PLOS https://journals.plos.org/plosone/ customercare@plos.org https://journals.plos.org/plosone/feed/atom All PLOS articles are Open Access. https://journals.plos.org/plosone/resource/img/favicon.ico https://journals.plos.org/plosone/resource/img/favicon.ico 2026-04-13T10:10:17Z Shah Faisal Mohammad Fawad Ali Mamirkulova Shynara 10.1371/journal.pone.0347213 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Shah Faisal Mohammad, Fawad Ali, Mamirkulova Shynara</p> Background <p>The recombinant production of <i>Pseudomonas aeruginosa</i> exotoxin A (ETA), a critical component for immunotoxin development, remains hindered by its complex disulfide bond architecture, cytotoxicity, and aggregation propensity. Despite recent advancements in strain engineering, a systematic, data-driven approach integrating high-throughput screening with machine learning for ETA optimization has remained largely unexplored.</p> Methods <p>We implemented a combinatorial optimization platform, screening 12 engineered <i>E. coli</i> strains across a matrix of four induction temperatures, three chaperone systems, and four redox-modulating additives. A high-throughput fluorescence-based solubility reporter was developed for rapid screening of 576 unique conditions, followed by training of an XGBoost machine learning model to predict soluble yield. The model was validated using 5-fold cross-validation with hyperparameter optimization to mitigate overfitting. Statistical analyses included one-way ANOVA with Tukey post-hoc test, Pearson correlation, and multiple regression.</p> Results <p>The disulfide-competent strain SHuffle T7, induced at 12°C with co-expression of the DnaKJE/GroEL chaperone system and supplementation with 2 mM oxidized glutathione, yielded 3.24 ± 0.4 mg/L of soluble, enzymatically active ETA. This represents a 15-fold improvement over conventional BL21(DE3) systems (F (11,24) = 45.32, p < 0.0001). Structural validation via redox-sensitive PAGE and nano-LC-MS/MS confirmed native disulfide pairing. The trained machine learning model demonstrated high predictive accuracy (R² = 0.92, RMSE = 0.24 mg/L) with consistent performance across cross-validation folds (average R² = 0.91 ± 0.02), and identified cytoplasmic redox potential and translational rate as the primary determinants of soluble expression.</p> Conclusions <p>We present an integrated platform that synergizes experimental high-throughput screening with predictive machine learning to overcome the challenge of ETA production. While validation on additional protein targets is needed to fully establish generalizability, this work establishes an optimized, scalable protocol for therapeutic-grade ETA and provides a transferable computational framework for the rational optimization of other complex, disulfide-rich proteins.</p> Chen Chen Ying Wang Yu Hou Pengfei Nie 10.1371/journal.pone.0347195 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Chen Chen, Ying Wang, Yu Hou, Pengfei Nie</p> This study examined the integrated effects of complex training combining barbell back squats (BBS) and drop jumps (DJ) on jump performance and concentric-phase neuromuscular activation in volleyball athletes. In a randomized controlled design, twenty male volleyball athletes were allocated to an intervention group (IG, n = 10) or a control group (CG, n = 10). The IG completed an 8-week, twice-weekly complex training protocol (BBS followed by DJ), with loads progressively adjusted according to individual 1RM values, whereas the CG performed an intensity-matched BBS protocol. Primary outcomes were countermovement jump (CMJ) and approach jump (AJ) height and propulsion impulse (expressed in BW·s), while concentric-phase integrated electromyography (iEMG) and root mean square (RMS) amplitude were secondary outcomes. The results showed that, compared with the CG, the IG exhibited greater improvements in both CMJ and AJ height (CMJ: Δ = 6.13 vs 2.65 cm; AJ: Δ = 7.28 vs 2.78 cm; both <i>p</i> < 0.05). In addition, gains in propulsion impulse were larger in the IG (CMJ: Δ = 0.06 vs 0.02 BW·s; AJ: Δ = 0.08 vs 0.03 BW·s; both <i>p</i> < 0.05). Furthermore, electromyography revealed task-specific recruitment patterns: under BBS, the quadriceps and tibialis anterior showed higher iEMG and RMS values, whereas under DJ the lateral and medial heads of the gastrocnemius were more strongly activated, indicating complementary effects across key lower-limb muscle groups. Taken together, these findings indicate that an 8-week BBS–DJ complex program, compared with resistance training alone, is more effective in improving jump performance and propulsion impulse and in optimizing task-specific concentric activation patterns of the lower-limb musculature in volleyball athletes, and may serve as a feasible and evidence-based prescription for volleyball-specific conditioning. The PLOS One Staff 10.1371/journal.pone.0347164 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by The PLOS One Staff </p> Khadeja Zaza Andrew Symon Sahar Hassan Hadil Ali-Masri Jenny McNeill Janine Stockdale Weam Alhulaibi Berit Mortensen 10.1371/journal.pone.0347114 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Khadeja Zaza, Andrew Symon, Sahar Hassan, Hadil Ali-Masri, Jenny McNeill, Janine Stockdale, Weam Alhulaibi, Berit Mortensen</p> Background <p>The Quality Maternal and Newborn Care Framework index (QMNCFi) is a validated English-language instrument developed to assess women’s experiences during pregnancy, childbirth, and the postnatal period. These experiences include respect, dignity, communication, continuity of care, and involvement in decision-making. Despite Arabic being spoken in 22 countries, substantial variations exist in dialects, terminology, and healthcare practices. Because maternity care models, communication styles, and clinical terminology vary across Arabic-speaking contexts, ensuring semantic and experiential equivalence is essential when adapting the QMNCFi for use in Middle Eastern settings. This study aimed to translate and culturally adapt the QMNCFi into Arabic and to document the international collaborative methodological process supporting this adaptation.</p> Methods <p>We followed an internationally recognized six-stage approach for translation and cultural adaptation (forward translation, synthesis, back translation, expert committee review, pre-final testing, and finalization). Two research teams, representing institutions across five countries, collaborated under a unified protocol. Cognitive interviews were conducted with 48 postpartum participants in Palestine and the Kingdom of Saudi Arabia.</p> Results <p>Refinements included adding a country identifier within demographic items to distinguish data collection sites, aligning demographic categories (e.g., education and income/currency), clarifying items with context-relevant examples, and adding “not applicable” where appropriate. These adjustments improved clarity and contextual fit without altering item order or scoring. Inter-rater agreement reached 99.1%, exceeding the a priori 80% benchmark. Operational challenges, including ethics approvals, data-sharing restrictions, supervision structures, and cross-site coordination, were addressed through structured mentorship, version-controlled documentation, and regular joint meetings.</p> Conclusion <p>A shared language did not ensure semantic or experiential equivalence. Addressing institutional, regulatory, capacity, and linguistic factors was essential for developing a usable Arabic QMNCFi. This work provides a transparent methodological guideline for same-language, multi-country adaptation of health measurement tools and prepares the Arabic QMNCFi for psychometric validation and future implementation in Arabic-speaking maternity care settings.</p> Nazlee Sharmin Ava K. Chow 10.1371/journal.pone.0347026 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Nazlee Sharmin, Ava K. Chow</p> Background <p>With advancements in the fields of treatment, diagnosis, and genomics, knowledge of cellular biochemistry is becoming increasingly crucial for oral health professionals. However, dental students often feel demotivated to study foundational-level biochemistry because they are overwhelmed by the volume and complexity of the material and fail to recognize its relevance to dental practice. To address this, we developed a focused, self-directed assignment for 1^st-year Dental Hygiene (DH) students to enhance their understanding of protein structure and underscore the application of this knowledge in dental practice.</p> Methods <p>The assignment was developed in quiz-style using Google Forms and integrated into a foundational-level biochemistry course as a supplementary activity. The activity included follow-up questions asking students about their perceived accomplishments and confidence in understanding protein structure and function. A descriptive study was conducted to explore students’ perceptions of the assignment and its impact on their understanding of protein structure and function. Students’ anonymous responses to the follow-up questions and their performance on the assignment were analyzed for the study. Descriptive statistics were calculated from the data using Microsoft Excel.</p> Results <p>Although the assignment was not mandatory, 86% of the class (n = 25) completed it, achieving an average score of 6.04 out of 10. Sixty percent of participants (n = 15) reported improved knowledge of protein structure-function relationships, and 48% (n = 12) indicated that completing the assignment helped them understand how a simple change in protein sequence can lead to significant changes in protein structure and function.</p> Conclusion <p>While the assignment included a limited number of follow-up questions, which restricted our ability to explore student perceptions in detail, it demonstrates the potential of a well-designed, interactive, case-based assignment to stimulate student motivation by highlighting the relevance and application of biochemistry content in the future dental profession.</p> Noshin Ibnat Rib Fariza Shams Fahad Khan Senzuti Sharmin Sakib Abrar Hossain Abdus Sadique Jahidul Alam Pronoy Debnath Arman Hossain Aura Rahman Syeda Naushin Tabassum Tahrima Saiha Huq Muhammad Maqsud Hossain 10.1371/journal.pone.0346980 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Noshin Ibnat Rib, Fariza Shams, Fahad Khan, Senzuti Sharmin, Sakib Abrar Hossain, Abdus Sadique, Jahidul Alam, Pronoy Debnath, Arman Hossain, Aura Rahman, Syeda Naushin Tabassum, Tahrima Saiha Huq, Muhammad Maqsud Hossain</p> This study marks the first identification and genomic characterization of <i>Comamonas kerstersii</i> isolates from diarrheal patients in Bangladesh. We carried out the whole genome sequencing of three <i>C. kerstersii isolates</i> to analyze genomic features using bioinformatics tools. We hypothesize that <i>C. kerstersii</i> can contribute to the diarrheal disease process through indirect mechanisms, potentially by interacting synergistically with other enteric pathogens such as <i>Vibrio cholerae</i> (both O1 and non-O1 serogroups). The presence of diverse virulence factors, including type IV pili, type VI secretion systems, chemotaxis proteins, and toxin genes such as <i>zot</i> and RTX, suggests a capacity for adhesion, motility, and immune evasion. Notably, genomic analyses indicate that <i>C. kerstersii</i> shares several offensive and defensive virulence factors with other pathogenic <i>Comamonas</i> spp, including mechanisms for biofilm formation, nutrient acquisition, and stress tolerance. These factors, combined with antimicrobial resistance genes identified genes – <i>aph(6)-Id, aph(3”)-Ib, mph(E), mph(F), msr(E), sul2,</i> and <i>tet(A),</i> may enhance survival and adaptability of <i>C. kerstersii</i> in the gut environment, potentially augmenting the pathogenicity of co-infecting diarrheal pathogens. These initial findings highlight the need for extensive genomic surveillance across diarrheal patients, along with further investigation into molecular interactions with co-pathogens that could reveal novel pathways influencing diarrheal disease outcomes. Ayat ElZayat Rawaa Jilani Assel Krimly Lamar Awan Lamar Alsiamy Nawal Baeshin 10.1371/journal.pone.0346935 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Ayat ElZayat, Rawaa Jilani, Assel Krimly, Lamar Awan, Lamar Alsiamy, Nawal Baeshin</p> Background <p>Diabetic patients are particularly vulnerable to medication errors. Assessing adherence to the WHO Five Moments for Medication Safety among diabetic patients is essential for identifying gaps in practice and improving patient safety in this high-risk group. This is the first study to assess medication practices based on the WHO Five Moments among diabetic patients in Saudi Arabia.</p> Methods <p>This cross-sectional study was conducted on 473 adult diabetic patients in Jeddah, Saudi Arabia. Patients completed a structured, self-administered questionnaire. The questionnaire comprised questions of the WHO Five Moments for Medication Safety. Content validity was confirmed through expert review, translation to Arabic followed forward–forward-backward procedure, and pre-testing confirmed face validity.</p> Results <p>Diabetic patients generally exhibited the highest practice in moment two: taking medications (72%) and the lowest in moment five: stopping medications (54%), and 66% showed high overall medication safety practice. Multiple regression identified that following a regimen, using hypoglycaemic medication or insulin, and controlled HbA1c as positive predictors of total medication safety scores (P-value <0.05).</p> Conclusion <p>Diabetic patients in Saudi Arabia generally exhibited overall a high adherence to the “Five Moments for Medication Safety,” with the highest practice in taking medications and the lowest in stopping them.</p> Shiming Cheng Ying Hu Yan Cheng Zhiyang Qian Xiurong Xu Xiashuo Lei Xiaodeng Shi 10.1371/journal.pone.0346920 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Shiming Cheng, Ying Hu, Yan Cheng, Zhiyang Qian, Xiurong Xu, Xiashuo Lei, Xiaodeng Shi</p> <i>Polygonatum cyrtonema</i> is a valuable medicinal and edible plant whose sustainable utilization is challenged by wild resource depletion and germplasm degradation. This study established a multi-site provenance trial across three heterogeneous garden environments in Zhejiang Province, China, to evaluate 11 geographically diverse provenances. We systematically measured growth traits (plant height, stem diameter, leaf morphology) and medicinal components (polysaccharides, saponins, flavonoids, total phenolics), and applied combined ANOVA, correlation analysis, principal component analysis, and cluster analysis to quantify provenance variation patterns and environmental drivers. Results revealed highly significant differences (P < 0.01) among provenances, sites, and their interactions for all traits. Substantial phenotypic (PCV: 7.41%–46.89%) and genotypic (GCV: 5.99%–44.92%) coefficients of variation were observed, with particularly high variation in polysaccharides and key growth traits, coupled with substantial provenance repeatability (0.63–0.99), indicated strong potential for selective breeding. Correlation analysis showed significant positive associations between growth traits and key medicinal components. Geo-climatic analysis identified distinct environmental drivers: saponin content increased with altitude and temperature, while flavonoid accumulation was promoted in drier conditions. Based on principal component analysis (cumulative contribution: 85.20%), Songyang (3.34) and Yunhe (2.98) provenances achieved the highest comprehensive evaluation scores. Cluster analysis further classified the provenances into three groups, with Songyang and Yunhe forming a distinct cluster characterized by superior growth and medicinal compound accumulation. These provenances are recommended as elite materials for breeding programs. This study provides a scientific basis for the selective breeding of <i>P. cyrtonema</i> and holds significant practical implications for enhancing the quality and efficiency of the understory economy and promoting the sustainable use of medicinal plant resources. Yen-Lien Kuo Wen-Chin Wu Daigee Shaw Bin-Tzong Chie Yu-Tzung Chang Yi-Lun Chuang Yen-Ling Liu Chun-Ta Fan 10.1371/journal.pone.0346904 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Yen-Lien Kuo, Wen-Chin Wu, Daigee Shaw, Bin-Tzong Chie, Yu-Tzung Chang, Yi-Lun Chuang, Yen-Ling Liu, Chun-Ta Fan</p> Carbon pricing instruments have been found to be an effective incentive to mitigate climate change, but that surely increases the burden on the current generation. Some previous experiments found that people will have fewer or delayed gains after imagining the future. This research employed an experimental survey with a randomized treatment to investigate whether introducing imaginary future generations (IFGs) increases respondents’ probability of choosing carbon tax schemes. The survey was conducted at the end of 2021, collected 1,100 responses, with IFGs randomly introduced to half of the participants. Five carbon reduction schemes and their environmental, social, and economic consequences were presented to the respondents. These schemes include four hypothetical carbon tax schemes and a feed-in-tariff (FIT) scheme that is currently implemented in Taiwan as a comparator. Those carbon tax schemes can reduce carbon emissions by 50% from 2005 levels by 2050. This contrasts sharply with a no-tax scenario, which is projected to see emissions increase by 41%. The results showed that the carbon tax bundled with reduced VAT rates and lump-sum rebates was the most popular scheme, being the top choice for 35% of respondents. This appeal is likely attributable to its revenue recycling design, as well as its perceived superior social impacts compared to other schemes, which would increase the annual income of the lowest 20% income group by 7.5%. Moreover, the introduction of IFGs does significantly increase the probability by 11% that a respondent chooses the carbon tax scheme over the non-carbon tax scheme. The IFGs experience influences a broad demographic, including most respondents and wealthier individuals, rather than solely environmentalists, making them feel the social pressure of climate change concerns and be willing to mitigate it. Mulat Belay Simegn Habtamu Geremew Fraol Daba Chinkey Zekarias Tadele Alemneh Eyasu Bamlaku Golla Alegntaw Abate Mohammed Ahmed Ali Smegnew Gichew Wondie Hawi Kumbi Werkneh Melkie Tilahun 10.1371/journal.pone.0346903 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Mulat Belay Simegn, Habtamu Geremew, Fraol Daba Chinkey, Zekarias Tadele Alemneh, Eyasu Bamlaku Golla, Alegntaw Abate, Mohammed Ahmed Ali, Smegnew Gichew Wondie, Hawi Kumbi, Werkneh Melkie Tilahun</p> Background <p>Inconsistent condom use represents the most proximal behavioral risk factor for acquisition and transmission of sexually transmitted infections, including human immunodeficiency virus. However, certain situations hinder female sex workers from practicing consistent condom use. This study aimed to assess the pooled estimate of inconsistent condom use among female sex workers and identify factors associated with it.</p> Methods <p>This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, 2020 reporting checklist. Electronic databases (PubMed, Cochrane Library, Epistemonikos, Hinari, and Science Direct), Google Scholar, and other university repositories were searched until March 20, 2024, based on the eligibility criteria. Three independent reviewers screened the titles, abstracts, and full texts. Two independent reviewers extracted the data. The Joanna Briggs Institute quality appraisal checklist was used. The Higgin’s I² test was used to quantify heterogeneity. Pooled analysis was conducted using a random-effects model. Sensitivity and subgroup analyses were done. Publication bias was assessed using Egger’s regression test and funnel plot. The pooled prevalence and statistical association were declared at a p-value < 0.05 with the 95% CI.</p> Results <p>A total of 24 studies involving 23,496 female sex workers with a median age of 27.3 years were included. The overall pooled prevalence of inconsistent condom use among FSW in Africa was estimated at 46.73% (95% CI: 37.60, 55.86), I² = 99.59%, and p = 0.00. Condom availability (AOR = 0.68; 95% CI: 0.50, 0.92), depression (AOR = 1.51; 95% CI: 1.00, 2.30), no education (AOR = 1.87; 95% CI: 1.19, 2.93), two or more nonpaying clients (AOR = 2.90; 95% CI: 1.51, 5.54), having >9 current client number (AOR = 0.46; 95% CI: 0.29, 0.74), violence (AOR = 1.74; 95% CI: 1.33, 2.27), and police harassment (AOR = 2.28; 95% CI: 1.03, 5.05) were significant factors.</p> Conclusion and recommendation <p>Inconsistent condom use was high in Africa. Factors including availability of condoms, depression, and education, having two or more nonpaying clients, client numbers, violence, and police harassment were significant factors. Strategies like improving peer education, providing mental health support, empowering women, and improving female sex workers educational status, ensuring condom availability, and strengthening supply for easily accessible condoms can decrease inconsistent condom use and protect FSWs from STI including HIV.</p> Keyu Chen Zushun Li Beiyu You Xingyu Tao 10.1371/journal.pone.0346900 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Keyu Chen, Zushun Li, Beiyu You, Xingyu Tao</p> Building Information Modelling (BIM) project operation and maintenance information management in smart cities currently faces challenges like data redundancy, a large number of management and maintenance personnel, and complex processes. Blockchain technology, with its decentralized and non-tamperable characteristics, offers a potential solution to these challenges. However, its direct application is not a panacea, as its complex deployment and cumbersome approval processes can introduce new challenges. Therefore, this paper proposes a lightweight blockchain-based BIM project O&M information management framework. A Design Science Research (DSR) methodology was used to construct this framework, aiming to optimize the information management process and ensure its efficient application. First, a one-to-many mapping tool was developed to allow a single blockchain node to register multiple users, thus simplifying the deployment process and enabling a lightweight blockchain. An InterPlanetary File System (IPFS)-based tool was also built for generating digital fingerprints to enhance data security and traceability. Secondly, to deal with the complex BIM collaboration process, multiple types of smart contracts were designed and developed to automate the coordination and management of various interactions and transactions in BIM projects, thereby improving the efficiency and accuracy of the entire collaboration process. Finally, this study validates the effectiveness of the proposed BIM information management approach using Hyperledger Fabric. The validation results show that the proposed approach is not only technically feasible in the field of BIM information management, but also effectively addresses key storage and efficiency challenges prevalent in smart city BIM applications in terms of performance metrics, including response latency and data processing throughput. Erik C. Tracy Elizabeth D. Young Kelly A. Charlton 10.1371/journal.pone.0346897 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Erik C. Tracy, Elizabeth D. Young, Kelly A. Charlton</p> Upon hearing a spoken utterance, listeners associate certain attributes (e.g., emotional) with self-identified gay male talkers and other attributes (e.g., reserved) with self-identified straight male talkers. In the current study, we explored whether listeners associated additional personal attributes with these types of talkers, and whether different contexts (e.g., listeners being informed of the talker’s sexual orientation) affected how strongly listeners associated personal attributes with talkers. Twenty-four talkers (twelve who self-identified as gay and twelve who self-identified as straight) from an established corpus were examined. Notably, previous work found that these talkers’ self-described sexual orientation (SO) did not always align with listener-perceived SO (i.e., a self-identified gay talker was perceived as straight sounding, and vice versa). Listeners evaluated these talkers for eight attributes (e.g., boring, confident, intelligent, mad, old, outgoing, sad, and stuck-up) in three contexts: talkers’ SO not referenced, talkers’ SO truthfully referenced (i.e., listeners were informed that a straight talker was straight), and talkers’ SO falsely referenced (i.e., listeners were informed that a straight talker was gay). Results suggested that self-identified gay and straight talkers whom listeners perceived as sounding gay were perceived as confident, mad, stuck-up, and outgoing; self-identified gay and straight talkers whom listeners perceived as sounding straight were perceived as sad and old. Furthermore, listeners’ judgments did not differ when the talkers’ SO was truthfully referenced, falsely referenced, or not referenced for all attributes except sad and stuck-up. The results indicate that perceived SO generally has the greatest effect on listeners’ perception of a talker’s attributes and, for most attributes examined, this is the case regardless of whether the listeners are informed (truthfully or falsely) of the talkers’ self-identified SO. Patricia Mendivil-Hernández Jorge Alvis-Arrieta Miguel Garcés-Prettel 10.1371/journal.pone.0346893 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Patricia Mendivil-Hernández, Jorge Alvis-Arrieta, Miguel Garcés-Prettel</p> Women-led cultural enterprises in Colombia have emerged as a strategic opportunity to strengthen the cultural economy, support heritage tourism, and foster inclusive territorial development. This study examines the significant predictors of entrepreneurial maturity among women in the artisan sector. The analysis draws on data from 512 women registered in the 2023 database of the Departmental Institute of Culture and Tourism of Cundinamarca. A quantitative approach was employed, using a non-experimental, cross-sectional design and a binary logistic regression model. The findings reveal significant relationships between maturity and variables such as age, primary source of income, and participation in associations. Distance from the capital showed only a marginal effect. These results offer valuable insights for designing targeted strategies to enhance cultural and territorial development through the empowerment of women artisans. Romain Lerouge Michela Arnaboldi 10.1371/journal.pone.0346887 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Romain Lerouge, Michela Arnaboldi</p> The economic and social impact of cultural participation has recently become once more a subject of interest for policy-making, especially as a driver potentially affecting social inclusion and quality of life. Two topics of interest emerge in research on this subject. The first topic concerns the relationship between cultural experiences and life satisfaction, this being a comprehensive measure of the highest human motivation. The second topic relates to the multi-faceted relationship between cultural participation and family background. According to previous studies, these two topics are strictly intertwined; however, they have not been analysed in an integrated manner. Drawing on equality of opportunity theory, this study integrates both perspectives to provide a general overview on the link between cultural participation and life satisfaction for on people coming from different family backgrounds. Research based on a survey disseminated in Italy (N = 1 235) was conducted to investigate if and how family background moderates people’s ability to achieve life satisfaction through their involvement in cultural events. The results support customised policies that introduce a new approach to assessing the impact of cultural participation, thereby disclosing the role it plays in disadvantaged backgrounds and highlighting the cultural events responsible for the strongest benefits. Ofir Sivan Ali Pearson Stephanie Begun 10.1371/journal.pone.0346869 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Ofir Sivan, Ali Pearson, Stephanie Begun</p> Introduction <p>There is a growing literature connecting information and communication technologies (ICTs) to community-based practices including community organizing, community development, and participatory planning. Over a decade ago, the American Academy of Social Work and Social Welfare launched the Grand Challenge to Harness Technology for Social Good. Despite its potential to answer this challenge, community practice is absent from all systematic reviews on social work and technology. The proposed scoping review will address this gap by identifying, organizing, summarizing, analyzing, and synthesizing the existing literature connecting community practice and ICTs in social work and related disciplines.</p> Methods <p>This protocol was developed using Arksey and O’Malley’s [2005] framework and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols [PRISMA-P]. Search will be conducted in the following databases: Sociological Abstracts [ProQuest interface, 1952-], [Social Service Abstracts ProQuest interface, 1977-], Applied Social Service Index Abstracts [ProQuest interface, 1987-], Social Work Abstracts [Ovid interface, 1968-], Communication Abstracts [EBSCO interface, 1915-], Social Science Citation Index [Web of Science interface, 1900-], and Emerging Sources Citation Index [Web of Science interface, 2005-]. Published records eligible to include in this scoping review include conceptual and empirical peer-reviewed articles. Selection criteria, and methods of data extraction, management, and analysis are detailed.</p> Discussion <p>The proposed scoping review will explore the engagement of community practitioners with ICTs. This review will also identify ICT-facilitated community-based practices that the social work profession can reclaim in a bid to address the Grand Challenge to Harnessing Technology for Social Good. Limitations, implications for future research, and methods of disseminating the results are discussed.</p> Sadik Abdulwehab Frezer Kedir 10.1371/journal.pone.0346867 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Sadik Abdulwehab, Frezer Kedir</p> Introduction <p>Diabetes mellitus is a growing public health concern in Ethiopia, with increasing prevalence and a high proportion of undiagnosed cases. Effective self-care is crucial for managing diabetes; however, many patients face challenges ranging from personal beliefs to systemic and sociocultural constraints. Although multiple qualitative studies have explored these challenges, a synthesized, context-specific understanding that incorporates broader social and health system factors remains limited. This review aimed to synthesize qualitative evidence on barriers and facilitators of diabetes self-care practice in Ethiopia.</p> Methods <p>A qualitative systematic review was conducted in accordance with PRISMA 2020 and PRISMA-QS guidelines. A comprehensive search of PubMed/MEDLINE, Scopus, CINAHL, Web of Science, and Google Scholar was performed using relevant keywords and Medical Subject Headings. Eligible studies included primary qualitative and mixed-methods studies with extractable qualitative findings that explored diabetes self-care barriers and facilitators among patients, caregivers, or healthcare providers in Ethiopia. Purely quantitative studies, reviews, editorials, and studies conducted outside Ethiopia were excluded. Thematic synthesis was employed to integrate findings, and the GRADE-CERQual approach was used to assess confidence in the review findings.</p> Results <p>Eleven studies were included, comprising qualitative and mixed-methods designs conducted across diverse urban and semi-urban healthcare settings in Ethiopia. Study participants included adults with type 1 and type 2 diabetes, as well as healthcare professionals and caregivers. Six major barriers to diabetes self-care were identified: health system limitations, individual-level challenges, socioeconomic constraints, behavioral and lifestyle factors, cultural and social norms, and lack of social support. Key facilitators included strong family and social support, health education and counseling, patient motivation and skills, culturally aligned practices, and signs of health system readiness.</p> Conclusion and Recommendation <p>Diabetes self-care in Ethiopia is shaped by interconnected individual, cultural, and systemic factors. While substantial barriers persist, important enablers, particularly family involvement and supportive healthcare interactions, offer opportunities for improvement. Interventions should be culturally sensitive, community-centered, and supported by strengthened health systems. Policy efforts should prioritize integration of diabetes care into primary healthcare services, capacity building of healthcare providers, and incorporation of patients’ lived experiences into care planning.Prospero registration number CRD420251033692</p> Dayna Lee-Baggley Hayam Bakour Bill Howatt Debra Gilin Ehsan Etezad 10.1371/journal.pone.0346786 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Dayna Lee-Baggley, Hayam Bakour, Bill Howatt, Debra Gilin, Ehsan Etezad</p> This research developed the Belonging at Work Scale (BWS), a 7-item, unidimensional measure of work group inclusion focusing specifically on belongingness. Collecting data from 2 Canadian employee samples across 2 studies (<i>N</i> = 1535, <i>N</i> = 3148), we examined the factor structure, psychometric properties, and group means of the BWS across diverse groups of employees (gender, ethnicity, neurodiversity, sexual orientation). The BWS showed strong reliability as well as configural, metric and scalar invariance across all diverse groups, indicating equivalent fit and applicability. An intersectionality analysis (Study 1) found that women in comparison to men, non-heterosexual individuals in comparison to heterosexual individuals, and participants in intersecting demographic minority groups report less belonging at work on average. Additionally, a greater sense of belonging as measured by the BWS was associated with fewer reports of 10 harmful misbehaviours in the workplace as well as lower rates of taking leaves of absence (Study 2). The development of this scale aims to support organizations in practically measuring their levels of inclusion to ultimately address any identified inclusion-related issues. Study limitations, implications and suggestions for future research are discussed. Hyunyu Jeon Soo-Hyun Kim Dayeon Shin 10.1371/journal.pone.0346774 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Hyunyu Jeon, Soo-Hyun Kim, Dayeon Shin</p> Objective <p>Dairy products are known to improve blood lipid profiles and insulin sensitivity and to reduce risk factors for metabolic syndrome (MetS) and nonalcoholic fatty liver disease (NAFLD). However, the mechanisms through which dairy product consumption influences NAFLD via MetS components remain unclear. This study examined the mediating effects of MetS components on the association between dairy product consumption and NAFLD.</p> Methods <p>This study included 12,775 Korean adults from the Korea National Health and Nutrition Examination Survey (KNHANES) 2019–2021. Dairy product intake was assessed using a 24-hour dietary recall. NAFLD was defined using a hepatic steatosis index score >36, and MetS was classified according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Multivariable logistic regression analyses were conducted to examine the associations among dairy intake, NAFLD, and MetS components. Mediation analyses with bootstrapping (n = 1,000) were performed to investigate the mediating effects of individual MetS components on the association between dairy consumption and NAFLD.</p> Results <p>Consumption of more than one serving of dairy products was associated with a lower prevalence of NAFLD among women (adjusted odds ratio [AOR], 0.75; 95% confidence interval [CI], 0.59–0.96). Regarding MetS components, intake of one serving of dairy products was associated with lower odds of elevated triglycerides in men (AOR, 0.75; 95% CI, 0.63–0.89). In women, consumption of at least one serving was associated with decreased hyperglycemia (AOR, 0.84; 95% CI, 0.73–0.97), abdominal obesity (AOR, 0.69; 95% CI: 0.55–0.87), low high-density lipoprotein cholesterol (AOR, 0.83; 95% CI: 0.72–0.95), and elevated triglyceride levels (AOR, 0.71; 95% CI, 0.60–0.85). Mediation analyses indicated that, among women, significant proportions of the associations between dairy product consumption and NAFLD were mediated by waist circumference (58.0%), systolic blood pressure (18.2%), and high-density lipoprotein cholesterol (51.7%), whereas no significant mediation effects were observed among men.</p> Conclusions <p>Dairy product consumption was associated with a lower prevalence of MetS and NAFLD among women. Mediation analysis further suggested that dairy product consumption may reduce the risk of NAFLD by improving metabolic dysfunction among women.</p> Mostafa Shams Kaushik Ghosh 10.1371/journal.pone.0346734 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Mostafa Shams, Kaushik Ghosh</p> Predicting future insurance claims using observed covariates is essential for actuaries in setting appropriate insurance premiums. For this purpose, actuaries commonly employ parametric regression models, which assume the same functional form tying the response to the covariates across all data points. However, these models may lack the flexibility required to accurately capture, at the individual level, the relationship between covariates and claims frequency and severity. This limitation is particularly relevant as claims data are often multimodal, highly skewed, and heavy-tailed. In this paper, we explore the use of Bayesian nonparametric (BNP) regression models to predict claims frequency and severity based on covariates. Specifically, we model claims frequency as a mixture of Poisson regression and the logarithm of claims severity as a mixture of normal regression. We then employ Dirichlet process (DP) and Pitman–Yor process (PY) as priors for the mixing distribution over the regression parameters. Unlike parametric regression, such models allow each data point to have its own individual parameters, thereby making them highly flexible and resulting in improved prediction accuracy. We describe model fitting using Markov chain Monte Carlo (MCMC) methods and illustrate their applicability using two independent real-world insurance datasets. The proposed BNP models reduced the mean squared error for the French and Belgian claims frequency data by approximately 52% and 33%, respectively (relative to standard Poisson regression), and for the corresponding claims severity data by nearly 45% and 79%, respectively (relative to standard multiple linear regression). Zhigang Zhang Jiaqi Gao Rong Liu Qibing Tao 10.1371/journal.pone.0346727 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Zhigang Zhang, Jiaqi Gao, Rong Liu, Qibing Tao</p> Hybrid–cloud scheduling must balance cost, performance, and reliability; yet existing approaches often suffer from burdensome parameter tuning, a limited set of optimized QoS indicators, and high computational overhead. To address these issues, we propose an EMPA–ASA–based hybrid–cloud resource scheduling algorithm and make three contributions: 1) we realize state-driven adaptive scheduling and resource allocation via MDP + Q-learning, updating the policy online as system conditions evolve; 2) we introduce an <i>M</i>/<i>M</i>/<i>c</i> queueing model to quantitatively encode QoS constraints, thereby improving responsiveness and load adaptivity; and 3) we fuse EMPA with Adaptive Simulated Annealing (ASA), augmented by Lévy flights to strengthen global exploration and accelerate convergence. We implement a full prototype and conduct performance evaluations. The results show that EMPA–ASA outperforms baselines across multiple QoS metrics—including end-to-end delay, response time, throughput, and packet-loss rate—and reduces total cost by approximately 48% and 70% relative to GA and PSO, respectively; its advantages in QoS and cost are especially pronounced under high-load scenarios. These findings indicate a superior cost–performance trade-off, providing an efficient and reliable solution for hybrid–cloud resource scheduling. Wenbo Dong Bai Li Zhiwei Xu Qi Wang Zhihui Hou Hongling Jia 10.1371/journal.pone.0346716 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Wenbo Dong, Bai Li, Zhiwei Xu, Qi Wang, Zhihui Hou, Hongling Jia</p> Human papillomavirus (HPV) infection continues to pose a significant global health challenge. Although gut microbial metabolites have been associated with HPV infection, the mechanisms underlying this relationship remain inadequately understood. A network pharmacology approach was utilized to comprehensively explore the connections between gut microbial metabolites and HPV infection. Using gutMGene, GeneCards, OMIM and other databases, 43 key targets were identified as common elements between gut microbial metabolites and HPV infection. Protein-protein interaction network analysis further screened 10 core targets, including IL6, AKT1, IL1B, CASP3, NFKB1, EGFR, PPARG, JUN, PTGS2, and TLR4. Gene ontology (GO) enrichment analysis of these 43 key targets indicated their involvement in lipopolysaccharide response, oxidative stress, and inflammatory signaling. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of the 10 core targets highlighted the TNF, Toll-like receptor, C-type lectin receptor, and IL-17 signaling pathways as the main enriched pathways. A comprehensive microbiota-metabolite-target-pathway network was constructed, illustrating that these core targets interact with 13 gut microbial metabolites, 97 gut microbes, and 10 key pathways. Among the 13 metabolites screened, succinate and short-chain fatty acids (acetate, butyrate, propionate) exhibited favorable drug-likeness and toxicological profiles, with succinate being the most notable. Molecular docking analysis indicated that succinate binds to IL1B with a binding energy of −5.66 kcal/mol, suggesting a potential interaction with this core inflammatory target. These results suggest that key gut microbial metabolites, particularly succinate, may influence HPV infection through immune-related pathways and potential interactions with IL1B. This study provides a new direction for understanding the relationship between microbial metabolites and HPV infection and offers a foundation for future investigations. Joshua J. March Janet F. McLean Josephine Ross Jan R. Kuipers Sheila J. Cunningham 10.1371/journal.pone.0346703 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Joshua J. March, Janet F. McLean, Josephine Ross, Jan R. Kuipers, Sheila J. Cunningham</p> Associating information with the self enhances processing of that information, with simple text cues like self-referent pronouns (i.e., ‘You’) increasing response speed and accuracy in processing tasks. Research suggests this can be applied in educational contexts, such as children’s mathematical word problem-solving. Whilst children show faster and more accurate word problem-solving when self-pronouns are included in the text, the mechanisms underlying these effects are unclear. The current study extends previous research by using eye-tracking to monitor 9- to 11-year-old children’s processing during mathematical word problem-solving. Children were faster to solve subtraction problems that contained a self-referential pronoun, but this was not the case for addition problems. Eye tracking data revealed that faster processing time was driven by reduced fixation length on referent information in the self-pronoun problems across problem types: children spent less time looking at self-pronouns than terms referring to another person (e.g., character names). This suggests that self-pronouns may facilitate problem-solving by supporting active storage of items bound to self in working memory, reducing the need for revisitation during mathematical word-problem solving. This is likely to be particularly beneficial for more cognitively challenging problems, providing an explanation for patterns of self-reference effects reported previously. Mozhi Li Jinying Cao Qiheng Sun 10.1371/journal.pone.0346702 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Mozhi Li, Jinying Cao, Qiheng Sun</p> Employee engagement has been widely recognized as an important indicator of organizational functioning and performance. While prior research has primarily examined engagement at the individual level, emerging studies suggest that engagement may spread through social interactions, leading to a shared, collective form of organizational engagement. Building on social contagion theory, this study examines the relationships between participative leadership, leader–member exchange (LMX) congruence (i.e., the degree of agreement between leaders’ and employees’ LMX ratings), and collective organizational engagement. Using matched survey data from 243 respondents nested within 54 commercial organizations operating in mainland China across manufacturing, information technology, services, real estate, and fast-moving consumer goods sectors, we employed polynomial regression and response surface analysis to examine patterns of congruence and incongruence in LMX ratings. The results indicate that participative leadership is positively associated with collective organizational engagement. When leaders’ and employees’ LMX ratings are congruent, the High–High profile is associated with higher levels of collective organizational engagement than the Low–Low profile. Under incongruent conditions, the Low–High profile is associated with higher collective organizational engagement than the High–Low profile. Furthermore, the interaction between participative leadership and specific LMX congruence profiles shows differential predictive relationships with collective organizational engagement. These findings contribute to the literature by extending engagement research to the collective level and by clarifying how leadership practices and leader–employee perceptual alignment relate to collective organizational engagement. Shanshan Ji Teng Wang Lu Guan Chengyang Zhao Shuai Quan Xuewei Dong Xianzhi Zhang Fandi Meng Zhicheng Tian 10.1371/journal.pone.0346667 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Shanshan Ji, Teng Wang, Lu Guan, Chengyang Zhao, Shuai Quan, Xuewei Dong, Xianzhi Zhang, Fandi Meng, Zhicheng Tian</p> Polymer membranes offer an extremely attractive solution for achieving sustainable carbon dioxide capture and have the potential for large-scale application. The authors prepared almost amorphous polyethylene oxide separation membranes through cross-linking methods, with a CO₂/H₂ separation coefficient of 7.9. However, there is still the drawback of low CO₂ permeability. To improve the performance of the cross-linked membranes, this paper utilized the swelling property of the cross-linked membranes and immersed them with different end groups of PEG aqueous solutions. The effects of different end groups on the gas separation performance of the cross-linked membranes were investigated. The results showed that after being impregnated with different end group PEG, the gas permeabilities of the cross-linked membranes increased. When using a polyethylene glycol with a molecular weight of 250 g/mol for impregnation, a 47.0wt.% increase in weight was observed, and the gas permeability and CO₂/H₂ separation coefficient of the cross-linked membranes increased significantly. The CO₂ permeability increased from 170 Barrer of the original membrane to 1457 Barrer, and the separation coefficient of H₂ increased from 7.9 to 13. Shuangli An Junjie Wu Jiawang Li 10.1371/journal.pone.0346637 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Shuangli An, Junjie Wu, Jiawang Li</p> In the process of intelligentization in modern manufacturing, especially in industrial fields such as automobile manufacturing, semiconductor production, and electronic product assembly, product quality control is crucial. Traditional defect detection methods face problems such as supervised learning methods relying on a large amount of labeled data, weak generalization ability, and high cost. In the process of intelligent manufacturing, industrial product quality control is a key link to ensure production safety and product consistency. Especially in typical industrial scenarios such as automobile manufacturing, semiconductor production, and electronic product assembly, traditional defect detection methods are difficult to meet the needs of actual production lines for high-precision and high-efficiency detection due to their reliance on a large amount of labeled data, weak generalization ability, and high cost. To solve the problem of defect detection in small and zero sample scenarios in these industries, improve detection sensitivity and localization accuracy, and enhance the model’s generalization ability to unknown defects, a unsupervised industrial image defect detection method based on autoencoder and Generative Adversarial Networks (GANs) is proposed. This study constructs an Multi-level Deep feature Adaptive fusion AutoEncoder (MDAAE) module, extracts multi-scale features through Pre-Trained Convolutional Neural Backbone Networks (PTCNBN), introduces Attention Mechanism (AM) to dynamically calculate feature weights, and achieves feature fusion and reconstruction. Meanwhile, the self-AM is fused to improve the GANs. The self-attention module efficiently captures long-range dependencies and generates an adversarial network training objective function to optimize the generator’s unsaturated loss. The results showed that the Area Under the Curve (AUC) of the Recall-Precision curve of the research method reached 93.6 ± 0.5%, and its F1-Score value exceeded 0.890 ± 0.003 in defect types such as scratches and dents. In practical applications, the inference time of the research method remained stable at 3.0 ± 0.2 GB of central processor memory, and the Fréchet Inception Distance (FID) value fully converged at the 2230th iteration, with a stable FID value of 3. The false alarm rate was only 8.6 ± 0.7% under strong light conditions. The proposed UIIDD method based on autoencoder and GANs had good robustness, generalization ability, reliability, and efficiency. This study effectively solves the problems of poor robustness, weak generalization ability, and high cost of traditional defect detection methods. Christina Thomas Brianna Johnson Emma M. Baillargeon Rosalind L. Heckman 10.1371/journal.pone.0346615 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Christina Thomas, Brianna Johnson, Emma M. Baillargeon, Rosalind L. Heckman</p> Stroke affects the sensorimotor control of the upper extremity, limiting functional movements which require coordination between the shoulder and distal joints. StartReact has been used to investigate motor planning, independent of motor initiation and execution, but it is unclear if observed deficits in motor planning at the shoulder are due to task requirements or stroke-related impairments. Our aim was to decouple these factors by studying motor planning of shoulder movement in participants who have not had a stroke. Participants performed unilateral shoulder abduction movements from two initial positions in response to auditory cues. Muscle activity was recorded from the sternocleidomastoid (SCM) muscles as an indicator of startReact. Middle deltoid (DELT) activity and shoulder abduction position were also recorded. We hypothesized that unilateral shoulder abduction could be triggered by a loud acoustic stimulus (LAS) used to study startReact. We further hypothesized that these LAS-triggered movements would be initiated at shorter onset latencies but otherwise would not differ in movement timing or kinematics compared to volitional movements as evidence of motor planning. We found a significantly higher probability of early SCM activity with LAS delivery, consistent with evidence of motor planning for unilateral shoulder abduction from both initial positions. Shoulder abduction onset, movement duration, and DELT onset were shorter and peak velocity was greater with LAS-triggered movement compared to voluntary movement for both initial positions. Differences in the displacement between LAS-triggered and voluntary movements depended on task training. Overall, our findings further knowledge of shoulder sensorimotor control and highlight challenges with using startReact to investigate stroke-related movement impairments. Alexandre Emond Carl Laflamme Martine Therrien Meijiang Liao Claudia Maios Audrey Labarre Pierre Drapeau J. Alex Parker 10.1371/journal.pone.0346613 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Alexandre Emond, Carl Laflamme, Martine Therrien, Meijiang Liao, Claudia Maios, Audrey Labarre, Pierre Drapeau, J. Alex Parker</p> Intronic hexanucleotide repeat expansions in the <i>C9orf72</i> gene represent the most common genetic cause of the neurodegenerative diseases amyotrophic lateral sclerosis (ALS) and frontotemporal dementia. This expansion decreases <i>C9orf72</i> expression in affected patients, indicating that loss of <i>C9orf72</i> function (LOF) acts as a pathogenic mechanism. Several models using <i>Danio rerio</i> (zebrafish) for <i>C9orf72</i> depletion have been developed to explore disease mechanisms and the consequences of <i>C9orf72</i> LOF. However, inconsistencies exist in reported phenotypes, and many have yet to be validated in stable germline ablation models. To address this, we created a zebrafish <i>C9orf72</i> knockout model using CRISPR/Cas9. The <i>C9orf72</i> LOF model demonstrates, in a generally dose-dependent manner, increased larval mortality, persistent growth reduction, and motor deficits. Additionally, homozygous <i>C9orf72</i> LOF larvae exhibited mild overbranching of spinal motoneurons. To identify potential therapeutic compounds, we performed a screen on an established <i>Caenorhabditis elegans</i> (<i>C. elegans</i>) <i>C9orf72</i> homologue (<i>alfa-1</i>) LOF model, identifying 12 compounds that enhanced motility, reduced neurodegeneration, and alleviated paralysis phenotypes. Motivated by the shared motor phenotype, 2 of those compounds were tested in our zebrafish <i>C9orf72</i> LOF model. Pizotifen malate was found to significantly improve motor deficits in <i>C9orf72</i> LOF zebrafish larvae. We introduce a novel zebrafish <i>C9orf72</i> knockout model that exhibits phenotypic differences from depletion models, providing a valuable tool for <i>in vivo C9orf72</i> research and ALS therapeutic validation. Furthermore, we identify pizotifen malate as a promising compound for further preclinical evaluation. Wanyun Liu Ping Huo Xiuming Zhou Dayan Xiong 10.1371/journal.pone.0346592 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Wanyun Liu, Ping Huo, Xiuming Zhou, Dayan Xiong</p> The water-soluble gadolinium fullerenes Gd@C₈₂-TEGs nanoparticles as a novel magnetic resonance imaging (MRI) contrast agent were fabricated by the metal fullerenes Gd@C₈₂ assembled with tetraethylene glycol (TEG). The loading Gd amount in Gd@C₈₂-TEGs nanoparticles was 8.0 wt%. The average particle size of water-soluble Gd@C₈₂-TEGs nanoparticles was 97 nm and the nanoparticles were uniformly spherical shape and had good dispersibility and no aggregation. The 97 nm spherical shape of Gd@C₈₂-TEG nanoparticles ensured high relaxivity. The proton relaxivity (<i>r</i>₁) and transverse relaxivity (<i>r</i>₂) were high up to 37.1 mM⁻¹·s⁻¹ and 64.9 mM⁻¹·s⁻¹, which greater than that of commercial Magnevist under the same conditions. The Gd@C₈₂-TEGs nanoparticles exhibited pronounced <i>T</i>₁-weighted MRI <i>in vitro</i>. The MRI signal-enhancing efficiency of Gd@C₈₂-TEGs nanoparticles was superior to that of gadolinium diethylenetriamine pentaacetate Gd-DTPA (Magnevist). The Gd@C₈₂-TEGs nanoparticles had no significant effect on cell metabolism and structure, and the survival rate of cells was more than 80%, which indicated that the as-prepared Gd@C₈₂-TEGs nanoparticles were no cytotoxicity. Kazuaki Naya Hideaki Sakuramoto 10.1371/journal.pone.0346585 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Kazuaki Naya, Hideaki Sakuramoto</p> Introduction <p>In Japan, end-of-life care in intensive care units (ICU) remains inconsistent and often suboptimal, contributing to variability in the quality of dying and death. This study aimed to develop a culturally appropriate nurse-led intervention program to improve the quality of dying and death in Japanese ICU.</p> Methods <p>Using a structured framework for intervention development, we conducted a systematic and scoping review to identify modifiable factors and effective strategies for end-of-life care in ICUs. Eight evidence-based strategies were synthesized into four core components: symptom management, multidisciplinary bedside conferences, family conferences, and end-of-life care. A preliminary intervention program was developed and evaluated through expert interviews and web-based surveys to assess its clarity, feasibility, and alignment with the Japanese healthcare system.</p> Results <p>Based on expert feedback, revisions were made to enhance the clarity, feasibility, and alignment with the Japanese healthcare system. Key improvements included initiating symptom management early upon ICU admission, allowing flexible scheduling of conferences, and incorporating structured tools and frameworks commonly used in Japan. Additionally, a ladder-based system was introduced to tailor the intervention intensity according to the patients’ clinical conditions.</p> Conclusion <p>The final nurse-led intervention program was designed to facilitate more consistent delivery of end-of-life care in the ICU regardless of individual providers’ knowledge or attitudes. This study demonstrates a rigorous and culturally adapted intervention development process that may serve as a model for improving end-of-life care in ICU in Japan and other healthcare systems.</p> Dhamindi Senadheera Krishantha Wisenthige 10.1371/journal.pone.0346571 2026-04-10T14:00:00Z 2026-04-10T14:00:00Z <p>by Dhamindi Senadheera, Krishantha Wisenthige</p> Rapid technological advancements have reshaped the global job market, emphasizing the importance of specialized competencies such as user interface (UI) and user experience (UX) design, alongside technical and interpersonal skills.. This study examines how UI/UX skills (UIUX), soft skills (SS), and technical skills (TS) influence the employability (EP) of IT undergraduates in Sri Lanka, addressing a notable gap in existing literature that often examines these competencies in isolation and predominantly within Western contexts. The current study offers a detailed examination of employability determinants in Sri Lanka’s IT sector by incorporating gender as a moderating factor and investigating the mediating roles of self-efficacy (SE) and proficiency levels (LP). The collection of data involved 345 IT undergraduates participating in structured surveys, which were subsequently analyzed using partial least squares structural equation modelling (PLS-SEM). The results demonstrate that gender significantly affects the relationship between soft skills and technical skills with employability, underscoring differences in the assessment of these competencies among different genders. Moreover, the degree of proficiency influences the connection between technical skills and employability, yet it does not play a significant mediating role in the relationship between soft skills and UI/UX employability. Self-efficacy has proven to be a significant mediator across various skill categories UI/UX, soft, and technical highlighting its essential function in converting competencies into career success. This work seeks to add to existing knowledge by tackling the main significant gap of examining the combined effect of UI/UX, soft, and technical skills on employability. This study contributes to the theoretical understanding of employability by presenting an integrated model that elucidates the complex interactions among skills, mediators, and gender within the Sri Lankan IT sector. The results provide actionable insights for educators, policymakers, and industry leaders, advocating for curriculum alignment with industry needs and the promotion of self-efficacy through mentorship and experiential learning.