The recent COVID-19 pandemic has made people acutely aware of the importance of indoor air quality (IAQ) and building ventilation systems, particularly in densely occupied places like offices and schools. As a result, governments and other public entities are increasingly investing in the installation, maintenance, and upgrades of ventilation systems in public buildings. However, little is known about the effect of building ventilation systems on actual IAQ and its impact on occupant behavior. This paper exploits exogenous closing and opening events of schools during the COVID-19 pandemic, combined with policy measures focusing on maximizing ventilation rates inside classrooms, to assess the effectiveness of building ventilation systems in primary schools. We use a unique sensor network implemented before the COVID-19 pandemic, consisting of measurement devices installed in 252 classrooms across 27 Dutch primary schools, continuously monitoring IAQ indicators such as CO levels and fine particle concentrations. Using high-frequency data from 2018 to 2022 school years, we compare the IAQ differences between natural and mechanical ventilation through a fixed-effect identification strategy. Our results show that mechanically ventilated classrooms perform better with respect to CO and fine particle levels. However, the post-COVID-19 ventilation measures implemented after school reopening had stronger effects on naturally ventilated (NV) classrooms, suggesting behavioral changes at the classroom level. We also investigate the longer term effects of these post-COVID-19 ventilation measures and show some evidence of decay in effectiveness, as well as a strong seasonal effect, particularly in NV classrooms, which seems the result of a trade-off between ventilation and thermal comfort.
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http://dx.doi.org/10.1093/pnasnexus/pgad429 | DOI Listing |
Crit Care Explor
January 2025
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Intermediate care (IC) is prevalent nationwide, but little is known about how to best organize this level of care. Using a 99-item cross-sectional survey assessing four domains (hospital and physical IC features, provider and nurse staffing, monitoring, and interventions/services), we describe the organizational heterogeneity of IC within a five-hospital healthcare system. Surveys were completed by nurse managers from 12 (86%) of 14 IC settings.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
Introduction: Positive end-expiratory pressure (PEEP) and prone positioning can improve gas exchange by promoting uniform lung aeration. However, elevated ventilation pressures may increase intracranial pressure (ICP) and disrupt cerebral autoregulation. This study investigated the effects of PEEP on ICP and cerebral autoregulation in a porcine model with healthy lungs and normal ICP, comparing prone and supine positions.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Rehabilitation, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Extubation failure rates are notably high in patients in neurointensive care. Ineffective cough is the variable independently associated with extubation failure, but its quantification remains challenging. Patients with primary central nervous system injury requiring invasive mechanical ventilation were included.
View Article and Find Full Text PDFHosp Pediatr
January 2025
Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Objective: Children with chronic ventilator dependence are a complex and heterogeneous population with unique needs. We sought input from parents, clinicians, and hospital staff to identify opportunities for process improvement during hospitalization and discharge preparation.
Methods: We conducted a qualitative study at a large referral center for children with chronic ventilator dependence.
Introduction: Nasal synchronized intermittent positive pressure ventilation (nSIPPV) is an effective non-invasive ventilation technique, especially for preterm infants. Patient-ventilator synchrony is essential for providing effective respiratory support; however, no automated system is currently available for monitoring this parameter. A new tool for automatic assessment of patient-ventilator synchrony, the SyncNIV system, was developed and applied in this pilot study to evaluate differences between nSIPPV and non-synchronized nasal intermittent positive pressure ventilation (nIPPV) in preterm infants with respiratory distress.
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