students and improve the identification of at-risk individuals. Full article

As universities increasingly work towards the adoption of their third mission—fostering entrepreneurship and innovation—the concept of the Entrepreneurial University (EntUni) emphasizes the need to cultivate a defined set of entrepreneurial competencies in students, such as opportunity recognition, risk-taking, perseverance, self-efficacy, and adaptability. The purpose of this study is to identify which entrepreneurial competencies are most critical for student readiness within the context of an Entrepreneurial University. However, limited consensus remains on which competencies are most essential. This study identifies the entrepreneurial competencies most critical for students within an Entrepreneurial University context through a mixed-methods approach. A student survey assesses self-perceived competencies; a stakeholder survey captures the perspectives of faculty, industry experts, and entrepreneurs; and qualitative interviews with industry professionals explore best practices for competency development. Findings reveal six core competencies that EntUnis should help students cultivate: proactiveness, perseverance, grit, risk propensity, self-efficacy, and entrepreneurial intention. Industry experts further highlight the importance of teamwork, ethical and sustainable thinking, and ambiguity tolerance—competencies often underdeveloped in academic environments. The study also identifies a disconnect between entrepreneurial education and practical application, with many students demonstrating high entrepreneurial intention but limited participation in start-up activities. These insights offer actionable implications for educators, policymakers, and university administrators. Overall, the study highlights the importance of experiential learning, academia-industry collaboration, and structured competency-building to enhance entrepreneurial readiness. By addressing these gaps, EntUnis can better equip students to drive innovation, economic growth, and societal impact. Full article