PloS One[JOURNAL]
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200 papers
Analysis of strength degradation of coal and rock masses and stability of mined areas under long term immersion environment.
Zuoqi W, Keming H, Ni Z … +2 more , Zhiyong Z, Jiashun L
PLoS One · 2026 · PMID 42391311 · Full text
To address the stability challenges of suspended roof goaf and engineering disasters in coal mine goafs under long-term water immersion, coal rock mass was selected as the research object. Triaxial compression tests unde...
To address the stability challenges of suspended roof goaf and engineering disasters in coal mine goafs under long-term water immersion, coal rock mass was selected as the research object. Triaxial compression tests under seepage-stress coupling were conducted to analyze the strength degradation and permeability evolution of coal rock mass. Based on the bearing characteristics of coal pillars in suspended roof goaf, a critical criterion for instability of room pillar suspended roof goaf was established, then the numerical simulation studies were conducted using UDEC 7.0 to investigate the influence of different mining parameters and occurrence conditions on the stability of goaf. The research results show that: (1) When the seepage pressure is constant, as the confining pressure increases, the peak stress of the coal samples increases gradually, while the permeability coefficient gradually decreases; when the confining pressure is constant, as the seepage pressure increases, the peak stress gradually decreases, while the permeability coefficient increases gradually. (2) When the stability safety factor of the coal pillar is lower than 1.5, the coal pillar will not be able to maintain long-term stability and corresponding reinforcement measures need to be taken. (3) The increase of occurrence depth will lead to the increase of coal pillar deformation, but as long as the ratio of mining and remaining is moderate, the coal pillar can support the overlying strata and maintain stability; (4) The increase in ratio of mining and remaining strengthens the supporting effect of coal pillars, which helps to improve the stability of the roof, reduce the subsidence of the rock strata above the goaf, and lower the risk of roof collapse. The research results can provide technical references for the prevention and control of hanging roof disasters in mines with similar coal mining processes.
Biogenic Silver-Selenium nanocomposite with anticancer activity and potent efficacy against vancomycin-resistant Staphylococcus aureus.
Aloufi AS, Abdulrahman MS, Hashem AH … +6 more , Saied E, Abdel Tawab A, Alsenani F, Alharbi A, Alzarea SI, Elkady FM
PLoS One · 2026 · PMID 42391307 · Full text
The rapid emergence of multi-drug resistant (MDR) pathogenic bacteria as well as the continued burden of malignant diseases requires the safe development of novel and multifunctional therapeutic agents. The WHO designate...
The rapid emergence of multi-drug resistant (MDR) pathogenic bacteria as well as the continued burden of malignant diseases requires the safe development of novel and multifunctional therapeutic agents. The WHO designated vancomycin-resistant Staphylococcus aureus (VRSA) as "high priority" AMR pathogen. Thus, this study aimed to ecofriendly synthesis of silver-selenium nanocomposite (Ag-Se NC) and evaluate its in vitro anticancer effect and inhibitory activity against VRSA clinical isolates. Biogenic Ag-Se NC was successfully synthesized using the aqueous peel extract of Cucumis melo (C. melo) through an eco-friendly green synthesis approach. Following visual color transformation of the preparation mixture, nanocomposite formation was validated based on comprehensive physicochemical characterization using different spectroscopic analyses. The greenly synthesized Ag-Se NC revealed the Ag and Se specific surface plasmon resonance (SPR) peaks, high crystallinity, and predominantly spherical morphology with an average particle size of ~35 nm. Biological evaluations revealed that Ag-Se NC possesses selective cytotoxicity, displaying low toxicity toward WI-38 normal lung fibroblasts (IC₅₀ = 203.4 µg/mL) while exerting a potent, concentration-reliant inhibitory effect towards malignant cell lines, including hepatocellular carcinoma (Hep-G2) and breast adenocarcinoma (MCF-7) with IC50 90.97 and 38.18 μg/mL respectively. Furthermore, the Ag-Se NC demonstrated appreciated antibacterial activity, in comparison with the linezolid standard antimicrobial agent, against 11 VRSA clinical isolates, with MIC values ranging from 64 to 512 µg/mL and a mean MIC of 203.64 µg/mL. The marked NC bactericidal effects were indicated by their minimum inhibitory concentration index (MICi) values of 1-4, rapid time-kill kinetics, and significant membrane disruption evidenced by the protein leakage assay. The obtained NC also exhibited a respected inhibitory effect against VRSA biofilm development, in the range of 34.68 ± 2.4-72.89 ± 1.87%, as well as a strain-dependent partial eradication effect on the fully formed bacterial biofilm, ranging from 16.81 ± 0.96 to 42.59 ± 0.78%. Notably, variable interactions were observed when Ag-Se NC was combined with vancomycin against VRSA isolates; one isolate showed synergistic interaction with fractional inhibitory concentration index (FICi) = 0.5 and three isolates exhibited additive effects (FICi ranged from 0.5 to 1). In conclusion, these findings highlight Ag-Se NC as a promising green-synthesized nanoplatform with combined anticancer and bacterial inhibitory effects in both planktonic and biofilm growth forms and antimicrobial-potentiating activities.
Preparation and physicochemical characterization of a biodegradable chitosan/carboxymethyl cellulose hydrogel synthesized in NaOH/urea medium.
Morales J, Vásquez A, Orellana Catalán IP
PLoS One · 2026 · PMID 42391306 · Full text
The use of super absorbent polymers in agriculture for water and fertilizers retention in soils has become popular with the increasing need for resource optimization. The objective of the present study was to use chitosa...
The use of super absorbent polymers in agriculture for water and fertilizers retention in soils has become popular with the increasing need for resource optimization. The objective of the present study was to use chitosan extracted from shrimp shell waste and reagent grade carboxymethylcellulose to synthesize a biodegradable super absorbent polymer with potential use for soil amendment in agriculture. The super absorbent polymer was synthesized using epichlorohydrin as a crosslinking agent in an alkaline NaOH/urea medium. The structure of the product was confirmed by FTIR and TGA. The polymer was found to be biodegradable with a progressive weight loss percentage reaching 79.1% after 14 days. An adsorption ratio of 15.8 and 17.2 was obtained for water and 22% w/v urea solution, respectively, so the product was categorized as super absorbent in both conditions. In addition, after two hours in the medium, absorption percentages of 48.3% were recorded for water and 22% w/v for urea solution. The reported method is effective for synthesizing a biodegradable super absorbent polymer with potential use for soil amendment and susceptibility to pH changes for both adsorption equilibrium and over time adsorption.
Action-guilt, survivor-guilt, and depression in combat-related PTSD.
Esquillo MA, Kumar R, Morris EE … +5 more , Bass C, Turner M, Tillman G, Hart J, Motes MA
PLoS One · 2026 · PMID 42391305 · Full text
Identifying the role of guilt in post-traumatic stress disorder (PTSD) has important implications for understanding the development and treatment of PTSD. The present study is a secondary analysis of data collected on ve...
Identifying the role of guilt in post-traumatic stress disorder (PTSD) has important implications for understanding the development and treatment of PTSD. The present study is a secondary analysis of data collected on veterans with combat-related PTSD (N = 61) who enrolled in a clinical trial. Hierarchical regression analyses were used to explore associations between action- and survivor-guilt on the Clinician Administered PTSD Scale (CAPS), PTSD symptom severity on the CAPS, and depression on the Quick Inventory of Depressive Symptomatology (QIDS). Action- and survivor-guilt independently predicted PTSD total symptom severity, but in examining PTSD symptom cluster severity, only action-guilt independently predicted avoidance and numbing severity in PTSD. However, depression symptom severity on QIDS also mediated the association between action-guilt and PTSD total symptom severity and avoidance and numbing severity. Thus, action- and survivor-guilt appear to have independent contributions to PTSD symptom severity, and action-guilt, more specifically, appears to affect avoidance and numbing severity in PTSD through depression. The findings are discussed in terms of the potential role of guilt in PTSD and in relation to previous research on guilt and depression in PTSD and PTSD treatment.
Explainable machine learning for predicting activities of daily living at discharge in stroke patients: A retrospective study using SHAP interpretability.
Ye Q, Fang G, Li L … +3 more , Li Q, Yang Y, Liu L
PLoS One · 2026 · PMID 42391297 · Full text
PURPOSE: We aimed to develop a machine learning model to predict activities of daily living (ADL) at discharge in stroke patients and identify key predictors to guide rehabilitation decisions. MATERIALS AND METHODS: Data...
PURPOSE: We aimed to develop a machine learning model to predict activities of daily living (ADL) at discharge in stroke patients and identify key predictors to guide rehabilitation decisions. MATERIALS AND METHODS: Data of 589 stroke inpatients (2019-2024) were split into good (BI ≥ 60) and poor (BI < 60) ADL groups. Continuous variables were processed using Z-score normalization, followed by preliminary univariate regression screening (P < 0.05) and final feature selection via LASSO regression (lambda.1se = 0.0488). The screened features were used to train and validate ten machine learning algorithms; 30% of the dataset (n = 177) was allocated as an independent test set for model evaluation, and SHAP analysis was performed to interpret the optimal model. RESULTS: Six of 41 features were retained. Random forest achieved the best performance (AUC = 0.958; accuracy = 0.936; sensitivity = 0.934; specificity = 0.950). SHAP identified the top drivers: admission Barthel Index, standing balance, Brunnstrom stages (upper and lower limb), dressing, and grooming abilities. CONCLUSION: The ADL risk prediction model constructed using machine learning, particularly the random forest model, shows excellent predictive performance and clinical interpretability, making it valuable for individualized risk assessment of daily living skills in stroke patients at discharge.
Deep learning based two-way feature depiction model for brain tumor detection.
Urooj S, Napte K, Alsubaie N
PLoS One · 2026 · PMID 42391295 · Full text
Brain tumors are one of the most fatal disorders that cause one of the highest mortalities in the world. Gliomas are the most common primary brain tumors originating from glial cells in the central nervous system. Tradit...
Brain tumors are one of the most fatal disorders that cause one of the highest mortalities in the world. Gliomas are the most common primary brain tumors originating from glial cells in the central nervous system. Traditionally, a tissue sample is extracted and examined for its genetic and characteristic properties. This method is invasive, painful, and takes a longer period to produce results. Various automatic Deep learning (DL) based schemes have been presented for the brain glioma detection, but they lack due to poor explainability, lower generalization, poor feature depiction, class imbalance problem and lower detection rate. This paper presents a deep learning based brain tumor detection using two way feature depiction model (TWFDM) that combines the 2D-Deep Convolution Neural Network (DCNN) and 1D-DCNN. The 2D-DCNN accepts the raw MRI images and the 1D-DCNN accepts the handcrafted local binary pattern (LBP), gray level cooccurrence matrix (GLCM), and Histogram of Oriented Gradient (HOG) features. Furthermore, improved particle swarm optimization (IPSO) is used for feature selection to minimize the computational complexity of the TWFDM system. The proposed TWFDM achieves an overall accuracy of 96.25%, a recall of 96.34%, a precision of 96.31%, and an F1-score of 96.32% on the Brain MRI dataset for four-class classification, representing an important improvement over traditional techniques.
Morpho-biochemical diversity and phytochemical profiling of Rubus fruticosus L. landraces.
Owais M, Khan I, Nisar M … +7 more , Khan A, Ihsan M, Nazir N, Ali F, Zahoor M, Khan S, Lee SY
PLoS One · 2026 · PMID 42391292 · Full text
The flora of Khyber Pakhtunkhwa, Pakistan, is severely threatened by illegal harvesting of non-timber forest resources, resulting in the genetic loss of native plant species, including Rubus fruticosus L., a genetically...
The flora of Khyber Pakhtunkhwa, Pakistan, is severely threatened by illegal harvesting of non-timber forest resources, resulting in the genetic loss of native plant species, including Rubus fruticosus L., a genetically diverse shrub of considerable economic and medicinal importance. The present study was designed to assess the morphological diversity, seed protein profiles, and phytochemical composition of fifteen landraces of R. fruticosus collected from different ecological zones of the Malakand Division, Khyber Pakhtunkhwa, Pakistan. Morphological characteristics were evaluated using the International Board for Plant Genetic Resources (IBPGR) descriptors, incorporating both qualitative and quantitative traits in a randomized complete block design. Seed protein diversity was assessed through sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), while phytochemical composition was quantified using high-performance liquid chromatography with ultraviolet detection (HPLC-UV). Morphological traits exhibited significant variability, with a mean coefficient of variation (CV) of 36.72%. The most variable traits were single fruit weight (CV = 73.16%), five-fruit weight (CV = 64.38%), number of branches per plant (CV = 33.33%), plant height (CV = 31.31%), and stalk length (CV = 30.11%). Principal component analysis (PCA) explained 89.71% of the total variation, with plant height, leaflet number, and fruit weight contributing predominantly to landrace differentiation. SDS-PAGE analysis of seed proteins revealed 21 polymorphic bands (molecular weight range: 14.4-97.4 kDa), with high diversity indices recorded for markers B-03, B-06, B-08, B-12, and B-21 (Shannon diversity index H' = 1.10-1.39; CV = 35.36-93.54%). HPLC-UV analysis identified twelve phenolic compounds in selected genotypes, including quercetin (5.12-8.74 µg/mL), morin (3.45-6.89 µg/mL), and epigallocatechin gallate (2.88-7.23 µg/mL). The morphological, biochemical, and phytochemical diversity observed among R. fruticosus landraces highlights their potential for conservation programs and future breeding initiatives.
The effect of auditors' digital literacy on reduced audit quality behavior: A chain mediation model and the moderating role of prosocial behavior.
Yang M, Guo L, Ren G … +2 more , Wang Q, Liu Y
PLoS One · 2026 · PMID 42391288 · Full text
Reduced audit quality behavior is prevalent in audit practice and poses a serious threat to overall audit quality. With the increasing adoption of digital auditing, auditors' digital literacy has become essential not onl...
Reduced audit quality behavior is prevalent in audit practice and poses a serious threat to overall audit quality. With the increasing adoption of digital auditing, auditors' digital literacy has become essential not only for adapting to the modern audit environment but also for improving audit quality and curbing inappropriate audit practices. This study examines the effect of auditors' digital literacy on reduced audit quality behavior by introducing digital self-efficacy and task performance as mediating variables and constructing a chain mediation model, while also exploring the moderating role of prosocial behavior. Empirical analysis based on 480 valid questionnaires revealed that digital literacy negatively influences reduced audit quality behavior. Digital self-efficacy and task performance partially mediate this relationship. Additionally, digital self-efficacy positively enhances task performance, resulting in a chain mediating effect. Prosocial behavior moderates these relationships, significantly affecting the mediating roles of digital self-efficacy and task performance. Accordingly, fostering a digitally enabled audit environment that enhances auditors' analytical efficiency, judgment accuracy, and procedural compliance requires auditors to effectively leverage digital technologies to mitigate audit quality-threatening behavior.
A pilot randomized trial on the usability and acceptability of an app (MyIBDDiet) to improve the self-management of anti-inflammatory diet for individuals with inflammatory bowel disease: A protocol paper.
Kaur R, van Diepen K, Raiesdana S … +10 more , Chappell KD, Ajibulu L, Gozdzik M, Halloran B, Hoentjen F, Kroeker KI, Peerani F, Prado CM, Kao D, Wong K
PLoS One · 2026 · PMID 42391282 · Full text
UNLABELLED: The role of diet in the management of inflammatory bowel disease (IBD) is increasingly recognized with recent guidelines providing specific dietary recommendations. Although mobile health apps targeting diet...
UNLABELLED: The role of diet in the management of inflammatory bowel disease (IBD) is increasingly recognized with recent guidelines providing specific dietary recommendations. Although mobile health apps targeting diet and lifestyle habits in IBD are emerging, few are designed for self-management or have been formally evaluated for effectiveness. We have co-designed a diet guidance and tracking app (MyIBDDiet) with and for patients with IBD with the aim of improving overall diet profile. We will be conducting a 60-day single-centre pilot randomized trial of 40 IBD patients randomized in 1:1 ratio to MyIBDDiet app or usual care. Participants in the usual care group will crossover to the MyIBDDiet app group after 30 days. Primary outcome is usability assessed using a mixed method quantitative [Theoretical Framework of Acceptability (TFA), mHealth App Usability Questionnaire (MAUQ)], and qualitative approach (semi-structured interviews). Secondary outcomes include clinical efficacy evaluated by change in diet quality [Mini-EAT questionnaire, Automated Self-administered 24-Hour Dietary Assessment Tool (ASA-24), Healthy Eating Index (HEI), Mediterranean Diet Serving Score (MDSS)], changes in biomarkers of processed food intake (spot urine sodium and chloride), changes in IBD disease activity [Patient Reported Outcome (PRO2 and PRO3), C-reactive protein, fecal calprotectin], changes in quality of life [EuroQol-5 Dimension (EQ-5D), Short Inflammatory Bowel Disease Questionnaire (SIBDQ)] and safety. Exploratory outcomes include changes in fecal microbiome and serum and fecal metabolome. Additional quantitative data will be collected from the digital analytics of MyIBDDiet app. The pilot data generated will inform the design of an adequately powered randomized trial and future mobile app development and evaluation by providing a framework for evaluation of clinical effectiveness. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06683105. Registered on 8 November 2024.
Protocol for the SACLA trial: Efficacy and safety of subretinal monteplase for submacular hemorrhage in a phase II single-arm multicenter decentralized clinical trial.
Yoshida N, Kobayakawa Y, Funakoshi K … +22 more , Kimura S, Hosoya K, Shinkawa Y, Furukawa T, Mitsutake T, Hoshiko T, Takamori A, Kawahara N, Terasaki H, Oishi A, Koizumi H, Inoue T, Takeda A, Ikeda Y, Yoshida S, Morizane Y, Kadonosono K, Inoue M, Kamei M, Todaka K, Sonoda KH, Enaida H
PLoS One · 2026 · PMID 42391281 · Full text
Submacular hemorrhage (SMH), which may arise from age-related macular degeneration, retinal arterial macroaneurysm, and other causes, can result in severe vision loss and central visual field impairment. Although tissue...
Submacular hemorrhage (SMH), which may arise from age-related macular degeneration, retinal arterial macroaneurysm, and other causes, can result in severe vision loss and central visual field impairment. Although tissue plasminogen activator (tPA) is used off-label to treat SMH in many countries, no formulation has been approved for this indication. Because early intervention is critical when tPA is used for SMH, limited access to centers that can provide this treatment may delay care and reduce treatment opportunities. Decentralized clinical trials (DCTs) reduce or eliminate the need for participants to travel to trial sites. We therefore designed the investigator-initiated SACLA trial to evaluate subretinal tPA for SMH. The DCT framework is intended to reduce logistical barriers related to the disease severity and rarity. The SACLA trial is a phase II multicenter, open-label, single-arm surgical study with a pre-post comparison design (jRCT2071250003). Twenty eligible participants will undergo pars plana vitrectomy followed by subretinal injection of 0.1 mL (8,000 IU) of tPA. Participants will remain hospitalized at the trial site until the primary outcome, change in central foveal thickness (CFT) from baseline at Week 1, is assessed. Thereafter, follow-up visits will be conducted at either the trial site or partner sites within the DCT framework. Secondary efficacy outcomes include change in CFT from baseline, presence of a foveal hemorrhage measuring at least 1 disc diameter, best-corrected visual acuity (BCVA), and change in BCVA from baseline at Weeks 4 and 12. Adverse events will be collected throughout the 12-week observation period to assess safety. The protocol and related study documents were reviewed and approved by the Saga University Hospital Institutional Review Board. This study is designed to generate prospective evidence on the feasibility, short-term anatomical response, and safety of subretinal tPA for SMH.
COMBINA: The EAAD four-level approach for depression and suicide prevention and wellbeing promotion in the community and vulnerable populations. A cross-country study protocol from the MENTBEST project.
Hogg B, Coppens E, Gatto DL … +26 more , de Córdoba-Gil C, Ayuso Mateos JL, Bakiu K, Callanan A, Pashoja AC, Conceição V, Dandi E, Faurholt-Jepsen M, Katsoridou C, Khan A, Luyten J, McGreevy KR, Mere R, O'Shea D, Papaioannou G, Qirjako G, Reich H, Värnik P, Värnik A, Vivas AB, Arensman E, Van Audenhove C, Gusmão R, Amann BL, Schnitzspahn K, Hegerl U
PLoS One · 2026 · PMID 42391280 · Full text
Depression and suicide are leading public health problems requiring complex multilevel interventions. This study protocol details the COMBINA trial, which expands the evidence-based European Alliance Against Depression (...
Depression and suicide are leading public health problems requiring complex multilevel interventions. This study protocol details the COMBINA trial, which expands the evidence-based European Alliance Against Depression (EAAD) Community-Based 4-level intervention to also focus on improving wellbeing and tailored to five groups with increased vulnerability to depression: young people, older people, migrants/refugees, the long-term unemployed, and people with an existing mental health condition. In this prospective, non-randomised controlled trial, the COMBINA project will be newly implemented during a 24-month period, from late 2024 to late 2026, in five regions in Albania, Estonia, Greece, Ireland, and Spain. These regions will be compared to five control regions in the same countries, chosen to reflect a similar context, size, and sociodemographic characteristics. Main outcomes are a comparison between the intervention and control regions in the rates of deaths by suicide and hospitalisations for suicide attempts and the levels of wellbeing, depressive symptoms, anxiety symptoms, depression-related stigma, and willingness to seek psychological help in the general population. A process evaluation and economic evaluation will also be conducted. This intervention protocol also details the steps taken to promote successful implementation across a range of different cultural and regional contexts, with challenges including different existing mental health resources and differing capacities for the population to use digital tools. The COMBINA project includes co-creation, whereby materials and implementation strategy were designed with people from the vulnerable groups. The trial is funded by the European Union (grant agreement no. 101080651 and carried out according to the Declaration of Helsinki. Ethical approval has been obtained in all participating countries. The results will be published in peer-reviewed academic journals, presented at scientific meetings and disseminated through COMBINA stakeholders, with participation from the co-creators. This trial protocol (version 1.1, 24/10/2024) was registered in the ISRCTN registry (ISRCTN10521127) on 14/11/2025 (https://www.isrctn.com/ISRCTN10521127).
Optimising Cold Spray Additive Manufacturing: Pressure-driven enhancement of mechanical performance in copper deposits.
Camilleri S, Tran TTT, Nomoto K … +5 more , Duguid A, Harbidge M, Rashid R, Krishnan K, Elumalai NK
PLoS One · 2026 · PMID 42391279 · Full text
Cold spray additive manufacturing (CSAM) is a solid-state process capable of producing dense metallic components without melting, making it highly attractive for copper applications requiring both electrical conductivity...
Cold spray additive manufacturing (CSAM) is a solid-state process capable of producing dense metallic components without melting, making it highly attractive for copper applications requiring both electrical conductivity and mechanical integrity. In this study, the influence of spray pressure at 30 bar, 40 bar, 50 bar and 60 bar on particle velocity, microstructure, and properties of cold-sprayed copper was systematically investigated using a LightSPEE3D system. The cold spray deposits were characterised by X-ray diffraction (XRD), hardness testing, eddy current conductivity, tensile evaluation, and scanning electron microscopy (SEM). The results reveal that increasing spray pressure enhances particle velocities beyond the critical threshold for copper, leading to improved inter-particle bonding and microstructural refinement consistent with severe plastic deformation and possible continuous dynamic recrystallisation (cDRX)-assisted mechanisms. XRD analysis suggested progressive crystallite refinement and increased dislocation density with pressure, which directly correlated with improved ductility. While hardness decreased due to recovery and recrystallisation, electrical conductivity increased, likely due to improved inter-particle continuity and reduced interfacial discontinuities. Tensile testing showed a clear strength-ductility transition, with deposits at higher pressures exhibiting substantially improved ductility approaching bulk copper behaviour and fully ductile fracture morphologies. Overall, the findings identify an optimum processing window at higher spray pressures, where copper cold spray deposits achieve a balanced combination of conductivity, ductility, and strength. This study highlights the critical role of spray pressure in controlling the interplay between particle velocity, dynamic recrystallisation, and multifunctional performance in CSAM copper components. This study establishes a process-structure-property relationship linking particle velocity, XRD-derived microstructural evolution, conductivity, and tensile behaviour within a LightSPEE3D CSAM system.
Fascia iliaca compartment block for surgical analgesia in children with osteogenesis imperfecta: A retrospective cohort study.
Xie Y, Zhang L, Yuan Q … +2 more , Jiang X, Wang Q
PLoS One · 2026 · PMID 42391278 · Full text
BACKGROUND: Osteogenesis imperfecta (OI) is a rare genetic bone disorder. Children with OI have a higher risk of intraoperative pain. The fascia iliaca compartment block (FICB) can reduce pain, improve intraoperative hem...
BACKGROUND: Osteogenesis imperfecta (OI) is a rare genetic bone disorder. Children with OI have a higher risk of intraoperative pain. The fascia iliaca compartment block (FICB) can reduce pain, improve intraoperative hemodynamic stability, and facilitate postoperative recovery. This study explores the feasibility and potential role of FICB in multimodal analgesia by describing its application experience in children with OI. METHOD: This study involved children with OI who underwent surgery for femoral shaft fractures. The FICB group received ultrasound-guided FICB combined with general anesthesia, whereas the control group received general anesthesia alone. Hemodynamic parameters, serum inflammatory markers, intraoperative opioid consumption, recovery time, postoperative pain scores, and the incidence of postoperative nausea and vomiting (PONV) were recorded. RESULTS: A total of 126 children were enrolled. A significant time × group interaction was observed for changes in MAP and HR during surgery (F3,372 = 21.86 and F3,372 = 16.34, both P < 0.001). At all intraoperative time points, MAP and HR were lower in the FICB group than in the Control group (all P < 0.001). A significant time × group interaction was found for postoperative VAS scores (F2,248 = 3.18, P = 0.04); and they were lower in the FICB group at 2, 4, and 12 hours postoperatively (all P < 0.001). CRP levels also showed a significant time × group interaction (F1,124 = 290.3, P < 0.001); both groups exhibited elevated postoperative CRP versus baseline (P < 0.001), but the FICB group had lower levels. The FICB group had a shorter recovery time (P < 0.001), lower intraoperative fentanyl and remifentanil use (both P < 0.001), and a lower incidence of PONV (P = 0.026) compared to the Control group. CONCLUSION: In pediatric patients with OI undergoing femoral shaft fracture surgery, ultrasound-guided FICB has the potential to enhance intraoperative hemodynamic stability, alleviate postoperative pain, and decrease the incidence of adverse reactions, thereby facilitating the implementation of optimized multimodal analgesia.
Comparative effects of bioelectric and manual toothbrushing on acrylic denture teeth: Surface integrity and wear analysis.
Pimenta LA, Nowik CN, Zeinali S … +1 more , Kim YW
PLoS One · 2026 · PMID 42391277 · Full text
Bioelectric toothbrushes deliver a low-level microcurrent intended to disrupt biofilm with reduced mechanical force, yet their effects on denture-tooth wear remain unclear. This in vitro study compared surface roughness...
Bioelectric toothbrushes deliver a low-level microcurrent intended to disrupt biofilm with reduced mechanical force, yet their effects on denture-tooth wear remain unclear. This in vitro study compared surface roughness and material loss of acrylic denture teeth brushed with a bioelectric toothbrush versus a soft-bristle manual toothbrush. Thirty-six heat-cured polymethylmethacrylate (PMMA) maxillary central incisors were randomly allocated to three groups (n = 12): manual brushing, bioelectric brushing without current ("OFF"), and bioelectric brushing with current ("ON"). Specimens underwent 20,000 brushing strokes (≈2 years of home cleaning) under a 200 g load using a brushing simulator in a 1:1 dentifrice/water slurry. Surface roughness (Ra, µm) and specimen weight (g) were recorded before and after brushing, and surface topography was qualitatively assessed by digital microscopy. Baseline roughness did not differ among groups (p > 0.05). After brushing, Ra increased significantly in the manual group (1.538 ± 0.219 to 2.233 ± 0.370 µm) and the bioelectric-OFF group (1.481 ± 0.199 to 2.157 ± 0.403 µm), whereas the bioelectric-ON group showed a smaller, non-significant change (1.547 ± 0.252 to 1.838 ± 0.197 µm); the bioelectric-ON condition resulted in significantly lower final roughness than the other groups (p < 0.05). No significant weight loss was detected in any group (p = 0.71). Microscopy corroborated profilometry, showing fewer and shallower scratches on specimens brushed with the bioelectric toothbrush in the ON mode. Within the limitations of this in vitro model, bioelectric activation was associated with reduced surface roughening of PMMA denture teeth without measurable material loss; however, clinical studies are needed to confirm its relevance under real-world oral conditions.
"Shining a light on chronic pain": A qualitative study of stakeholder views towards chronic pain at work and the Pain-at-Work Toolkit.
Thornton AC, Wainwright E, Chaplin WJ … +7 more , Abbott-Fleming V, McWilliams DF, Walsh DA, Taylor G, McNamee P, Walker-Bone K, Blake H
PLoS One · 2026 · PMID 42391275 · Full text
PURPOSE: The study explored the views of organisational stakeholders who participated in the feasibility trial of the Pain-at-Work Toolkit towards the implementation of the toolkit in 'real-world' workplace settings. Thi...
PURPOSE: The study explored the views of organisational stakeholders who participated in the feasibility trial of the Pain-at-Work Toolkit towards the implementation of the toolkit in 'real-world' workplace settings. This digital toolkit was co-created with healthcare professionals, employers, and people with chronic pain and aimed to inform and enable individuals to self-manage their chronic pain at work. DESIGN/METHODOLOGY/APPROACH: A qualitative study using semi-structured interviews with 15 stakeholders from 12 organisations that participated in a feasibility trial of the Pain-at-Work Toolkit. Purposive sampling was used to ensure the inclusion of stakeholders with management or supportive roles who have responsibility for the health and wellbeing of employees. FINDINGS: The findings illuminate three key themes: not all disabilities are visible; not all line managers are equal; and who has control? These surmise that invisible disabilities such as chronic pain are underestimated, poorly understood, and inconsistently provisioned for in organisational policies. It highlights the key role that line managers play in employee disclosure and access to support but demonstrates that line managers vary in their delivery of support to employees. Lastly, it explores stakeholder perceptions of the roles of the employer relative to the employee with chronic pain. It confirms the need for additional resources to plug organisational gaps and give workers tools to self-manage their pain at work. ORIGINALITY: This study indicates the need for resources / supports to upskill line managers so they can intervene to proactively support employees with chronic pain to reduce sickness absence and presenteeism (working when unwell). The research demonstrates organisational stakeholders' interest in a multi-faceted approach to help employees self-manage chronic pain in all types at work, such as that provided by the Pain-at-Work Toolkit. In addition, it clearly identifies the potential for complementary resources to educate and facilitate line managers to better support their staff.
Navigating ethical waters: The impact of ethical judgment, norms, and CSR skepticism on CSR engagement and purchasing intention in a breast cancer campaign.
Cheng Y, Jiang YN, Zhang Q
PLoS One · 2026 · PMID 42391266 · Full text
Corporate social responsibility (CSR) campaigns play a crucial role in shaping consumer perceptions and behavior. This study examines Delta Air Lines' CSR campaign centered on breast cancer awareness, focusing on how eth...
Corporate social responsibility (CSR) campaigns play a crucial role in shaping consumer perceptions and behavior. This study examines Delta Air Lines' CSR campaign centered on breast cancer awareness, focusing on how ethical judgment and subjective norms are associated with CSR skepticism and how such skepticism, in turn, relates to CSR engagement and ethical purchasing intention. Drawing on the theory of reasoned action (TRA), a quantitative survey was conducted with 787 Delta Air Lines customers, all of whom provided informed consent prior to participation. The data, analyzed between August 1-7, 2024 using structural equation modeling, show that ethical judgment and subjective norms are associated with lower levels of CSR skepticism. In turn, CSR skepticism is negatively related to both CSR engagement and ethical purchasing intention, while higher levels of CSR engagement are associated with greater ethical purchasing intention. These findings provide insight into the role of ethical and social factors in shaping consumer responses to CSR initiatives and highlight the importance of fostering engagement to enhance the effectiveness of CSR campaigns and promote favorable consumer outcomes.
Incidence of Dengue Fever in Pakistan.
Nasim Z, Reiner RC, Sheikh S … +23 more , Khan NS, Ali M, Tejani I, Mehmood MT, Hassan J, Aziz K, Farooqi J, Ghanchi N, Khan E, Ali R, Chauhadry IA, Raza A, Hassan S, Sultan F, Chughtai O, Batool H, Rehman A, Khan MA, Ostroff S, Mokdad AH, Nasir N, Samad Z, Usmani BA
PLoS One · 2026 · PMID 42391264 · Full text
INTRODUCTION: Dengue is a growing health threat in Pakistan due to climate, urbanization, and inadequate sanitation. Despite recurrent seasonal outbreaks, comprehensive evidence on the dengue burden in Pakistan remains l...
INTRODUCTION: Dengue is a growing health threat in Pakistan due to climate, urbanization, and inadequate sanitation. Despite recurrent seasonal outbreaks, comprehensive evidence on the dengue burden in Pakistan remains limited due to due to underreporting, incomplete data capture, and inconsistencies in diagnostic practices. METHODS: We analyzed laboratory-confirmed dengue cases from January 2012 to December 2022 to estimate incidence rates per 1,000 individuals across Pakistan at the subnational level including all 4 provinces, 86 districts, and a federal territory, stratified by 5 distinct age groups (below 5 years, 5-14 years, 15-49 years, 50-69 years, and 70 + years) and sex. The population estimates were adjusted to account for variations in treatment-seeking behavior and the utilization of partnering laboratories to ensure that the estimated incidence rates accurately represent the broader population. RESULTS: The incidence rate of dengue in Pakistan exhibited an increasing trend. Across all age groups, the 15-49 years age group had the highest incidence rates, with 56 cases per 1,000 individuals in 2022 (estimated 1.6 million cases). Sex analysis showed a higher proportion of dengue cases in males compared to females, consistent across all age groups. Spatial analysis revealed regional disparities, with higher incidence rates reported from Sindh compared to other provinces. In 2022, Sindh had the highest incidence rate of 45.63 (95% UI: 34.13-60.68) per 1000 individuals (2.63 million estimated cases), while Baluchistan had the lowest incidence rates of 0.44 (95% UI: 0.08-4.48) per 1,000 individuals (6,785 estimated cases). All age groups experienced increasing incidence, with the 15-49 age group showing the most pronounced rise. CONCLUSION: The findings underscore the growing burden of dengue in Pakistan, highlighting the urgent need for effective public health interventions and enhanced data collection mechanisms to better understand and address this rising public health concern.
Muscle strength characteristics and the predictive value of handgrip strength in young obese males: A multi‑joint isokinetic and LASSO regression analysis.
Yang S, Li J, Chen S … +2 more , Zhang X, Zeng J
PLoS One · 2026 · PMID 42391262 · Full text
Obesity is a primary global public health concern, often associated with impaired muscle function and an increased risk of exercise-related injuries. This cross-sectional study aimed to elucidate the associations among m...
Obesity is a primary global public health concern, often associated with impaired muscle function and an increased risk of exercise-related injuries. This cross-sectional study aimed to elucidate the associations among muscular strength, body load, and functional capacity in young adults with obesity. A total of 75 male university students were recruited, including a normal-weight group (n = 47, BMI 18.5-24.99) and an obese group (n = 28, BMI ≥ 30). Assessments included handgrip strength, one-repetition maximum (1RM) for squat, deadlift, and bench press, as well as isokinetic strength evaluations across four major joints (shoulder, elbow, hip, and knee), yielding 32 strength-related variables. After normalizing all strength measures to body weight, the obese group demonstrated significantly lower relative strength across all parameters compared to the normal-weight group (P < 0.001), indicating a distinct "strength-to-load imbalance." To identify key predictors of handgrip strength while addressing potential overfitting, we employed least absolute shrinkage and selection operator (LASSO) regression with cross-validation. The final model retained five predictors: elbow flexion maximum work at 180°/s (EF180°Wmax), elbow flexion peak torque at 180°/s (EF180°Fmax), elbow extension peak torque at 60°/s (EE60°Fmax), shoulder flexion peak torque at 60°/s (SF60°Fmax), and group (obese vs. normal), together explaining 63.3% of the variance in handgrip strength (adjusted R² = 0.606), although this finding should be interpreted with caution due to the sample size and requires validation in larger cohorts. Notably, group membership remained a significant independent predictor (β = -0.23, P = 0.014), underscoring the persistent deficit in relative strength associated with obesity even after accounting for joint-specific strength. By incorporating a multidimensional assessment of strength across multiple joints, this study moves beyond the limitations of single-joint evaluations and offers theoretical support for the potential use of handgrip strength as a practical indicator of overall muscle function in obese populations. Further research with larger samples and longitudinal designs is needed to validate its utility as a screening tool. These findings have important implications for designing function-oriented, precision-based exercise interventions for obese populations.
Gold wrist-assisted PFNA reduces internal complications and enhances recovery in obese osteoporotic patients with intertrochanteric femur fractures.
Wu Z, Li J, Mao S … +7 more , Lu J, Zhao Y, Yu S, Tian D, Jing J, Ao R, Xu X
PLoS One · 2026 · PMID 42391253 · Full text
INTRODUCTION: Obese, osteoporotic patients with intertrochanteric fractures face higher surgical risks and delayed recovery. The "Gold Wrist," an auxiliary curved guiding instrument for proximal femoral nail anti-rotatio...
INTRODUCTION: Obese, osteoporotic patients with intertrochanteric fractures face higher surgical risks and delayed recovery. The "Gold Wrist," an auxiliary curved guiding instrument for proximal femoral nail anti-rotation (PFNA), was developed to assist guidewire placement and improve procedural efficiency. METHODS: In this retrospective cohort study, 500 patients (almost all with BMI > 28 and varying degrees of osteoporosis) underwent PFNA using either the Gold Wrist (n = 250) or conventional instruments (n = 250). Outcomes included operative time, fluoroscopy exposure, incision length, inflammatory markers, functional recovery, internal medicine complications, mechanical complications, hospitalization cost, and estimated carbon footprint. Finite element analysis assessed device mechanical stability. RESULTS: Finite element analysis confirmed reliable mechanical performance. The Gold Wrist group had shorter operative time (114.7 ± 34.6 vs. 127.3 ± 34.3 min), smaller incisions (6.15 ± 1.88 vs. 7.27 ± 1.79 cm), and lower TNF-α, IL-6, CRP, and CK levels (all P < 0.0001). Functional recovery was faster, with higher Harris Hip Scores (87.7 ± 2.7 vs. 84.7 ± 3.4) and greater hip motion. Internal medicine complications-including infection, deep vein thrombosis, pulmonary embolism, and cardiovascular events-were significantly reduced. Mechanical complications, including implant failure, were reported separately. Hospitalization costs and estimated carbon footprint were also lower. CONCLUSION: The auxiliary Gold Wrist device improves surgical precision, accelerates recovery, and reduces internal medicine complications in obese, osteoporotic patients undergoing PFNA. It offers a clinically effective and sustainable approach to managing high-risk intertrochanteric fractures.
Cirrhosis outcomes on rurality and weekend admissions revisited: A contemporary analysis of the national inpatient sample.
Khalyfa A, Tu BH, Shi Q … +1 more , Tanaka T
PLoS One · 2026 · PMID 42391252 · Full text
BACKGROUND AND AIMS: The impact of hospital rurality and weekend admission on outcomes in decompensated cirrhosis remains unclear. Studies suggest mixed effects of weekend admission on mortality and increased mortality i...
BACKGROUND AND AIMS: The impact of hospital rurality and weekend admission on outcomes in decompensated cirrhosis remains unclear. Studies suggest mixed effects of weekend admission on mortality and increased mortality in rural hospital admissions for decompensated cirrhosis. This study evaluated the influence of hospital rurality, weekend admission, and their interaction on outcomes in decompensated cirrhosis from 2016 to 2020. METHODS: A cross-sectional analysis of the National Inpatient Sample (NIS) assessed in-hospital mortality (primary outcome), likelihood of specific procedures (esophagogastroduodenoscopy, paracentesis, TIPS, hemodialysis), and time to first procedure. Regression models adjusted for demographics, liver disease etiology, clinical severity (APR-DRG mortality risk), and other factors. RESULTS: Among 11,845,223 hospitalizations, rural hospitalizations were linked to lower in-hospital mortality (OR: 0.84; 95% CI: 0.80-0.86) and higher transfer rates for severe cases (7.2% vs. 2.8%, p < 0.001). Weekend admissions showed a statistically significant but only modest reduction in mortality odds (OR: 0.99; 95% CI: 0.975-0.998). No significant interaction existed between rurality and weekend admission regarding mortality. Rural hospitals showed lower odds of performing procedures (95% CIs < 1), though time to procedure was comparable, except for earlier hemodialysis (-1.35 days; 95% CI: -2.59 to -0.11). Weekend admissions did not significantly impact procedure rates, except for paracentesis (OR: 0.94; 95% CI: 0.88-0.99). CONCLUSIONS: Using a national cohort of hospitalized patients with decompensated cirrhosis, we showed that rural hospitals exhibited lower in-hospital mortality, fewer procedures, and higher transfer rates, and that weekend admissions showed only a minimal, clinically insignificant reduction in mortality, irrespective of hospital rurality.
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