Abstract The study examines the development and application of microclimate standards for primary and secondary school classrooms, so as to ensure and promote the healthy growth of primary and secondary school students. The paper systematically reviews relevant domestic and international standards, analyzes the problems and shortcomings arising from their practical application and proposes effective countermeasures, in order to provide robust references aimed at optimizing the classroom environment in primary and secondary schools for student health, as well as offering practical support to advance the construction of a healthy China.

Objective: To evaluate the classroom environmental management and CO 2 volume concentration in primary and secondary schools from Liaoning, Tianjin, and Shanghai, thereby providing a scientific basis for developing targeted strategies to improve classroom air quality. Methods: From December 16 to 26, 2024, by using stratified random cluster sampling method, the questionnaire survey was conducted in 72 primary and secondary schools (24 each of primary, junior high, and regular high schools) across Liaoning, Tianjin and Shanghai. Information on heating, ventilation and other classroom environmental management was collected. Additionally, 108 classrooms were selected for on site microclimate measurements, including temperature, humidity, wind speed and CO 2 volume concentration. Univariate analysis and multiple linear regression models were employed to explore related factors of classroom CO 2 volume concentration. Results: Among the three provinces/municipalities, 20.8% of schools regularly monitored the microclimate. The overall compliance rate for classroom CO 2 volume concentration was 17.6%. Multiple linear regression analysis showed that CO 2 volume concentration in regular and junior high school classrooms were higher than in primary school classrooms ( β=0.067, 0.046, 95%CI =0.036-0.099, 0.013-0.080); classrooms ventilated regularly in the morning and afternoon had higher CO 2 volume concentration than those ventilated during every break between classes ( β=0.043, 95%CI = 0.007- 0.080); both temperature ( β=0.010, 95%CI =0.004-0.016) and humidity ( β=0.003, 95%CI =0.002-0.004) were positively correlated with CO 2 volume concentration (all P <0.05). Conclusions Excessive CO 2 volume concentration in primary and secondary school classrooms is a prominent issue, and ventilation frequency is a key intervenable factor for controlling CO 2 levels. It is recommended to promote ventilation during every break between classes as a core management measure and to emphasize air quality supervision in regular high school classrooms.

Objective: To understand the subjective and objective comfort evaluations of students from different age groups on desks and chairs, so as to provide reference for standardized allocation and use of desks and chairs. Methods: From January to April 2024, a total of 2 446 students were selected from 26 schools in 13 districts (counties/cities) in Shanghai, Tianjin, and Wuxi from Jiangsu Province by using cluster random method, including students in kindergartens, primary schools, junior high schools,senior high schools, colleges and universities. Standardized procedures were used to measure the height and weight of participants, and the matching desks and chairs models were selected according to the height. The subjective comfort of students on matching desks and chairs was investigated, and their objective comfort was evaluated by using a self designed questionnaire. The χ 2 test was used to analyze the differences of subjective perception and objective evaluation in comfort between different types of desks and chairs. Results: About 84.1% of the students subjectively thought that large desks and small chairs were very comfortable or relatively comfortable, followed by large desks and chairs (75.7%), and the proportion of small desks and chairs was the lowest among the three types (46.2%), and the difference was statistically significant ( χ 2=722.46, P <0.01). The reporting rates of primary school, junior high school and senior high school students who subjectively considered large desks and chairs to be very comfortable/relatively comfortable were higher than that of other types of desks and chairs, and the differences were statistically significant ( χ 2=297.49, 252.82, 343.67, P <0.01). However, there was no significant difference in the subjective comfort evaluation of different types of desks and chairs among kindergarten children ( χ 2=3.21, P >0.05), and 66.3% of the students in colleges and universities felt very comfortable/relatively comfortable when they used the matching standard desks and chairs. The objective evaluation results of the comfort for the three types of desks and chairs were consistent with the subjective evaluation, but the proportions of the objective evaluation as very comfortable/relatively comfortable were higher than that of the subjective evaluation ( χ 2=20.76- 813.47, P <0.01). Conclusions Large desks and chairs, as well as large desks with small chairs are perceived comfortable, while small desks and chairs are perceived less comfortable. It is recommended to match the large desks and chairs or large desks and small chairs that are suitable for them according to the "standard", to promote physical and mental health of students.

Objective: To investigate the differences in the comfort of desks and chairs furniture among students with different body types according to the standard, so as to provide a reference for guiding students with overweight and obesity to choose the correct study furniture and revising the standards. Methods: From January to April 2024, 2 443 students from 26 schools in 13 districts (counties/cities) in Shanghai, Tianjin, and Jiangsu Province were selected by the cluster random sampling method to conduct physical examination. The subjective and objective evaluations of the comfort of height matched desks and chairs were investigated. The students were divided into non overweight, overweight, and obesity groups according to relevant criteria, and stratified analysis was performed. The χ 2 test was used to analyze differences in the comfort evaluations of desks and chairs among students with different body types. Results: Among the 2 443 students surveyed, 16.7% and 12.6% were respectively classified as overweight and obese. All students assigned the highest comfort ratings to large desks and small chairs (84.1%), and consistency was observed between students subjective and objective evaluations. The reporting rate of samll desks and chairs of obesity students subjective evaluation was lower (36.8%) than that of overweight and non overweight/obesity students (52.1%, 48.0%) ( χ 2=14.63, P <0.01). The overweight and obese group of primary school students had a worse evaluation of the comfort of large desks and chairs and small desks and chairs than those of the non overweight and obese groups( χ 2=15.78, 7.63, P <0.05). Among high school students, the overweight and obese group had worse evaluation of the comfort of large desks and chairs, as well as large desks and small chairs, than those of the non-overweight and obese groups( χ 2=9.62, 11.77, P <0.05). The objective evaluations revealed low compliance ratings on the posture of the thighs and calves for naturally forming an angle greater than 90° (55.6%), and headroom height under the table (50.3%) with small desks and chairs ( χ 2=94.05, 166.47, P <0.05). Conclusions Compared with non overweight/obese students, students with overweight and obese students report poor comfort evaluations of height matched desks and chairs. Revision of the standard should consider the body types of students, and evaluations of the comfort of desks and chairs furniture by students with overweight and obesity should be improved.

Objective: To understand the home reading-writing levels among children and adolescents in Shanghai after school, and to explore its association with screening myopia, so as to provide a scientific basis for the prevention and control of myopia. Methods: From April to December 2024, 641 primary and middle school students were recruited from 2 urban schools and 1 rural school in Shanghai to participate in the survey. An illuminance meter was used to measure the illuminance of home reading-writing activities after school. Screening myopia was determined through visual acuity examination and refractive detection under non ciliary muscle paralysis conditions among children and adolescents. A binary Logistic regression model was used to analyze the association between home reading-writing illuminance and screening myopia. Results: The detection rate of screening myopia among children and adolescents in Shanghai was 59.9%. The median home reading-writing illuminance after school was 340.9(112.2, 753.5) lx, and 45.4% was found of less than 300 lx. The family illuminance in the primary school stage [432.0 (136.9, 837.0) lx] was higher than that in the junior high school stage [113.1(53.7, 375.1) lx], and main urban area group [503.9 (212.6, 969.5) lx] was higher than that in the rural group [141.6 (53.7, 416.9) lx], the differences were statistically significant (Z=-7.56, -9.95,both P<0.05). The results of Logistic regression analysis showed that compared with the family illuminance of 150-500 lx, children and adolescents with family illuminance<150 and >500 lx had increased risks of screening myopia detection[OR(95%CI)=1.56(1.01-2.42), 1.74(1.15-2.62),both P<0.05]. Conclusions The home reading-writing illuminance after school is suboptimal. Both excessively low and high home reading-writing illuminance levels are associated with screen-detected myopia. It is necessary for children and adolescents to improve lighting conditions during evening reading-writing activities, and strengthen health education according to different regions and school stages.

Objective: To understand the indoor light at night (LAN) exposure intensity during sleep among children and adolescents in Shanghai, so as to provide a basis for exploring potential health risks and formulating effective interventions. Methods: From April to December in 2024, a total of 628 students in grades 4-7 were recruited from three schools in Shanghai. A portable illuminance meter was used to measure LAN for one week, and participants recorded their sleep time. The Kruskal-Wallis H- test was used for comparison between groups, and the error bar chart was used to show the trend and variation range of average LAN exposure intensity in different sleep periods. Results: The indoor LAN exposure intensity of children and adolescents in Shanghai was [2.4(0.8, 5.9)lx] during sleep, and 28.8% of children and adolescents were exposed to indoor LAN≥5 lx. There was no significant differences in indoor LAN exposure intensity between boys [2.4(1.0, 5.9)lx] and girls [2.3(0.7, 5.9)lx] ( Z=-0.86, P > 0.05 ). The indoor LAN exposure intensity of primary school students [2.9(1.1, 6.6)lx] was higher than that of junior high school students [1.0(0.3, 3.1)lx] ( Z =-5.87), and indoor LAN exposure intensity of students in the main urban area [3.2(1.1, 7.8)lx] was higher than that of rural students [1.6(0.5, 4.3)lx] ( Z =-5.23)(both P <0.05). The indoor LAN exposure intensity showed an overall decreasing trend during sleep of children and adolescents ( tau=-0.81, P =0.02), with a slight increase before waking up. Conclusions Indoor LAN exposure intensity among children and adolescents in Shanghai is generally high, especially among primary school students and students living in the main urban area. Health policy and education should be strengthened to reduce the impact of LAN on children and adolescent health.

Organoids,recognized as invaluable models in tumor and stem cell research,assume a pivotal role in the meticulous analysis of diverse datasets pertaining to their growth dynamics,drug screening processes and related phenomena.However,the manual scrutiny and conventional statistical methodologies employed in handling organoid data often grapple with challenges such as diminished precision and efficiency,heightened complexity,escalated human resource requirements,and a degree of subjectivity.Acknowledging the remarkable efficacy of artificial intelligence(AI)in the realms of biology and medicine,the incorporation of AI into organoid research stands poised to enhance the objectivity,precision and expediency of analyses.This integration empowers organoids to more effectively fulfill objectives such as disease modeling,drug screening and precision medicine.Notably,significant strides have been made in AI-driven analyses of organoid image data.The amalgamation of deep learning into image analysis facilitates a more meticulous delineation of the microstructural intricacies and nuanced changes within organoids,achieving a level of accuracy akin to that of experts.This not only elevates the precision of organoid morphology and growth recognition,but also contributes to substantial time and cost savings in research endeavors.Furthermore,the infusion of AI technology has yielded breakthroughs in the processing of organoid omics data,resulting in heightened efficiency in data processing and the identification of latent gene expression patterns.This furnishes novel tools for comprehending cellular development and unraveling the intricate mechanisms underlying various diseases.In addition to image data,AI techniques applied to diverse organoid datasets,encompassing electrical signals and spectra,have realized an unbiased classification of organoid types and states,embarking on a comprehensive journey towards characterizing organoids holistically.In the pivotal domain of drug screening for organoids,AI emerges as a stalwart companion,providing robust support for real-time process monitoring and result prediction.Leveraging high-content microscopy images and sophisticated deep learning models,researchers can dynamically monitor organoid responses to drugs,effecting non-invasive detection of drug impacts and amplifying the precision and efficiency of drug screening processes.Despite the significant strides made by AI in organoid research,challenges persist,encompassing hurdles in data acquisition,constraints in sample quality and quantity,and quandaries associated with model interpretability.Overcoming these challenges necessitates dedicated future research efforts aimed at enhancing data consistency,fortifying model interpretability,and exploring methodologies for the seamless fusion of multimodal data.Such endeavors are poised to usher in a more comprehensive and dependable application of AI in organoid research.In summation,the integration of AI technology introduces unparalleled opportunities to organoid research,resulting in noteworthy advancements.Nevertheless,interdisciplinary research and collaborative efforts remain imperative to navigate challenges and propel the more profound integration of AI into organoid research.The future holds promise for AI to assume an even more prominent role in advancing organoid research toward clinical translation and precision medicine.

Objective: To understand the current status and associated factors of comorbidity of common illnesses among primary and middle school students in Shanghai, so as to provide a reference for improving the pathogenic environment and preventing the occurrence of comorbidity of common illnesses. Methods: From September to November 2021, a stratified cluster sampling method was used to select 30 331 middle school students from 112 schools in 16 districts of Shanghai, each with 2 primary schools, 2 junior high schools, 2 high schools and 1 vocational high school. Elementary school students, their health status and influencing factor questionnaires were analyzed. Results: The detection rate of two or more common diseases such as myopia, overweight and obesity, high blood pressure, and abnormal spinal curvature among primary and secondary school students in Shanghai was 38.91%, of which 29.64% of primary and secondary school students had two diseases at the same time, and 9.19% had three diseases, 0.09% had 4 diseases. The detection rate of comorbidity was higher in boys (44.12%) than in girls (33.40%), and higher in junior high school students (40.40%) than in high school students (38.58%) and primary school students (38.01%). The differences were statistically significant (χ2=366.44, 50.33, P<0.01). Multifactor Logistic regression analysis showed that girls sometimes supervise themselves and often remind themselves that their sitting and standing postures were negatively correlated with the common comorbidities of primary and secondary school students (OR=0.64, 0.93, 0.90); junior middle school students and watching TV/d ≥1 h, using computers for ≥1 h/d, and using mobile electronic devices for >1 h/d were positively correlated with the comorbidity of common diseases among primary and secondary school students (OR=1.07, 1.10, 1.06, 1.10) (P<0.05). Conclusions The prevalence of comorbidity of common illnesses among primary and middle school students in Shanghai is not optimistic, which might be associated with combined effects of various external environmental factors. Targeted intervention should be implemented to effectively prevent the occurrence of comorbidities among students.

Objective: To explore the association of tobacco/alcohol-excessive Internet usage and insufficient sleep with depressive symptoms among middle school students, so as to provide a reference for improving mental health of middle school students. Methods: In accordance with the cluster random sampling method, a total of 18 484 middle school students in Shanghai were surveyed from September to November 2022. Tobacco/alcohol-excessive Internet usage and sleep duration with depressive symptoms were assessed using the relevant scale items included in the questionnaire of Surveillance for Common Disease and Health Risk Factors among Students. The χ 2 test was used for inter group comparison, Logistic regression analysis and likelihood ratio test were used to analyze the independent and aggregated associations of tobacco/alcohol-excessive Internet use and insufficient sleep wiht depressive symptoms. Results: Self reported rates of tobacco/alcohol-excessive Internet usage, insufficient sleep and depressive symptoms among adolescents were 14.7%, 73.5% and 16.3%, respectively. Tobacco/alcohol-excessive Internet usage ( OR=2.69, 95%CI =2.44-2.97) and insufficient sleep ( OR=1.76, 95%CI =1.58-1.95) were associated with depressive symptoms ( P <0.05). Compared to middle school students with no tobacco/alcohol-excessive Internet usage and sufficient sleep, those with both tobacco/alcohol-excessive Internet usage and insufficient sleep showed the higher rate of depressive symptoms ( OR=4.71, 95%CI =4.08-5.44, P <0.05). Further stratified analysis results showed that, compared to the boys and the high school students, the separate and joint association of tobacco/alcohol-excessive Internet usage and insufficient sleep with depressive symptoms were more pronounced in the girls and the middle school students [ OR (95% CI ) for tobacco/alcohol-excessive Internet usage were 3.09 (2.68-3.56) and 4.74 (3.86-5.83), respectively; OR (95% CI ) for insufficient sleep were 1.86 (1.60-2.17) and 2.00 (1.58-2.53), respectively; and the OR (95% CI ) for the joint association were 6.05 (5.01-7.31) and 9.15 (6.98-11.99), respectively, P <0.05]. Conclusions Tobacco/alcohol-excessive Internet usage and insufficient sleep are associated with depressive symptoms in middle school students. Prevention and control strategies for adolescent mental health should be developed with consideration of health related behaviors, and also need to be tailored by focusing on gender and grade differences.

Objective: To understand the prevalence and trend of diet related behaviors among secondary school students in Shanghai, and to provide a scientific basis for developing appropriate health education strategies. Methods: Anonymous questionnaire surveys were conducted among 71 291 students selected by multi stage stratified cluster sampling method from junior high schools,senior high schools and vocational schools in Shanghai in the year of 2008,2012,2015,2017,2019. The questionnaire adopted was "Shanghai adolescent health related behavior questionnaire". Test for trend test were applied for the analysis of the prevalence of their dietary behaviors. Results: The proportion of middle school students nutritional status within the normal range in each survey year were 73.40 %, 72.60%, 68.06%, 68.73%, 67.53%, respectively, while the rate of overweight and obesity increased from 13.17% in 2008 to 23.73% in 2019. The proportion of "eating fried food" decreased significantly by year, from 12.05 % to 4.23% (male, APC=-7.94%, t =-4.33, female, APC= -9.29%, t=-7.71, P <0.05) respectively. And the proportion of "eating dessert" also decreased significantly by year, from 31.66% to 11.14% (male, APC=-8.41%, t =-6.37, female, APC=-8.67%, t=-6.96, P <0.05). In the five surveys, the percentages of healthy diet related behaviors of secondary school students were 12.81%-21.82%, no significant upward trend was observed in the whole( P >0.05). The proportion of diet-related behaviors of nutrition unbalance and easily leading to obesity decreased significantly from 35.47% to 17.00%(APC=-6.71%, t= -5.00 , P <0.05). The proportion of diet related behavior of nutrition unbalance and not easily leading to obesity increased significantly from 39.15% to 60.16%(APC=3.46%, t=6.18, P <0.05). Conclusion Overweight and obesity among secondary school students in Shanghai are increasing during the past decade, and the proportion of healthy dietary behaviors is low. The knowledge of rational diet should be publicized among these students in order to develop healthy dietary behaviors.