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Frontiers in Public Health

Aging and Public Health

Social Burden Induced by Age-related Diseases

Introduction: Bioaerosols are among pollutants that impair indoor air quality in schools and have been associated with increased respiratory morbidities. Knowledge of bioaerosols' sizes and the likely deposition sites within the child's respiratory tract are essential for the identification of associated risks. This study was designed to determine bioaerosols' size distribution and associated respiratory morbidities among school pupils in Ibadan North Local Government Area (INLGA), Ibadan. Methods: A descriptive cross-sectional study design was adopted. In nine randomly selected public primary schools in INLGA, indoor air sampling (when occupied and unoccupied) was conducted thrice weekly for three months each in the wet and dry seasons, respectively. Airborne Bacterial Respirable Fraction (BRF) and Fungal Respirable Fraction (FRF) of aerodynamic diameter of 1.1-4.7 µm which corresponds to regions between the human primary bronchus and the alveolar duct were sampled using a six-stage cascade impactor. The BRF and FRF were estimated and dichotomised into high (> median) and low (≤ median) categories. A standardised questionnaire was adapted to elicit information from 554 randomly selected pupils on socio-demographic characteristics and self-reported respiratory morbidities. Data were analysed using descriptive and inferential statistics at α0.05. Results: Median BRF and FRF during the wet season (2890 and 283 cfu/m 3 ) were significantly higher than dry season (1661 and 196 cfu/m 3 ), respectively and above WHO standards. Median BRF and FRF were significantly higher when classrooms were occupied (3906 and 230 cfu/m 3 ) than unoccupied (2800 and 214 cfu/m 3 ), respectively. About 67.5% of total bacterial and 77.8% fungal aerosols were respirable fractions. Age of pupils was 10.8±1.35 years and 57.4% were males. Exposure to high BRF and FRF was significantly associated with current rhinitis (aOR = 1.78, 95%CI: 1.11-2.85 and aOR = 1.83, 95%CI: 1.14-2.93) and current wheeze (aOR = 2.77, 95%CI: 1.73-4.43 and aOR = 1.88, 95%CI: 1.18-3.00), respectively. Male pupils were more likely to experience current rhinitis (aOR = 1.09, 95%CI: 1.15-1.58) and current wheeze (aOR = 1.11, 95%CI: 1.22-1.62) than females. Conclusion: Exposure to high levels of respirable bacterial and fungal fractions was associated with respiratory health outcomes among pupils.

Introduction: The presence of positive margins following tumor resection is a frequent cause of re-excision surgery. Nondestructive, real-time intraoperative histopathological imaging methods may improve margin status assessment at the time of surgery; optical coherence tomography (OCT) has been identified as a potential solution but has not been tested with the most common tissue types in surgical oncology using a single, standardized platform.Methods: This was a proof-of-concept evaluation of a novel device that employs wide-field OCT (WF-OCT; OTIS 2.0 System) to image tissue specimens. Various cadaveric tissues were obtained from a single autopsy and were imaged with WF-OCT then processed for permanent histology. The quality and resolution of the WF-OCT images were evaluated and compared to histology and with images in previous literature.Results: A total of 30 specimens were collected and tissue-specific microarchitecture consistent with previous literature were identified on both WF-OCT images and histology slides for all specimens, and corresponding sections were correlated. Application of vacuum pressure during scanning did not affect specimen integrity. On average, specimens were scanned at a speed of 10.3&nbsp;s/cm2 with approximately three features observed per tissue type.Conclusion: The WF-OCT images captured in this study displayed the key features of the most common human tissue types encountered in surgical oncology with utility comparable to histology, confirming the utility of an FDA-cleared imaging platform. With further study, WF-OCT may have the potential to bridge the gap between the immediate information needs of the operating room and the longer timeline inherent to histology workflow.

Seasonal Levels and Size Fractions of Indoor Air Bioaerosols as Predictors of Respiratory Morbidities among School Pupils in Ibadan, Nigeria

Respiratory allergies are an increasing global health concern, with current treatments primarily targeting symptoms rather than underlying immune dysregulation. Trichinella spiralisderived extracellular vesicles (TsEVs) have been implicated in modulating immune responses, but their role in allergic airway inflammation remains unexplored. This study investigates the immunomodulatory potential of TsEVs in mitigating ovalbumin (OVA)-induced allergic airway inflammation in mice. Methods: TsEVs were isolated from T. spiralis muscle larvae excretory-secretory products and characterized using nanoparticle tracking analysis. BALB/c mice were sensitized and challenged intranasally with OVA to induce respiratory allergy. TsEVs were administered intranasally before and during OVA challenge. Bronchoalveolar lavage fluid (BALF), lung tissue, spleens, and sera were analyzed for immune cell infiltration, cytokine production, regulatory T cell (Treg) expansion, and OVA-specific antibodies using histology, flow cytometry, and ELISA. Results: Intranasal administration of TsEVs significantly reduced eosinophilic infiltration and airway inflammation in OVA-sensitized mice. TsEVs treatment suppressed Th2 cytokines (IL-4, IL-5, IL-13) and OVA-specific IgE while enhancing IL-10 production. Importantly, TsEVs promoted expansion of CD4⁺FoxP3⁺ and CD4⁺FoxP3⁻IL-10⁺ regulatory T cells in lungs and spleen, contributing to a systemic anti-inflammatory profile. Ex vivo studies confirmed TsEVs-mediated modulation of allergen-stimulated immune responses. Discussion: Our findings highlight TsEVs as a promising therapeutic approach for allergic airway diseases by promoting immune tolerance and dampening inflammatory responses. These results pave the way for future translational applications of parasite-derived EVs in allergy treatment.

Trichinella spiralis-derived extracellular vesicles induce regulatory T cells and reduce airway allergy in mice

Malaria, caused by the parasite Plasmodium spp., remains the most prevalent and dangerous vector-borne infectious disease worldwide. Effective pathogen clearance during malaria hinges on the interplay between adaptive and innate immune responses, especially on T cells, B cells, antigen-presenting cells (APCs) and IFNγ response. In a previous study, we demonstrated that dendritic cell (DC) depletion resulted in impaired T cell responses. However, substantial CD4 + and CD8 + T cell activation was still detectable, suggesting that other APCs compensate for the lack of DCs. In the present study, we report an increase in splenic marginal zone macrophages (MZMΦ), and marginal metallophilic macrophages (MMMΦ) with an altered cytokine profile in DC-deficient mice upon P. yoelii infection. Ablation of macrophages by clodronate liposome (CL) application resulted in partially reduced T cell activation, which correlated with elevated parasitemia. To further elucidate the specific role of splenic macrophage subsets we studied P. yoelli infections in two transgenic C57BL/6 mouse lines. Treatment of CD169DTR mice with diphtheriatoxin (DT) efficiently depleted MMMΦ and MZMΦ, resulting in reduced IFNγ production by CD4 + T cells in P. yoelii-infected mice, though parasitemia progression was not modulated. In marked contrast, specific red pulp macrophages (RPMΦ) depletion in SpiC flox/flox x vav1cre mice resulted in elevated parasitemia. In conclusion, our data provide evidence that splenic macrophages located in or at the marginal zone contribute to CD4 + T cell activation, and that RPMΦs are indispensable for clearing of infected red blood cells (iRBCs) during P. yoelii infection.

Red pulp macrophages clear parasites, while marginal metallophilic and marginal zone macrophages support CD4 + T cell activation during Plasmodium yoelii infection

To accelerate the green transformation of power grids, enhance the accommodation of renewable energy, reduce the operational costs of rural distribution networks, and address voltage stability issues caused by supply-demand fluctuations, this study proposes an optimization method for distributed energy storage systems in rural distribution networks integrated with renewable energy.Initially, the K-means clustering method is employed to analyze one year of load and renewable generation data, generating four typical scenarios to represent varying conditions of electricity supply and demand. Based on this analysis, a collaborative optimization model for energy storage and renewable energy-integrated distribution networks is constructed, comprehensively considering operational costs of the rural grid as well as the investment and operational costs of energy storage systems, with the objective of minimizing total operational costs. The optimal locations and capacities of energy storage systems are determined using YALMIP toolbox and the beetle swarm optimization (BSO) algorithm, and the proposed method is validated on a modified IEEE 33-bus system. The results demonstrate that the optimized energy storage planning significantly reduces the operational costs of the rural distribution network, decreases electricity purchasing expenses and curtailment losses of wind and solar energy, and optimizes power flow distribution while enhancing nodal voltage stability. This approach not only improves the economic efficiency and operational performance of rural distribution networks but also provides robust theoretical and technical support for the efficient utilization of renewable energy resources.

Research on energy storage planning methods for distributed renewable energy integrated rural power distribution networks

Background: Reducing the length of hospital stay can significantly lower healthcare costs, minimize the risk of hospital-acquired infections and complications, and improve patient wellbeing. Accordingly, this study aimed to assess the length of hospital stay and its predictors among surgical patients at public hospitals in Addis Ababa, Ethiopia.Methods: A prospective cohort study was conducted among 394 surgical patients from August 1 and November 30, 2023. The length of hospital stay was analyzed using Kaplan-Meier survival curves, and group differences were assessed with the log-rank test. Variables with a p-value less than 0.05 in the multivariable Cox proportional hazards model were considered statistically significant predictors.

Hospital length of stay and its predictors among surgical patients at Public Hospitals in Addis Ababa, Ethiopia

Objective:This observational study sought to explore the prevalence and determinants of demoralization syndrome (DS) among elderly patients in North China diagnosed with advanced lung cancer (ALC), with the primary goal of mitigating their psychological distress. Methods:A convenience sampling approach was employed to recruit 420 ALC patients aged 60 years or older from four tertiary hospitals in North China. Data collection was carried out using structured questionnaires, which included the Chinese adaptation of the Demoralization Syndrome Scale and Perceptions of Social Support Questionnaire. Statistical analyses were performed using SPSS 26.0 software to derive meaningful insights. Results: Univariate analysis identified several significant factors influencing DS levels, including gender,smoking,average monthly household income, living alone, stage of cancer, social support, and self-management abilities. The mean DS score was notably elevated, with 32.8% of participants scoring within the high DS range. Multivariable linear regression analysis further established gender, average monthly household income, stage of cancer, social support, and self-management abilities as independent predictors of DS severity.The findings highlight the critical importance of addressing socioeconomic factors such as household income, strengthening social support networks, improving self-management skills, and implementing targeted interventions for female patients to reduce DS levels and alleviate psychological distress in elderly ALC patients, particularly those with stage IV cancer. These insights provide valuable guidance for healthcare professionals aiming to enhance the overall well-being of this high-risk population.

Demoralization syndrome in elderly patients with advanced lung cancer: A multi-center study in North China

To date, Education for Sustainable Development (ESD) and Inclusive Education have largely been treated as separate pedagogical approaches. Inclusion-oriented ESD, in particular, has not been widely adopted in formal education settings. As this is a relatively new area of research, we started by providing an understanding of inclusion-oriented ESD focusing on learners with special needs. Subsequently, we conducted a scoping literature review to explore how inclusion-oriented ESD is addressed in peer-reviewed journals, focusing on school-related education. Limiting the review to articles in English and German contributed to a predominant focus on European contexts, introducing potential language and database selection biases. We analyzed 20 peer-reviewed articles using quantitative and qualitative content analysis with MAXQDA software. The findings suggest that inclusion-oriented ESD constitutes an emerging yet insufficiently explored area of research. Most contributions examine the normative connection between ESD and Inclusive Education, with an emphasis on shared ethical principles such as empowerment and social justice. However, concrete examples and actionable guidance for implementation are largely absent. While only a limited number of studies specifically address the needs of learners with disabilities, those that do underscore the significance of structured learning environments and the professional competencies of educators. The review concludes that a comprehensive approach to inclusion-oriented ESD-integrating pedagogical frameworks, institutional support structures, and an inclusive school culture-is urgently required.

Education for Sustainable Development and Inclusive Education with Particular Consideration of Learners with Special Needs: A Scoping Literature Review

Translation and interpreting training offers a promising context for advancing bilingual proficiency, integrating skills development while bridging second language acquisition and translation studies. This study investigates the development of bilingual oral proficiency over a semester and examines how bilingual profile, learner type, and initial proficiency impact language development. Twentythree bilingual learners-primarily heritage Spanish speakers-completed the ACTFL Oral Proficiency Interviews and background questionnaires before and after one semester of translation and interpreting coursework. Although neither English nor Spanish proficiency significantly improved in heritage or second language learners, students with lower initial proficiency made greater gains, highlighting that initial proficiency influences expected improvements over a semester. These findings underscore the complexity of bilingual development and suggest that translation and interpreting courses can be both a professional end and a means of language development. This approach holds promise for enhancing proficiency among diverse learners, especially those starting at intermediate levels. While the study was conducted at a Hispanic-Serving Institution, its implications extend to other higher education contexts serving bilingual or multilingual student populations.