Search Results (298)

Background: Fungal infections pose a significant threat to public health, with over 6.55 million cases and 2.55 million deaths annually. Exposure to fungal spores in indoor environments primarily occurs through inhalation or direct contact with surfaces. Monitoring is critical for early detection and prevention of outbreaks, yet routine airborne fungal testing is not universally mandated across healthcare settings. Methods: A systematic review of peer-reviewed articles from four databases was conducted to identify current airborne fungal monitoring guidelines and best practices for sample collection, culture media, incubation conditions, and results interpretation. Results: Eighteen articles met the inclusion criteria, and four studies discussed potential guidelines for acceptable airborne fungal levels in healthcare environments. Guidelines ranged from <1 CFU/m³ for HEPA-filtered environments to >1000 CFU/m³ for non-filtered areas. The most common fungi identified were Aspergillus, Penicillium, Alternaria, Cladosporium, and Rhizopus, with six WHO-listed critical fungal pathogens found. Impaction was the sole sampling method used, with most studies employing Sabouraud dextrose or malt extract agar with chloramphenicol, incubation for 2–7 days at 25–30 °C, and morphological identification. Conclusions: The need for globally recognized fungal monitoring standards is pressing. Without them, preventable fungal exposure will persist, risking severe, potentially fatal infections for patients and healthcare workers. Full article

Background: The Endothelial Activation and Stress Index (EASIX) is a biomarker initially developed to predict survival in patients with acute graft-versus-host disease after allogeneic haemato-poietic stem cell transplantation and is regarded as a surrogate of endothelial dysfunction. This study aimed to evaluate whether EASIX reflects early hemodynamic instability and vasopressor requirement in critically ill patients. Methods: We retrospectively analysed 447 patients admitted to the intensive care unit (ICU) at the University Clinical Centre in Gdańsk. Illness severity scores—including the Simplified Acute Physiology Score II (SAPS II), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA)—and laboratory parameters, were collected at admission. EASIX, simplified EASIX (sEASIX), and modified EASIX (mEASIX) were calculated using established formulas. Vasopressor requirements, ex-pressed as norepinephrine equivalents (NEE), were recorded during the first 72 h. Statistical analyses included Spearman’s correlation, logistic regression, and receiver operating characteristic curve analysis. Results: In univariate analysis, EASIX was associated with ICU mortality (OR 1.333; 95% CI 1.135–1.576), but this association was not significant after adjustment. EASIX positively correlated with vasopressor requirements, severity scores (SOFA, SAPS II, APACHE II), and inflammatory and metabolic markers (PCT, CRP, lactate). It correlated with norepinephrine-equivalent doses within the first 48 h and moderately discriminated high-dose vaso-pressor use (>0.1 µg/kg/min). A weak negative correlation with ICU length of stay was observed. No association with age was found. Conclusions: EASIX is an age-independent marker associated with disease severity and early vaso-pressor burden in ICU patients. Rather than providing a direct measurement of endothelial function, it reflects a global signal of systemic stress and microvascular derangement and should be interpreted accordingly. Full article

This study examined the effects of a 16-week periodized resistance training program on the strength, power, and body composition of elite collegiate cheerleaders. Thirteen female athletes from a nationally top-ranked university team completed a structured program comprising hypertrophy and strength/power phases. Performance testing at pre-, mid-, and post-intervention included one-repetition maximum (1RM) assessments for the front squat, power clean, and shoulder press, as well as measurements of body mass, lean body mass, and body fat percentage. All strength measures improved significantly across the intervention (front squat: +14.0%, power clean: +17.7%, and shoulder press: +18.3%). Body fat percentage decreased by 6.7%, and lean body mass increased by 2.6%, while total body mass remained statistically unchanged. These results demonstrate that periodized resistance training can elicit meaningful improvements in performance and body composition without increases in body mass. Moreover, the final post-intervention 1RM values—1.43× body mass for the front squat, 1.11× for the power clean, and 0.73× for the shoulder press—offer preliminary benchmarks for the strength performance of high-level collegiate cheerleaders. Full article

In karst tunnel engineering, water-filled cavities located above the tunnel crown, under the combined effects of excavation disturbance and hydraulic pressure, are prone to triggering water and mud inrush disasters. The thickness of the water-resisting rock layer is therefore a key factor controlling the stability of the surrounding rock. To address the difficulty in accurately characterizing the mechanical behavior of the crown of horseshoe-shaped tunnels using conventional circular plate or beam models, this study innovatively develops an explicit analytical model for the minimum safe thickness of the water-resisting rock layer based on clamped elliptical thin plate theory and Kirchhoff plate theory, incorporating the influence of cross-sectional geometry. Parametric sensitivity analysis indicates that both karst water pressure and tunnel crown height significantly amplify the required minimum safe thickness, whereas an increase in the tensile strength of the surrounding rock effectively reduces the thickness demand. Specifically, when the karst water pressure increases from 2.5 MPa to 4.5 MPa, the minimum safe thickness rises from 7.5 m to 10.0 m, showing an approximately linear growth trend. The analytical model is further validated through numerical simulations under different “water pressure–thickness” conditions. The results demonstrate that at the calculated recommended thickness, the surrounding rock achieves stable convergence after excavation. High tensile stress and elevated pore pressure zones are mainly concentrated near the tunnel crown, without the formation of through-going tensile failure. Engineering application indicates that the proposed model can provide a quantitative basis for the design of water-resisting rock layer thickness and the assessment of water inrush risk in karst tunnels. Full article

A smart classroom integrates emerging technologies such as the Internet of Things and cloud computing, optimizes resource allocation, and transforms classroom interaction. A smart classroom encourages students to participate in a pressing concern as Chinese institutions steadily promote the development and implementation of such classrooms. Identifying the key spatial factors that influence learning engagement is essential. Current work has identified learning factors for a smart classroom that encourage dealing with learning environments, perceptions, experiences, and engagement by following a learner-centered educational philosophy. A questionnaire was designed to collect data from the Yibin Campus of Chengdu University of Technology and data was collected by using a survey method. The statistical analysis was applied to 156 valid student perception samples, which were empirically explored. Four factors related to classroom infrastructure and design are examined: physical environment, spatial layout, table and chair design, and technological equipment. Among these, technological equipment has the strongest effect on learning engagement. The findings provide practical guidance for designers seeking to optimize smart classroom environments, thereby enhancing teaching quality and improving learning efficiency. Full article

The mental health of students in university has become an increasingly pressing concern due to rising academic pressure, career uncertainty, and major life transitions. Identifying students’ psychological support needs requires an understanding of the challenges they face, as well as their expectations regarding support forms, intervention methods, and service providers. This study employed a mixed-methods cross-sectional design, combining large-scale questionnaire surveys (701 respondents) with qualitative interviews to assess the mental health status and psychological support needs of students at economics universities in Vietnam. The findings reveal that students commonly experience negative emotional states, particularly anxiety related to academic workload, financial instability, personal health, and future career orientation. A proportion of students reported depressive symptoms such as persistent sadness, prolonged stress, and physiological disturbances including insomnia and disordered eating. While severe behavioral disorders are uncommon, signs of declining academic motivation, social withdrawal, and weakened interactions with lecturers are evident. Students express a strong demand for mental health support, especially in career guidance, learning strategies, emotional regulation, and interpersonal problem-solving. Individual, professional, confidential counseling services are the most preferred forms of support, highlighting the need for a comprehensive mental health and psychological support system tailored to the context of Vietnamese universities. Full article

Noise pollution poses a serious threat to human health and well-being, especially in educational environments where concentration and learning are essential. While urban noise has been widely studied, its effects within university settings remain underexplored. This study investigates environmental noise and student perceptions on two campuses of the University of Guadalajara, Mexico—one located in an urban area and the other in a semi-rural setting. Noise levels were measured using the CESVA-SC260 integrating instrument (CESVA Instruments, SLU, Barcelona, Spain), and student perceptions were gathered through a survey. A total of 731 students participated, with 357 from the urban campus and 374 from the semi-rural one. Results showed that noise levels on both campuses frequently exceeded the WHO’s recommended limit of 55 dB(A) for educational facilities, with readings between 40.9 and 85.0 dB(A); 89% of measurements surpassed the threshold. Major sources of noise included vehicular traffic, student gatherings, and construction-related machinery. Survey responses indicated that 41% of students perceived noise as a health risk, and 96% reported adverse effects on well-being and identified it as a disruptor of academic tasks. These findings underscore the pressing need for targeted noise management strategies in university environments and call for further research into effective, context-specific interventions that enhances learning conditions. Full article

This study investigated the individual and interactive effects of thermal and acoustic parameters on university students’ concentration and satisfaction in a library environment. Measurements of temperature, relative humidity (RH), and sound pressure level (SPL), alongside questionnaire surveys assessing students’ concentration, environmental perceptions, and satisfaction, were conducted over ten continuous working days in four library rooms. The results revealed significant interactive effects between operative temperature (To), RH, and background noise level (LA90) on students’ concentration and overall satisfaction, highlighting the importance of an integrated approach to managing Indoor Environmental Quality (IEQ). Furthermore, multi-objective optimization using the NSGA-II algorithm suggested optimal ranges for To (22.6–24.8 °C), RH (41.0–48.4%), and LA90 (45.0–48.5 dB(A)). Existing library conditions surpassed these optimal levels, particularly on the first floor, indicating a pressing need for interventions to enhance student well-being and academic performance. Overall, this study provides insights into the interactions between thermal comfort and acoustic quality, offering recommendations for creating more conducive learning environments that boost student satisfaction and performance. Full article

Childhood malnutrition remains a pressing public health challenge in Europe, where stunting, wasting, and underweight coexist with rising rates of childhood overweight and obesity. This policy review provides a strategic roadmap for promoting healthy nutrition in early childhood by synthesizing WHO and EU guidance and proposing coordinated action across three time horizons. Short-term goals (1–3 years) include harmonizing food-based dietary guidelines, implementing universal nutrition screening in pediatric care, and strengthening breastfeeding-supportive environments. Mid-term priorities (3–7 years) focus on fiscal levers, such as sugar taxes and healthy food subsidies; reformulating children’s products; and embedding nutrition education within school curricula. Long-term strategies (7+ years) emphasize harmonized EU-wide monitoring systems, alignment of early-life nutrition with social protection policies, and sustained investment in research on the DOHaD. Through a unified, multisectoral strategy emphasizing early-life nutrition, equitable access to healthy foods, education, and robust regulation, Europe can effectively address the double burden of malnutrition and sustainably reduce childhood obesity. Full article

Objective: This study aimed to compare the accuracy of two large language models (LLMs)—ChatGPT (version 3.5) and Google Gemini (formerly Bard)—in answering dental caries-related multiple-choice questions (MCQs) using a simulated student examination framework across seven examination lengths. Materials and Methods: A total of 125 validated dental caries MCQs were extracted from Dental Decks and Oxford University Press question banks. Seven examination groups were constructed with varying question counts (25, 35, 45, 55, 65, 75, and 85 questions). For each group, 100 simulations were generated per LLM (ChatGPT and Gemini), resulting in 1400 simulated examinations. Each simulated student received a unique randomized subset of questions. MCQs were answered by each LLM using a standardized prompt to minimize ambiguity. Outcomes included mean score, passing rate (≥60%), and performance differences between LLMs. Statistical analyses included independent t-tests, one-way ANOVA within each LLM, and two-way ANOVA examining interactions between LLM type and question count. Results: Across all seven examination formats, Gemini significantly outperformed ChatGPT (p < 0.001). Gemini achieved higher passing rates and higher mean scores in every examination length. One-way ANOVA revealed significant score variation with increasing exam length for both LLMs (p < 0.05). Two-way ANOVA demonstrated significant main effects of LLM type and question count, with no significant interaction. Randomization had no measurable effect on Gemini performance but influenced ChatGPT scores. Conclusions: Gemini demonstrated superior accuracy and higher passing rates compared to ChatGPT in all simulated examination formats. While both LLMs struggled with complex caries-related content, Gemini provided more reliable performance across question quantities. Educators should exercise caution in relying on LLMs for automated assessment or self-study, and future research should evaluate human–AI hybrid models and LLM performance across broader dental domains. Full article

Background: In-hospital cardiac arrest (IHCA) constitutes a high-impact clinical event, associated with substantial mortality, frequent neurological and functional impairment. There is a pressing need for primary IHCA studies that evaluate risk predictors, given the inherent challenges of IHCA data collection, previously unharmonized reporting frameworks, and the predominant focus of prior investigations on other domains. Among potential contributors, the “off-hours effect” has consistently been linked to poorer IHCA outcomes. Accordingly, we sought to examine whether in-hospital mortality after IHCA varies according to the time and day of occurrence within a tertiary academic center in Northern Greece. Methods: We conducted a single-center observational cohort study using a prospectively maintained in-hospital resuscitation registry at AHEPA University General Hospital, Thessaloniki. All adults with an index IHCA between 2017 and 2019 were included, and definitions followed Utstein-style recommendations. Results: Multivariable logistic regression adjusted for organizational, patient, and process-of-care factors demonstrated that afternoon/night arrests, weekend arrests, heart failure comorbidity, and need for mechanical ventilation were independent predictors of higher in-hospital mortality. Conversely, arrhythmia as the cause of IHCA and arrests occurring in the intensive care unit or operating room were associated with improved survival. Subgroup analyses confirmed consistent off-hours differences, with weekend events showing reduced 30-day and 6-month survival and worse functional status at discharge. Afternoon/night arrests were more frequent, characterized by longer response intervals and lower survival at both time points. Conclusions: Organizational factors during nights and weekends, rather than patient case mix, drive poorer IHCA outcomes, underscoring the need for targeted system-level improvements. Full article

This article examines the theory of miracles formulated by the distinguished Shī’ī-Mu’tazilī theologian, al-Sharīf al-Murtaḍā (965–1044 CE), specifically to contextualize his controversial doctrine of Qurʾānic iʿjāz, known as ṣarfah. The study reconstructs al-Murtaḍā’s general theory of miracles by analyzing his primary works and comparing his positions with standard Muʿtazilī theology. The investigation focused on how his metaphysical and moral frameworks interact to define the nature of miracles. I argue that al-Murtaḍā articulated a “minimal theory of miracles,” wherein miracles function as restricted, localized, and audience-relative “breaches of norms” (khawāriq al-ʿādāt) rather than violations of universal laws. In his view, miracles are morally necessary but temporally restricted acts of God, designed solely to authenticate a prophet to their immediate community. Al-Murtaḍā’s theory shifts the evidential burden of prophetic proof—including the Qur’ān—from continuing intrinsic supernatural qualities to discrete historical testimony. Finally, this study suggests that al-Murtaḍā appears to offer a rationally coherent alternative notion of miracles, that may well succeed from some of the most pressing contemporary intellectual challenges. Full article

Background/Objectives: Antimicrobial Resistance (AMR) is a pressing global animal and public health challenge. There is limited data on AMR prevalence, trends, and drivers in bacterial pathogens from animal sources in Uganda. Thus, this study investigated the occurrence and factors associated with multidrug resistance (MDR) in bacterial isolates recovered from clinical samples of animals submitted to the national veterinary diagnostic laboratory in Uganda. Methods: A retrospective study analyzed antibiogram data of bacteria from animal samples submitted to the Central Diagnostic Laboratory, Makerere University in Uganda between 2014 and 2020. The cleaned dataset comprised 590 cases with antibiogram data. Statistical analyses were conducted using R software version 4.5.2. Results: Gram-negative bacteria were predominant (74.4%) among the samples from clinical cases. The overall MDR proportion in the general bacteria population was 41.7% over the seven-year period. Among the clinically relevant bacteria, MDR was highest in Escherichia coli (57.2%), followed by Staphylococcus aureus (35.8%) and Salmonella (15.5%). Univariable screening of predictors hypothesized that MDR was influenced by year of case submission, animal host type, and bacterial group (p < 0.05). Multivariable logistic regression showed that isolates submitted in 2019 (vs. 2015) had significantly higher odds of MDR (aOR = 4.21; 95% CI: 1.62–13.14), indicating a marked temporal increase in resistance. Gram-negative bacteria (vs. Gram-positives) were also more likely to exhibit MDR (aOR = 1.62; 95% CI: 1.07–2.48). Conclusions: The high occurrence of MDR in bacterial pathogens from animal clinical submissions revealed the need for improved antimicrobial stewardship and integrated AMR surveillance in Uganda, particularly within the central region from which most diagnostic samples originated. Full article

An improved understanding of the sanitation enabling environment and status of market development (“sanitation economy”) is crucial not only for advancing national and global sanitation goals, but also for attracting the financing necessary to drive meaningful progress in low- and middle-income countries (LMICs). This need is particularly pressing as the sanitation sector faces a significant funding gap that must be bridged to meet the growing demands for sanitation services, infrastructure, and innovation. This paper reviews frameworks that assess the sanitation economy in LMICs with the aim of informing the development of more impactful future frameworks and the wider application of existing frameworks. Frameworks were identified through internet search and interviews with representatives of international sanitation sector organisations and universities. Thirty-nine frameworks were identified that have been or are currently being used in sanitation. Frameworks are diverse in the structure they adopt, their focus areas, the number of indicators, the number of countries covered, the frequency with which they have been applied, their reliance on primary versus secondary data sources, and their uptake and impact. Overall, use of the frameworks has been piecemeal and sporadic in LMICs. Only few frameworks have been picked up and applied by another organisation, although the results of some frameworks are widely used and cited. To ensure future efforts to measure and monitor the sanitation economy are evidence-based and make the best use of limited resources, frameworks currently in use should be independently evaluated and there should be greater collaboration and adoption of common frameworks. Full article

University Dual Training is constructed at the intersection of academic and professional spheres, shaping a complex and multifaceted educational model. The aim of this study is to analyze the media representation of University Dual Training within the Spanish higher education landscape. The analysis focused on news articles published in the digital press of Spanish universities between 2021 and 2025. Following the methodological principles of a systematic review, a total of 81 news items (comprising 747 lexical segments) were identified and categorized 60 from 25 public universities and 21 from 7 private institutions. Data analysis, supported by the MAXQDA 24 software, enabled the identification of trends in the use of keywords, temporal evolution, and prevailing themes, along with the degree of relevance attributed to this training modality. The findings reveal an institutional tendency in media dissemination centred on promoting University Dual Training as a pathway for educational innovation, highlighting experiences and collaborations with companies, and projecting a discourse in which universities present themselves as committed to this modality. The study concludes that digital university newspapers convey the relevance and impact of University Dual Training as a modality that brings together diverse stakeholders, creating a space of collaboration and shared responsibility that strengthens student training and employability. Full article