Search Results (5,366)

Background/Objectives: E-cigarette use has increased substantially among university students in recent years, coinciding with a broader shift in nicotine consumption patterns globally. Despite initial perceptions of e-cigarettes as harm-reduction tools, growing evidence indicates significant health risks, misinformation, and limited awareness—especially within higher education environments. This structured literature review aims to synthesize peer-reviewed evidence on the health impacts, behavioral determinants, and the role of nursing in addressing e-cigarette use among university students. Methods: A literature search was conducted across five databases (PubMed, CINAHL, Scopus, Embase, Dialnet) between February and March 2025. Eligible studies were published between January 2020 and January 2025 in English or Spanish. A total of 43 studies were included. Data were synthesized narratively, and methodological quality was assessed using Joanna Briggs Institute checklists and The Scale for the Assessment of Narrative Reviews Articles. Results: E-cigarette use among university students showed wide variability in prevalence, with higher rates among males, students in non-health disciplines, and users of disposable devices. Key behavioral and social determinants included peer influence, curiosity, stress management, and social media exposure. Despite documented health risks—such as nicotine dependence, respiratory and cardiovascular impairment, and mental health concerns—misconceptions about safety and cessation efficacy were common, even among health science students. Nursing-led interventions hold great potential for prevention but remain underdeveloped within university settings. Conclusions: The findings underscore the urgent need for evidence-based prevention strategies—particularly those led by nurses—to reduce e-cigarette use, bridge knowledge gaps, and mitigate associated health risks in higher education. Future efforts should prioritize institutional policy reinforcement, improved health communication, and the integration of vaping-related education into nursing curricula and public health campaigns targeting emerging adults. Full article

Introduction: People who exercise outdoors in urban environments may inhale increased amounts of polluted air due to temporary respiratory changes induced by physical activity. The objective of this scoping review was to map the physiological, morphological, and/or functional responses of the respiratory system to air pollution in healthy adults who exercise outdoors in urban environments. Methods: This review was conducted following the guidelines of the Preferred Reporting Items Extension for Scoping Reviews (PRISMA-ScR). A comprehensive search of Medline (PubMed), Redalyc, Scielo, and Web of Science was conducted to identify clinical trials, quasi-experimental studies, and cross-sectional studies published in the last 10 years in English. Studies with healthy adult participants engaged in outdoor physical activity in urban environments were included. Texts with participants with preexisting respiratory diseases, elite athletes, animal models, and computer simulations were excluded. Results: The most frequently reported air pollutants were PM_2.5, PM₁₀, and ozone (O₃); the most common forms of exercise were walking, running, and cycling. Exposure to air pollutants during physical activity was associated with reductions in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁), as well as increases in the fraction of exhaled nitric oxide (FeNO) and proinflammatory biomarkers. Conclusion: The findings indicated that there are modifications in lung function in those who exercise outdoors. However, the association between these respiratory responses and air pollution was not statistically significant in most cases. Some authors suggested that the health benefits of physical activity could mitigate the harmful effects of air pollution. Full article

The health risks of PM_2.5-bound metals highlight the need for burden assessment, metal prioritization, and key factor analysis to support effective air quality management, yet relevant studies remain limited. Shandong Province is one of the most polluted regions in northern China, providing an ideal setting for this investigation. We monitored 17 PM_2.5-bound metals for three years across Shandong, China and performed disease burden assessment based on disability-adjusted life years (DALYs). Furthermore, key influencing factors contributing to high-hazard metals were identified through explainable machine learning. The results showed that PM_2.5-bound metal concentrations were generally higher in inland areas than in coastal regions, with Ni concentrations elevated in coastal areas. K, Ca, Zn, and Mn exhibited the highest three-year average concentrations among the metals, while Cr averaged 6.12 ng/m³, significantly exceeding the recommended annual limit of 0.025 ng/m³ set by Chinese Ambient Air Quality Standards. Jinan carried the greatest burden at 4.67 DALYs per 1000 people, followed by Zibo (3.78), Weifang (2.98), and Rizhao (2.80). CKD, interstitial pneumonia, and chronic respiratory diseases account for the highest DALYs from PM_2.5-bound metals in Shandong Province. Industrial emissions are the largest contributors to the disease burden (>34%), with Cr, Cd, and Pb as the primary contributing metals requiring priority control. Fractional vegetation cover was identified as the key factor contributing to the reduction in their concentrations. These results underscore that prioritizing the regulation of industrial combustion, particularly concerning Cr, Cd, and Pb, and enhancing fractional vegetation cover could reduce disease burden and provide public health benefits. Full article

Background: Although several epidemiological studies have suggested a potential association between infections and Parkinson’s disease (PD), relatively few have specifically examined the relationship between upper respiratory tract infections (URIs) and PD, apart from coronavirus disease 2019 (COVID-19). Objectives: We investigated whether a history of URI was associated with the diagnosis of PD among Korean individuals aged ≥40 years, using data from the Korean National Health Insurance Service–Health Screening Cohort. Methods: A total of 5844 patients newly diagnosed with PD were identified and matched with 23,376 control participants at a 1:4 ratio based on age, sex, income, and geographical region. Conditional logistic regression analyses were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for PD, adjusting for potential confounders including smoking, alcohol consumption, body mass index, blood pressure, comorbidity scores, blood glucose, and serum cholesterol levels. Results: Overall, no significant association was found between a history of URI and PD when considering a two-year exposure window. However, in the one-year window analysis, individuals with a history of URI had a modestly reduced odds of PD (≥1, ≥2, or ≥3 episodes: (adjusted OR: 0.93, 95% CI: 0.88–0.97, aOR: 0.91, 95% CI: 0.87–0.96 and aOR: 0.92, 95% CI: 0.87–0.98, respectively). Subgroup analyses revealed that the inverse association was more pronounced among women, older adults (≥65 years), and those with higher comorbidity scores. No clear dose–response trend was observed across increasing frequencies of URI diagnoses. Conclusions: Our findings suggest that the apparent protective association between recent URI history and PD is unlikely to be causal and may instead reflect confounding by medication use or reverse causation related to the prodromal phase of PD. These results should therefore be interpreted with caution and regarded as hypothesis-generating. Further prospective studies incorporating detailed prescription data and long-term follow-up are warranted to clarify the role of infections and anti-inflammatory medications in the pathogenesis of PD. Full article

In this study, a prototype system was developed as a potential alternative to lockdown measures against the spread of airborne infectious diseases such as COVID-19. The system integrates real-time estimation functions for respiratory flow and mask leakage into a low-cost powered air-purifying respirator (PAPR) designed for the general public. Using only a single differential-pressure sensor (SDP810) and a controller (Arduino UNO R4 WiFi), the respiratory flow (Q_3e) is estimated from the differential pressure (ΔP) and battery voltage (V_b), and both the wearing status and leak status are transmitted to and displayed on a smartphone application. For evaluation, a testbench called the Respiratory Airflow Testbench was constructed by connecting a cylinder–piston drive to a mannequin head to simulate realistic wearing conditions. The estimated respiratory flow Q_3e, calculated solely from ΔP and V_b, showed high agreement with the measured flow Q_3m obtained from a reference flow sensor, confirming the effectiveness of the estimation algorithm. Furthermore, an automatic leak detection method based on the time-integrated value of Q_3e was implemented, enabling the detection of improper wearing. This system thus achieves respiratory flow estimation and leakage detection based only on ΔP and V_b. In the future, it is expected to be extended to applications such as pressure control synchronized with breathing activity and health monitoring based on respiratory and coughing analysis. This platform also has the potential to serve as the foundation of a PAPR Wearing Status Network Management System, which will contribute to societal-level infection control through the networked sharing of wearing status information. Full article

Enteroviruses, a diverse genus within the Picornaviridae family, are responsible for a wide range of human infections, including hand, foot, and mouth disease, respiratory disease, aseptic meningitis, encephalitis, myocarditis, and acute flaccid paralysis. Despite their substantial global health burden and the frequent emergence of outbreaks, no specific antiviral therapies are currently approved for clinical use against non-polio enteroviruses. This review provides a comprehensive overview of the current landscape of antiviral strategies targeting enteroviruses, including direct-acting antivirals such as capsid binders, protease inhibitors, and viral RNA polymerase inhibitors. We also examine the potential of host-targeting agents that interfere with virus–host interactions essential for replication. Emerging strategies such as immunotherapeutic approaches, RNA interference, CRISPR-based antivirals, and peptide-based antivirals are also explored. Furthermore, we address key challenges, including viral diversity, drug resistance, and limitations in preclinical models. By highlighting recent advances and ongoing efforts in antiviral development, this review aims to guide future research and accelerate the discovery of effective therapies against enterovirus infections. Full article

Until recently, Stenotrophomonas maltophilia was considered a low-virulence pathogen, usually found as an environmental commensal and colonizer of moist abiotic surfaces. Lately, it has increasingly been implicated in invasive infections with high associated morbidity and mortality. Most epidemiological studies involving patients with S. maltophilia infections have recorded risk factors and their associations with outcomes in critically ill patients. The aim of this study was to investigate its epidemiology as a pathogen in patients hospitalized in medical wards and potential factors associated with mortality. For this purpose, S. maltophilia-positive cultures from patients admitted to medical wards from 1 January 2023 to 30 June 2025 were collected, demographics and patient characteristics were recorded and analyzed and associated with clinical outcome. Twenty-nine patients and their first positive S. maltophilia positive culture were included in the study with a direct attributable mortality of 27.6%. Patients with cardiovascular and chronic obstructive pulmonary disease more commonly developed respiratory tract infections. Among the recorded comorbidities, only diabetes was associated with worse outcome. Most of the strains retained sensitivity to co-trimoxazole and levofloxacin and treatment outcome was not affected by the choice of regimen. This study highlights the rise of S. maltophilia to a true pathogen affecting immunocompetent patients; in combination with its antimicrobial resistance, this justifies its recognition as an emerging pathogen of public health concern. Full article

Background and Aim: Mechanical ventilatory support is often required in patients with acute respiratory distress syndrome (ARDS). However, early differences in ventilatory mechanics and severity scores between COVID-19 and non-COVID-19 ARDS patients remain unclear. This study aimed to compare respiratory parameters and clinical severity scores in COVID-19 and non-COVID-19 ARDS patients managed in the emergency department (ED) and evaluate their association with in-hospital mortality. Methods: In this retrospective cohort study, adult patients with ARDS (PaO₂/FiO₂ < 300 mmHg) who received mechanical ventilation in the ED were included. Ventilator parameters and clinical severity scores (SOFA, APACHE II, PSI, and Charlson Comorbidity Index) were recorded at the 120th minute after intubation. Patients were categorized as COVID-19 or non-COVID-19 ARDS, and outcomes were compared between survivors and non-survivors. Logistic regression was used to identify independent predictors of in-hospital mortality. Results: A total of 70 patients were enrolled (32 COVID-19, 38 non-COVID). Plateau pressure, driving pressure, and PEEP were significantly higher in COVID-19 patients, while compliance was without statistical significance. Overall, in-hospital mortality did not differ significantly between the COVID-19 (53.1%) and non-COVID-19 groups (71.1%, p = 0.12). Mechanical power (21.6 vs. 16.8 J/min, p = 0.01) and Charlson Comorbidity Index (6 vs. 5.5, p = 0.02) were significantly higher in non-survivors across the full cohort. Among clinical scores, SOFA was significantly higher in the COVID-19 group (p = 0.02), and APACHE II was significantly higher in non-survivors within the COVID-19 subgroup (p = 0.02). In multivariate analysis, mechanical power and Charlson Comorbidity Index were associated with mortality. Conclusions: COVID-19 patients with ARDS exhibited higher early ventilatory pressures than non-COVID-19 patients, yet early respiratory mechanics were not independently associated with mortality. Mechanical power and Charlson Comorbidity Index were significantly associated with in-hospital mortality. These findings underscore the need to consider both ventilatory load and systemic health status in early outcome assessments of ARDS patients. Full article

This narrative case-based review describes the environmental and public health impacts in Chañaral, a town in northern Chile affected by the accumulation of copper mining tailings for the past 80 years. The review included 34 scientific articles published between 1978 and 2025. The keywords used were “mining tailings” and “Chañaral”, without year limits, and covering disciplines such as ecology, public health, environmental history, and territorial studies. The scientific evidence demonstrates the negative impacts on the ecosystem and the human population exposed to toxic metals and arsenic. Geomorphological and biogeochemical alterations have been found on the Chañaral coast, affecting marine biodiversity and water quality. In addition, epidemiological studies indicate exposure to toxic metals measured in street dust and urine, raising concerns on respiratory health in children and metabolic conditions in adults. According to the social sciences, the lack of environmental monitoring and human exposure data contributes to the high health risk perception in the population, posing the need to strengthen environmental monitoring, raise awareness on the risks of exposure to toxic metals, and promote mitigation and restoration strategies. These measures will contribute to sustainable conditions for the Chañaral community through the improvement of comprehensive public policies. Full article

The circadian rhythm of the central brain clock in the suprachiasmatic nucleus (SCN) is synchronized by light. White adipose tissue (WAT) is one of the metabolic endocrine organs containing a molecular clock, and it is synchronized by the SCN. Excess WAT is a risk factor for health issues including type 2 diabetes mellitus (DM2). We hypothesized that bright-light exposure would affect the human WAT transcriptome. Therefore, we analyzed WAT biopsies from two previously performed randomized cross-over trials (trial 1: n = 8 lean, healthy men, and trial 2: n = 8 men with obesity and DM2). From 7:30 h onwards, all the participants were exposed to either bright or dim light. Five hours later, we performed a subcutaneous abdominal WAT biopsy. RNA-sequencing results showed major group differences between men with obesity and DM2 and lean, healthy men as well as a differential effect of bright-light exposure. For example, gene sets encoding proteins involved in oxidative phosphorylation or respiratory chain complexes were down-regulated under bright-light conditions in lean, healthy men but up-regulated in men with obesity and DM2. In addition to evident group differences between men with obesity and DM2 and healthy lean subjects, autonomic or neuroendocrine signals resulting from bright-light exposure also differentially affect the WAT transcriptome. Full article

This study examines the impacts of industrial wastewater from the Uttara Export Processing Zone (UEPZ) on natural resources, agriculture, and the health of nearby communities in Nilphamari, Bangladesh. Using a quantitative, self-report approach, data were collected from 162 households across four villages in Nilphamari Sadar Upazila, selected based on proximity to the UEPZ. Findings reveal significant environmental degradation: almost all (96%) respondents reported that water in nearby rivers and ponds has changed color and is odorous, unpleasant to taste, and contaminated, harming aquatic biodiversity. Agricultural productivity has declined, with 67 percent of respondents experiencing reduced crop yields, increased crop diseases, and rising cultivation costs due to greater dependence on fertilizers and pesticides. Also, 96 percent of respondents reported that the fish population diminished, reducing alternative income sources. Health impacts were pronounced; 69 percent of the respondents experienced water pollution-related complications, including skin, respiratory, gastrointestinal, and eye problems. Perceptions of wastewater health risks were strongly aligned with reported illnesses. Binary logistic regression further indicated a positive association between degraded crop health and human health problems. The study concludes that UEPZ’s wastewater disposal negatively affects natural resources, agriculture, and public health, underscoring the need for improved waste management and mitigation to protect affected communities. Full article

Background: Differentiating between bacterial and viral infections in pediatric emergency care is challenging, often leading to unnecessary antibiotic use. The MeMed BV (MMBV) test is a host-response assay designed to differentiate bacterial from viral infections, but real-world data in pediatric settings remain limited. Methods: We conducted a pragmatic, single-center, prospective cohort study to assess the clinical utility of MMBV in children with acute respiratory infections or fever without source. Patients were assigned to standard of care (SOC) or MMBV testing (SOC+MMBV) based on time of presentation to the emergency department. The primary outcome was antibiotic prescribing. Secondary outcomes included diagnostic test utilization, hospitalization rates, and length of stay. Analyses were stratified by hospitalization status, clinical severity [National Institute for Health and Care Excellence (NICE) traffic light system], and patient age. Results: From July 2023 to April 2024, 343 patients were enrolled (171 SOC, 172 SOC+MMBV). In the SOC+MMBV arm, reduced antibiotic prescribing was observed among outpatients and those with non-severe signs and symptoms. Antibiotic prescribing was significantly reduced in children under five years with a low-risk profile, according to the NICE traffic light system (26.3% vs. 7.5%; p = 0.034). Multiplex PCR testing was significantly reduced in the SOC+MMBV group (28.7% vs. 16.3%; p = 0.006) compared to SOC for both inpatients and outpatients. No significant differences were observed in overall diagnostic test use or length of stay. Conclusions: MMBV improved antibiotic and diagnostic stewardship in a real-world pediatric ED setting, significantly reducing unnecessary antibiotic use among low-risk children under five and minimizing unnecessary multiplex PCR testing across the cohort. Full article

Respiratory infections are a major concern in pig farming as they negatively impact animal health and productivity. Coughing is a key symptom of respiratory disease and can be classified as productive or non-productive, but human assessment often leads to inconsistencies. This study aimed to use a machine learning model to classify pig coughs and investigate their association with respiratory infections. Cough sounds from 49 fattening pigs were recorded and analyzed using a Python-based machine learning system. The model’s accuracy in detecting coughs was 0.72, compared to 0.69 for farmers. For classification of non-productive coughs, the machine learning results showed strong agreement with infection status by Mycoplasma hyopneumoniae, with a Spearman’s correlation of 0.80 and a Cohen’s Kappa of 0.79. However, the association with Porcine Circovirus type 2 was weak, with correlation and Kappa values of 0.05 and 0.037, respectively. These findings indicate that machine learning can classify pig coughs more accurately than human evaluators and that non-productive coughs are strongly linked to Mycoplasma infection but not to PCV2. This suggests the potential use of machine learning for more reliable disease monitoring and early detection in swine production. Full article

Obesity is a significant health issue, as it is related to human diseases such as asthma and respiratory viral infections. Asthma patients with obesity have more severe diseases, which can be presented with type 1 (e.g., IFN-γ) high inflammation. The interactions of obesity or saturated fatty acids (e.g., palmitic acid, PA) with IFN-γ in airway viral infections have not been clear. In this study, we determined the role of obesity risk factors high-fat diet (HFD) and PA in rhinovirus infection in the context of IFN-γ stimulation in mice and cultured human tracheobronchial epithelial cells. We further examined the therapeutic effect of a glycolytic inhibitor on metabolic reprogramming and viral infection in our experimental models. In mice, HFD in combination with IFN-γ significantly increased lung rhinovirus levels as well as neutrophilic inflammation. Similarly, PA and IFN-γ combination increased viral infection in mice, but HFD or PA alone had a minimal effect on viral infection. Mouse model data were confirmed in cultured primary healthy human airway epithelial cells where PA and IFN-γ together increased viral load. Mechanistically, HFD or PA in combination with IFN-γ up-regulated the glycolytic pathway and generated metabolites favoring viral replication. Inhibition of glycolysis by 2-DG effectively reduced viral infection in human airway epithelial cells. Our data suggest that hosts with obesity along with type 1 high inflammation may be at an increased risk of respiratory viral infections. Intervention of the glycolytic pathway or its metabolites may reduce the severity of viral infection. Full article

Objectives: This study investigates the nonlinear association between myeloperoxidase (MPO) levels and Helicobacter pylori (H. pylori) infection risk in Chinese adults, evaluating potential modifiers and clinical implications for infection prevention. Methods: An analysis was conducted on cross-sectional data from 15,180 adults who underwent routine health examinations between January and December 2021. H. pylori infection was diagnosed using the 14C-urea breath test with a threshold of disintegrations per minute (DPM) ≥ 100. ELISA was used to measure plasma MPO levels. Nonlinear associations were assessed through logistic regression, restricted cubic splines, threshold effect analysis, and subgroup interactions. Results: The study identified a U-shaped correlation between MPO levels and the risk of H. pylori infection. Compared to the middle tertile (T2: 20.6–31 ng/mL), participants in the lowest (T1: ≤20.6 ng/mL; OR = 1.36, 95% CI: 1.24–1.49) and highest tertiles (T3: ≥31 ng/mL; OR = 1.12, 1.02–1.22) exhibited elevated infection risk after full adjustment (p < 0.001). DPM levels were notably elevated in T1 (β = 37.1, 26.66–47.57) and T3 (β = 19.27, 8.81–29.72) relative to T2 (p < 0.0001). RCS-based threshold analysis identified a nonlinear inflection at 24.0 ng/mL of MPO, where each additional 1 ng/mL of MPO below this threshold was associated with a reduced infection risk (OR = 0.959, 95% CI: 0.947–0.971), whereas levels above increased the risk (OR = 1.004, 95% CI: 1.002–1.007). This pattern aligned with H. pylori breath test values, which mirrored the U-shaped trend across MPO tertiles. Subgroup analyses revealed uniform associations between MPO and H. pylori infection risk/DPM across various factors such as age, sex, BMI, and metabolic comorbidities, with all interaction p-values exceeding 0.05. Conclusions: MPO levels exhibit a robust U-shaped association with H. pylori infection risk, independent of anthropometric and metabolic confounders. Monitoring MPO may aid in identifying individuals at bidirectional infection risk, suggesting novel insights into the inflammation–infection interplay. The study’s cross-sectional design limits the ability to establish causal relationships, necessitating further longitudinal research to validate these findings and elucidate their clinical implications. Full article