PLOS ONE Alerts: New Articles

Correction: Air pollution in the places of Betula pendula growth and development changes the physicochemical properties and the main allergen content of its pollen

2026-06-17T14:00:00Z

by The PLOS One Staff

Correction: A treadmill training program in a gamified virtual reality environment combined with transcranial direct current stimulation in Parkinson’s Disease: Study protocol for a randomized controlled trial

2026-06-17T14:00:00Z

by Pere Bosch-Barceló, Carolina Climent-Sanz, Oriol Martínez-Navarro, Maria Masbernat-Almenara, Anni Pakarinen, Pradip K. Ghosh, Helena Fernández-Lago

Correction: A Preliminary proteomics-based assessment of biotic indicators in Central Mexican water bodies biotic indicators by proteomics in Mexican water bodies

2026-06-17T14:00:00Z

by Catalina E. Gardella-García, Eduardo Domínguez-de-la-Cruz, Gerardo Pérez-Ramírez, Randy E. David, Juan Enrique Chacón-Hernández, Sandra Cotino-Nájera, María de Lourdes Muñoz

Correction: Global learning opportunities within social innovation in health (GLOWS): A modified Delphi process to identify and pilot core competencies for learning

2026-06-17T14:00:00Z

by Emily Wallace, Yusha Tao, Ogechukwu B. Aribodor, Zixuan Zhu, Angelica Borbón, Beatrice Halpaap, Bertha M. Chakhame, Eunice C. Jacob, Fatema Ahmed, Joel Msafiri Francis, Komang G. Septiawan, Kovey Mawuli, Linet Mutisya, Marlita Putri Ekasari, Nwadiuto Okwuniru Azugo, Tina Fourie, Adriana S. Ruiz, Jackeline Alger, Abigail Ruth Mier, Weiming Tang, Gloria Aidoo-Frimpong, Jackline Nanono, Jesson James A. Montealto, Obidimma Ezezika, Per Kåks, Wenjie Shan, Jana Deborah Mier-Alpano, Gifty Marley, Elizabeth Chen, Joseph D. Tucker

Computer-aided diagnosis system for thoracic computed tomography of rib fractures in older emergency patients: A preliminary study

2026-06-17T14:00:00Z

by Shan Xiong, Wenze Wu, Sibin Liu, Jianmin Cheng, Bing Wan

The peculiarities of older individuals related to osteoporosis and hyperostosis may lead to a higher rate of misdiagnosis of rib fractures on computed tomography (CT) images in older than in middle-aged/young people when using radiologist-only reading. However, none of these studies on rib fracture computer-aided diagnostic (CAD) systems grouped patients by age or evaluated the value of using CAD in older patients. To address these gaps, we divided 1,012 blunt chest trauma emergency patients who underwent chest CT into middle-aged/young and older groups with a cutoff age of 60 years. CT images were read by six radiologists from three institutions (each with 7 years of experience in thoracic CT diagnosis) using two reading methods, radiologist-only and radiologist-CAD reading, to explore the value of a deep learning (DL)-based CAD system for detecting rib fractures in emergency older patients. The final findings of the independent panel consisting of two senior radiologists with or without a thoracic surgeon were set as the reference standard. The sensitivity was calculated by dividing the number of true positives by the overall number of fractures, as confirmed by an expert panel. The false positives per patient (FPPP) was calculated by dividing the number of false positives by the overall number of patients. Sensitivity and FPPP were used to evaluate the diagnostic efficiency. Sensitivity, FPPP, and reading time were compared between the two groups, as well as reading methods. The results showed the following: (1) Sensitivity for detecting fresh fractures using radiologist-only reading was lower in the older than in the middle-aged/young group (86.7% [95% confidence interval (CI): 86.3%, 91.7%] vs. 91.5% [95% CI: 89.9%, 92.9%], p < 0.05). With the assistance of the CAD system, the sensitivity increased in the older group to the same level as that in the middle-aged/young group using radiologist-only reading (92.5% [95% CI: 90.4%, 94.2%] vs. 91.5% [95% CI: 89.9%, 92.9%], p > 0.05). (2) The FPPP of fresh fractures with radiologist-only reading was higher in the older than in the middle-aged/young group (0.47 vs. 0.37, p < 0.05). With the assistance of the CAD system, the FPPP in the older group decreased to the same level as that in the middle-aged/young group when using radiologist-only or radiologist-CAD reading (0.37 vs. 0.37/0.39, p > 0.05). (3) The reading time of fresh fractures when using radiologist-only reading was longer in the older than in the middle-aged/young group (6.1 vs 5.4 min, p < 0.05). With the assistance of the CAD system, the reading time in the older group was reduced by approximately 36% (p < 0.05). We conclude that the efficiency of intermediate-level radiologists in diagnosing fresh rib fractures by radiologist-only reading in older emergency patients was lower than that in middle-aged/young patients. When a DL-based CAD system assists radiologists, the diagnostic efficiency of identifying fresh fractures in older patients improves to the same level as independent radiologist-only reading in middle-aged/young patients while reducing the reading time.

“The impact of COVID-19 on employee productivity and the future of remote work”

2026-06-17T14:00:00Z

by Sultan Alenazi, Jagannath Mohanty, Maheswaran Srinivasan, Durga Prasad Samontaray

Purpose

This paper explores the impact of the COVID-19 pandemic on employee productivity and the future of remote work beyond the pandemic years. Using data collected from 646 remote workers, we examined the influence of interpersonal relations, time management, stress, and skill development on productivity.

Design/methodology/approach

We validated our model using structural equation modelling (SEM), and the results revealed that the sudden shift to remote work had no significant negative impact on productivity.

Findings

The results of this study may encourage HR managers to expand remote work opportunities, thereby enhancing talent attraction and retention in a highly competitive job market.

Originality/value

Despite prevalent concerns about COVID-19 and the evolving nature of workplaces, employees perceived remote work as offering greater flexibility in task organization and the opportunity to create a healthier work-life balance. Furthermore, our findings suggest that HR managers should consider allowing remote work post-pandemic as a strategic aspect of workplace evolution.

Best-first search–based approach for mining top-k closed frequent itemsets from uncertain databases

2026-06-17T14:00:00Z

by Nguyen Le, Huy Vo, Thien Nguyen

Uncertain data mining has become critical due to data generated by sensor networks, RFID systems, and data integration platforms. Mining top-k closed frequent itemsets from uncertain databases is particularly challenging because probabilistic support evaluation is expensive and the search space grows exponentially. Most existing methods rely on depth-first search (DFS) traversal, which explores candidates in enumeration order and often discovers high-support patterns late, leading to weak pruning and costly closure verification. This paper proposes TUFCI, a best-first-search-based algorithm for mining top-k closed frequent itemsets from uncertain databases. TUFCI explores candidates in descending order of probabilistic support using a priority queue, enabling early discovery of strong patterns, rapid threshold elevation, and safe early termination. Support-ordered exploration also improves closure checking by prioritizing supersets most likely to violate the closure property, thereby reducing redundant superset examinations. Experimental results demonstrate that TUFCI significantly outperforms DFS-based approaches in runtime and reduces the number of closure checks, especially on dense datasets.

Robot-assisted reconstruction using ureteroureterostomy and Lich–Gregoir ureteral reimplantation for complicated duplex kidneys in children

2026-06-17T14:00:00Z

by Huazhang Liu, Chang Tao, Xiang Yan, Guangjie Chen, Guangping Zeng

Objective

This study aimed to evaluate the efficacy of robot-assisted reconstruction using end-to-side ureteroureterostomy (UU) and Lich‒Gregoir ureterovesical reimplantation (UR) for complicated duplex kidneys in children.

Methods

A retrospective study was conducted on pediatric patients who underwent combined robotic UU and Lich‒Gregoir UR between January 1, 2021, and January 1, 2024. The inclusion criterion was the presence of concurrent upper- and lower-pole ureteral pathologies. Surgical time, postoperative length of stay, pre- and postoperative anteroposterior diameter of the renal pelvis (APD), ureteral diameter (UD), renal function (RF) of the affected kidney, and complications were analyzed.

Results

In total, 12 patients presented with urinary tract infections (UTI, n = 9), incontinence (n = 2), and abdominal pain (n = 1). Upper-pole pathologies included ectopic ureters (10 cases) and ureteroceles (2 cases). Lower-pole pathologies comprised ureteral stricture (n = 4) and vesicoureteral reflux (VUR, n = 8). The median surgical time was 177.5 minutes (range: 140–205 minutes), and the median hospital stay was 5 days (range: 3–7 days). Postoperative complications included two cases of UTI, both managed conservatively. At a median follow-up of 19 months (range: 12–31 months), no anastomotic stricture, urinary leakage, or ureteral stump syndrome occurred. Postoperative voiding cystourethrogram (VCUG) revealed no VUR in any patient. Pre- and postoperative APD (22.92 ± 9.07 mm vs. 7.33 ± 5.03 mm, p < 0.001) and UD (11.08 ± 3.15 vs. 5.83 ± 2.41 mm, p < 0.001) differed significantly in the upper pole system, as did the lower pole APD (14.00 ± 6.25 vs. 5.25 ± 3.02 mm, p < 0.001) and UD (7.75 ± 2.26 vs. 4.75 ± 1.36 mm, p = 0.003). The RF of the affected moiety improved significantly (36.58 ± 4.66% vs. 42.75% ± 3.10%, p < 0.001).

Conclusions

Robot-assisted reconstruction using UU and Lich–Gregoir UR is a safe and effective approach for complex duplex kidneys requiring concurrent upper- and lower-tract reconstruction, demonstrating durable resolution of obstruction and reflux as well as functional preservation.

Spatiotemporal patterns of prevalence and mortality from respiratory infections and tuberculosis across Japan and its prefectures

2026-06-17T14:00:00Z

by Xiaohui Li, Gang Wu, Zhimin Ding

Background

Respiratory infections and tuberculosis (RIT) remain major contributors to global morbidity and mortality. In rapidly ageing societies, demographic shifts may decouple disease occurrence from fatal outcomes. Japan offers a representative setting to examine long-term spatiotemporal patterns of RIT burden in an advanced ageing context.

Methods

A population-based spatiotemporal analysis of Japan from 2010 to 2023 was conducted using standardized national and prefectural estimates. Annual RIT prevalence and deaths were examined by sex and age group. Long-term trends were quantified using estimated annual percentage change (EAPC) from log-linear models of rates, and changes in the etiological composition of RIT mortality were assessed by age and sex.

Results

National RIT prevalence fell from 31.40 million cases in 2010 to 27.52 million in 2023, and the prevalence rate decreased from 24,536.02 to 22,070.66 per 100,000 (EAPC −1.11). In 2023, prevalent cases were similar between females (13.95 million) and males (13.57 million). Adults aged 75 years and older increased from 2.47 million prevalent cases in 2010 to 3.28 million in 2023 despite declining rates. Total RIT deaths decreased from 104,048 in 2010–98,091 in 2023, while the death rate changed from 81.31 to 78.68 per 100,000 (EAPC 0.83). Mortality remained higher in males than females, with 61,683 versus 36,407 deaths in 2023, and was concentrated in adults aged 75 years and older (87,545 deaths), although their death rate declined from 629.40 to 429.91 per 100,000. Across prefectures, prevalence rates declined universally (−8.47% to −56.30%), whereas deaths increased in most prefectures (−10.74% to 153.64%), with the largest rises observed in Saitama (153.64%), Chiba (130.41%), and Osaka (63.79%). Etiology-specific patterns shifted, with Streptococcus pneumoniae declining from 28.9% to 20.4% of deaths, while Staphylococcus aureus rose from 12.2% to 19.0% and Legionella spp. from 8.6% to 11.5%, most notably among adults aged 75 years and older.

Conclusions

In ageing settings exemplified by Japan, declining RIT prevalence can coexist with persistent, older-adult–concentrated mortality, subnational inequality, and an evolving etiological profile. Age-focused care, prefecture-tailored prevention, and etiology-aware management may reduce avoidable deaths and geographic disparities.

A risk assessment indicator system for common diseases in children and adolescents

2026-06-17T14:00:00Z

by Yun Shao, Bohan Hu, Yuting Lu, Shuo Yu, Ji Liang

Background

Adolescence is a critical stage for healthy development. Currently, common diseases such as myopia, obesity, dental caries, and spinal curvature abnormalities are highly prevalent among children and adolescents, with an obvious trend of younger onset. These diseases are caused by the complex interaction of multi-dimensional factors. However, existing interventions are mostly limited to individual diseases, lacking systematic prevention and control tools. Therefore, there is an urgent need to construct a scientific evaluation index system for health-influencing factors.

Objective

Targeting the four key common diseases emphasized in China’s national health policies – myopia, obesity, dental caries, and spinal curvature abnormalities – among children and adolescents aged 7–19 years, this study constructed a multi-dimensional risk assessment indicator system to support evidence-based prevention and policy-making for this population.

Methods

Guided by the National Program of Action for Children’s Development in China (2021–2030) and the “Healthy China 2030” Planning Outline, a three-level indicator framework was initially formulated through literature research and expert meetings. The Delphi expert consultation method was adopted for two rounds of screening and optimization of indicators. Experts scored each indicator on a scale of 1–5 in terms of importance, feasibility, and sensitivity, with indicators excluded if their mean score was < 3.5 and coefficient of variation >0.3.

Results

The effective return rate of the two-round Delphi is 100.0%, the mean expert familiarity coefficient (Cs) was 0.83, and the mean judgment coefficient (Ca) was 0.93, and the expert authoritative coefficient (Cr) value is 0.88. In the second round of consultation, the importance coordination coefficient is 0.284, the feasibility coordination coefficient is 0.185, and the sensitivity coordination coefficient is 0.314, all of which are statistically significant (P < 0.001). This indicator system consists of a total of 55 three-level indicators.

Conclusion

Validated through two rounds of expert deliberation, the indicator system demonstrates sound scientific rigor. The preliminary development of a risk assessment indicator system for common diseases in children and adolescents can be used for the measurement of the level of factors affecting the health of common diseases in children and adolescents after its reliability and validity are verified in practical applications.

Unveiling the psychological network of work alienation among nursing interns: A resource conservation perspective and network analysis

2026-06-17T14:00:00Z

by Yang Guo, Xixi Huang, Chengguo Guan, Ruonan Wang, Jie Yao, Luying Yang, Sha Li

Background

Clinical internship is critical for nursing students, but heavy workload and emotional demands increase the risk of work alienation. Traditional linear models fail to capture complex interrelationships among psychological factors.

Objective

To apply psychological network analysis to explore the associative structure of work alienation in nursing interns, identifying central and bridge nodes to generate hypothesis‑generating intervention priorities.

Methods

A cross-sectional survey was employed. Nursing interns from four tertiary hospitals in the Guanzhong region of Shaanxi Province were recruited via convenience sampling from January to August 2025. Data were collected using the Nurse Work Alienation Scale, Compassion Fatigue Scale, Moral Distress Scale, Ethical Sensitivity Questionnaire for Nursing Students, and NASA Task Load Index. A total of 934 valid responses were obtained. A regularized partial correlation network model was estimated using the EBICglasso method (γ = 0.5). Node strength and bridge strength were calculated, and stability was assessed via bootstrap.

Results

Node strength analysis identified personal responsibility (1.19), burnout (1.18), and failure to maintain patient’s best interest (1.13) as the three most central nodes. Bridge strength analysis revealed secondary traumatic stress (STS) as the strongest bridge (0.43, 95% CI [0.31, 0.55]), followed by perceived workload (0.38) and self‑evaluation (0.38). Subgroup network comparisons showed no significant structural differences by gender, age, or education (all p > 0.05). Stability analysis confirmed good robustness for centrality estimates.

Conclusion

Psychological network analysis mapped the associative structure of work alienation, identifying personal responsibility, burnout, and STS as key hub and bridge nodes. These findings offer hypothesis‑generating targets for future interventions (e.g., trauma‑informed care, workload management, self‑efficacy enhancement), pending validation in longitudinal studies.

Source analysis and ecological risk assessment of potentially toxic elements in farmland soil around a mining area

2026-06-17T14:00:00Z

by Ying Hu, Jiantong Lu, Yan Gao, Xiaotang Ye, Chi Zhang, Jiankuan Li, Hewan Huang, Chenxi Li

In the context of the interplay between ecology, society, and economy, analyzing the characteristics of soil heavy metal pollution and constructing ecological security patterns have emerged as critical scientific issues that necessitate urgent attention for the advancement of high-quality agricultural development. This study focused on the farmland surrounding the Baiyun Mountain mining area in Nanyang, China, and involved the collection of 437 surface soil samples (0–20 cm) to analyze the spatial differentiation characteristics of nine heavy metal elements, including Ag, Cu, and Pb. An ecological risk assessment model was developed to evaluate the ecological risks posed by potentially toxic elements in the region, based on the theory of matter element extension. Additionally, the Positive Matrix Factorization (PMF) model was employed to analyze the sources of heavy metal pollutants. The results indicated that: (1) The average concentrations of Ag, Cu, Pb, Zn, Mo, Sb, Ba, As, and Hg were 0.06, 17.50, 22.72, 66.84, 1.15, 0.85, 426.39, 9.25, and 0.05 mg·kg^-1, respectively, with Zn, Mo, and Hg significantly exceeding the soil background values for Henan Province; (2) The ecological risk assessment of potentially toxic elements revealed that 93.82% of the samples were classified as clean, 5.49% as at mild risk, and 0.69% as at severe risk, with Hg identified as the primary ecological risk factor; (3) The primary sources of pollution can be categorized as follows: natural parent material sources (26.1%), mixed sources from transportation and mining development (25.8%), mixed sources resulting from pesticide use and mining emissions (19.8%), atmospheric deposition from fossil fuel combustion (15.1%), and sources from non-metallic mineral mining and building material industry (13.2%). This study provides a scientific basis for the prevention and control of soil pollution in farmland located in mining areas.

Retraction: Analysis of disease burden and future trends of ischemic heart disease in China and globally, 1990–2023

2026-06-17T14:00:00Z

by The PLOS One Editors

Expression of concern: Bioavailability of iron, zinc, phytate and phytase activity during soaking and germination of white sorghum varieties

2026-06-17T14:00:00Z

by The PLOS One Editors

Expression of Concern: Metabolic engineering of Bacillus subtilis with an endopolygalacturonase gene isolated from Pectobacterium. carotovorum; a plant pathogenic bacterial strain

2026-06-17T14:00:00Z

by The PLOS One Editors

Editorial note: Long non-coding RNA as a potential diagnostic biomarker in head and neck squamous cell carcinoma: A systematic review and meta-analysis

2026-06-17T14:00:00Z

by The PLOS One Editors

Expression of concern: Engineering Pseudomonas protegens Pf-5 for nitrogen fixation and its application to improve plant growth under nitrogen-deficient conditions

2026-06-17T14:00:00Z

by The PLOS One Editors

Retraction: Functional Study of Ectodysplasin-A Mutations Causing Non-Syndromic Tooth Agenesis

2026-06-17T14:00:00Z

by The PLOS One Editors

LXNet: A lightweight CNN for lung disease classification from Chest X-ray with XAI-based interpretability

2026-06-17T14:00:00Z

by Juiria Humayan, Md. Najmus Sakib Nahid, Amir Sohel, Md Alamgir Kabir, Md Shakhawat Hossain, Zahid Ullah, Mona Jamjoom

The diagnosis of lung diseases such as pneumonia and tuberculosis remains a major global health challenge, especially in resource-limited regions. Artificial Intelligence (AI) has shown strong potential in analyzing Chest X-Rays (CXR) for accurate and timely diagnosis, but most existing models are computationally heavy and lack interpretability, limiting their practical application. In this study, we present LXNet, a lightweight and explainable Convolutional Neural Network (CNN) for nine-class lung disease classification (Normal, Pneumonia, Higher Density, Lower Density, Obstructive Pulmonary Diseases, Degenerative Infectious Diseases, Encapsulated Lesions, Mediastinal Changes and Chest Changes). The model was evaluated on a diverse CXR dataset containing 6,743 images collected from a private imaging center (GRS Imagem, Brazil), enabling comprehensive multiclass assessment. LXNet contains only 0.35 million parameters and employs a no-pooling final block to preserve subtle diagnostic features while maintaining very low computational cost. Robustness was enhanced through adaptive Contrast Limited Adaptive Histogram Equalization (CLAHE), grayscale normalization and stratified class balancing. LXNet was benchmarked against pretrained CNNs (DenseNet201, ResNet50V2 and InceptionV3) under identical settings. Explainable AI (Grad-CAM, Score-CAM and LIME) provided meaningful visualizations. LXNet achieved 96.1% accuracy in 5-fold cross validation, outperforming the baselines (DenseNet201: 90.3%, InceptionV3: 88.9%) by 1–8%, with only 308 seconds of training on standard hardware. Statistical significance was confirmed using Wilcoxon signed-rank tests (p = 0.03125). These results demonstrate LXNet’s promising performance and interpretability; however, reduced external performance indicates limited generalizability and its clinical applicability requires further validation.

Mechanical properties of ECC connection plates in seamless Bridges

2026-06-17T14:00:00Z

by Ziwang Xiao, Lifeng Wang, Rikang Huang

Seamless bridges require high-performance connection systems due to the elimination of expansion devices. This study investigates the flexural performance of ECC connection plates (ECP) for seamless RC bridge decks using finite element analysis. A three-dimensional ABAQUS model was developed and validated against available experimental results from the literature. Parametric analyses were performed to evaluate the effects of ECC thickness, reinforcement ratio, concrete strength, and ECC strength. The results show that ECP significantly improves flexural capacity and ductility compared with conventional RC connection plates. Under the same reinforcement ratio, the ultimate load and ductility coefficient increased by 35.1% and 31.3%, respectively. Increasing ECC thickness and ECC strength enhances both load-bearing capacity and deformation ability, while a higher reinforcement ratio increases ultimate load but reduces tensile strain capacity. A theoretical formula for predicting the flexural bearing capacity of ECP was derived and verified using numerical results. The findings provide a basis for the design and optimization of ECP in seamless bridge decks.

Use of naloxone by EMS for opioid-associated out-of-hospital cardiac arrest and associated patient-centered outcomes: A systematic review

2026-06-17T14:00:00Z

by Hania Siddiqui, Khadija Brouillette, Chris Walsh, Sheldon Cheskes, Ian R. Drennan, Charles D.G. Keown-Stoneman, Steve Lin, Rohit Mohindra

Objective

As opioid-related fatalities continue to climb, it is imperative to advance our understanding of the management of life-threatening opioid emergencies, including cardiac arrest. Emergency medical services (EMS) administered naloxone reverses critical respiratory depression within minutes; however, the role of naloxone in cases of opioid-associated cardiac arrest (OA-OHCA) is unknown. This systematic review sought to summarize patient outcomes following EMS-administered naloxone in OA-OHCA cases.

Methods

Following PRISMA guidelines, a systematic search was conducted in OVID Medline, Embase, and Cochrane from database inception to December 2024. Original, peer-reviewed studies examining patients with OA-OHCA who were given naloxone by EMS were included. Two independent reviewers screened titles/abstracts and full-texts in Covidence based on predetermined inclusion criteria. Relevant data points were extracted, and a risk of bias assessment was conducted for included studies. No meta-analysis was performed due to heterogeneity across the included studies.

Results

The literature search yielded 4814 articles, of which 8 studies met eligibility and were included. Seven of the included studies were retrospective cohort studies conducted in the United States. The eighth included study was a prospective cohort study conducted in Denmark. The total sample size for drug-related OHCA patients was 1294 (range 16–471) from all the included studies. Risk of bias was assessed to be low to moderate in seven studies and serious in one study. A minority of patients achieved return of spontaneous circulation (ROSC), with ROSC ranging from 4.3% to 50%. Survival to hospital admission ranged from 11.1% to 55%, while survival to hospital discharge ranged from 0% to 20.4%.

Conclusions

There are a limited number of studies assessing the use of naloxone in patients who present in opioid-associated out-of-hospital cardiac arrest (OA-OHCA). Further research is needed to evaluate the effectiveness of naloxone in this patient population.

Factors influencing perceived importance of haemodialysis adherence among end stage kidney failure patients in tertiary care centres in Nepal

2026-06-17T14:00:00Z

by Pramita Shrestha, Anisha Koirala, Prajwal Satyal, Ashish Mani Bhurtel, Biraj Man Karmacharya

Background

Chronic Kidney Failure is a significant global public health concern requiring kidney replacement therapy such as dialysis. Perception of the importance of adhering to dialysis helps to determine how patients interpret and interact with the influencing attitude, thoughts and behaviours towards adhering to dialysis. This study aimed to assess the perception of the importance of adherence to haemodialysis and its associated factors among end-stage Kidney failure patients in tertiary care centres in Nepal.

Methods

This was a cross-sectional study conducted from May to August 2025 in two tertiary care centres in Nepal that included patients undergoing hemodialysis aged 18 years and above. The outcome variable was perception of the importance of adherence to dialysis and was measured using The End Stage Renal Disease Adherence Questionnaire (ESRD-AQ). The independent variables were socio-demographics, dialysis-related characteristics and accessibility factors.

Results

Among 283 hemodialysis patients in the study, their mean age was 50.6 years with higher prevalence of good perception (91%) among single [APR (adjusted prevalence ratio):1.12; 95% CI (confidence interval): 1.03–1.21)] and parents accompanying patients (APR:1.14; 95% CI:1.01–1.28) compared to married, and non-parent accompanying patients respectively.

Conclusion

The study showed good perception of hemodialysis adherence, especially among singles and those accompanied by their parents.

Impact of the FTO rs9939609 risk allele on subcutaneous adipose tissue fatty acid composition in adults with obesity class 2 and 3

2026-06-17T14:00:00Z

by Ingrid Løvold Mostad, Valdemar Grill, Sissel Skarra, Ann Kristin Hjelle de Soysa, Barbara Fielding

The FTO rs9939609 risk allele is linked to risk of obesity. Whether causality involves fatty acid (FA) metabolism remains to be fully investigated in adults with obesity. We tested for associations of the risk allele with the FA composition of android and gynoid subcutaneous adipose tissue. We recruited 95 participants with obesity class 2 and 3 and without diabetes, median BMI 42.8 (25^th, 75^th percentiles: 39.5, 46.5) kg/m². Participants carried no (TT, n = 33), one (AT, n = 31), or two (AA, n = 31) copies of the FTO risk allele. Biopsies were obtained by aspiration and total FA composition determined by gas chromatography-mass spectrometry (GC-MS). In the cohort overall, there were no significant genotype associations with any single FA. In males with the TT allele, mass of oleic acid (18:1n-9) in the gynoid depot was higher compared with the AT allele when corrected for depot size. We interpret these findings with caution due to the small numbers of males with the TT genotype. Disregarding genotype, in the cohort overall, proportions of saturated FAs were higher, and proportions of monounsaturated FAs lower in android versus gynoid adipose tissue, confirming previous studies. We found previously unreported sex-related differences in FA composition (weight %) and content (weight % corrected for depot mass). Our findings on FTO genotype are generally negative; observations to the contrary require confirmation as does the non-genetic and novel results on sex-related differences.

Pyridoxine requirement of Pacific white shrimp (Penaeus vannamei) fed soybean meal based diet

2026-06-17T14:00:00Z

by Han-Se Kim, Yeonji Lee, Mirasha Hasanthi, Kyeong-Jun Lee

This study aimed to determine the dietary pyridoxine requirement of Pacific white shrimp (Penaeus vannamei) fed a soybean meal–based diet. Seven experimental diets were prepared with graded pyridoxine supplementation at 0, 25, 50, 75, 100, 125, and 150 mg/kg diet (Con, P25, P50, P75, P100, P125, and P150, respectively). An additional negative control diet (Con⁻) was formulated by adding 0.4% tetracycline hydrochloride to verify microbial synthesis of pyridoxine. Juvenile shrimp (initial weight: 0.38 g) were randomly assigned to eight diets with quadruplicate tanks and fed the diets for 45 days. Growth performance and feed utilization were increased with dietary pyridoxine supplementation up to P75, whereas higher supplementation levels resulted in reduced responses (P < 0.001). Hepatopancreas pyridoxine concentration was gradually increased with increment in dietary pyridoxine levels (P < 0.001), reaching a plateau from P75 to P150, and remained lower in Con⁻ group than in Con group. Non-specific immune response, including lysozyme, anti-protease and nitroblue tetrazolium activities and antioxidant capacities including superoxide dismutase and glutathione peroxidase were significantly increased by dietary pyridoxine supplementation (P < 0.05). Digestive enzyme activities, intestinal morphological indices, and hepatopancreatic F- and B-cell prevalence were also positively influenced by dietary pyridoxine supplementation (P < 0.05). Gene expression analysis showed increased transcription of cystathionine-γ-lyase, cystathionine-β-synthase, pyridoxal kinase, crustin, and penaeidine in response to pyridoxine supplementation. Based on a broken-line regression analysis of weight gain, the dietary pyridoxine requirement was estimated to be 69.0 mg/kg diet.

Prevalence and risk factors of adverse birth outcomes in Bangladesh: Insight from a nationwide survey

2026-06-17T14:00:00Z

by Ahadul Hassan Bhuiyan Konok, Md. Shahadoth Hossain, Md. Hafizul Islam

Background

Adverse birth outcomes are significant public health concern in Bangladesh and can severely affect the health and wellbeing of children in later life. This study aimed to assess the prevalence of adverse birth outcomes (i.e., stillbirth, preterm birth, low birth weight (LBW), neonatal death) and identify the associated factors among the Bangladeshi population.

Methods

The study utilized nationally representative data from the Bangladesh Demographic and Health Survey (BDHS) to analyze index pregnancy outcomes for 10,254 ever-married women. The prevalence and associated factors of both composite and individual adverse outcomes were determined using appropriate statistical procedures.

Results

The findings indicate that 14.3% of pregnancies resulted in LBW, while 8.9% resulted in preterm birth, followed by stillbirths (1.3%) and neonatal deaths (1.3%). Overall, 14.2% of births were associated with at least one adverse outcome. Household wealth index, place of delivery, twin births, maternal desire, and regional factors were found to be associated with LBW. Factors affecting preterm birth included cesarean section delivery, wealth index, twin births and maternal desire to have children. Regarding stillbirths, associations were found with the cesarean section delivery, and twin births. For neonatal death, factors associated included cesarean section delivery, twin birth, and maternal desire. Lastly, the composite score of adverse birth outcomes was associated with wealth index, history of terminated pregnancies, place of delivery, decision-making autonomy, region, twin births, and maternal desire.

Conclusion

One in seven births in Bangladesh involved at least one adverse outcome, with LBW being the most prevalent. Socioeconomic disadvantage and limited women’s decision-making autonomy were consistently associated with adverse outcomes. Policies should prioritize equity-oriented maternal care, strengthen women’s autonomy, and ensure appropriate use of obstetric interventions.

Adverse events following HPV vaccine reported to the Vaccine Adverse Event Reporting System

2026-06-17T14:00:00Z

by Siqi Zhang, Yu Li, Miaomiao Liu, Jiajia Yang, Xiong Wang, Mingshan Wang

Background

Vaccination against high-risk HPV types is a key preventive measure. However, concerns regarding vaccine safety may hinder vaccination efforts. This study aims to evaluate adverse events (AEs) reported in the Vaccine Adverse Event Reporting System (VAERS) following HPV vaccination from 2006 to 2024, providing insights into its safety profile.

Methods

We analyzed VAERS data, a spontaneous reporting system containing de-identified AE reports. Four disproportionality analyses (ROR, PRR, BCPNN, and MGPS) were applied, and adverse event signals were defined only when the positive criteria were simultaneously met across all four methods. Statistical analyses were performed using R software and Microsoft Excel, with a significance threshold of p < 0.05.

Results

A total of 77,909 HPV vaccine-related AE reports were analyzed, with 68.4% involving females and 48.7% affecting individuals under 18. Serious AEs accounted for 11,659 reports, with headache and fatigue being the most common. Syncope was the most frequent signal, while postural orthostatic tachycardia syndrome (POTS) exhibited the strongest signal strength. Approximately 90% of AEs occurred within 30 days post-vaccination. Among vaccine types, HPV4 had the highest number of reports, and intramuscular injection was the most common administration route.

Conclusion

This study offers an updated pharmacovigilance assessment of adverse events reported following HPV vaccination, highlighting reported patterns and statistical signals that may warrant further investigation.

Unmasking factors affecting sleep pattern disturbances among patients undergoing hemodialysis: A cross-sectional study

2026-06-17T14:00:00Z

by Hala Sanad, Khaldoon Al-Roomi, Zahra Abdlmjeed, Mariam Ebrahim, Omar Al Omari, Rasha Eweida, Mohamed Elsehrawy, Khulood Alasfoor, Yusuf Altahoo, Eshrak Hashem, Ahmed El-Monshed, Magda Bayoumi

Background

The number of patients on hemodialysis is steadily increasing in Gulf Arab countries, including Bahrain. Such treatment modality has a negative impact on the quality of life, particularly sleep quality. This study aimed to assess the factors affecting the sleep pattern disturbances of hemodialysis patients in Bahrain.

Materials and Methods

A cross-sectional design was employed. A convenience sample of 174 patients was recruited to the study from one of the main dialysis centers in Bahrain. Data was obtained via the Pittsburgh Sleep Quality Index questionnaire. Both univariate and multivariate analyses were used. A p value of less than 0.05 was considered statistically significant.

Results

Most of the patients had poor sleep patterns (91%). It would appear that the main contributing factors are older age (p=0.009), self-rated health (p=0.001), anemia (p=0.002), excessive weight gain, and pain symptoms after dialysis session (p=0.001, p=0.001 respectively) and taking medications for sleep (p=0.016).

Conclusion

There is an extremely high level of poor sleep quality among patients on hemodialysis. The contributing factors are multifactorial. There is an urgent need to include sleep assessment, mental health screening, and psychosocial support education into the routine nephrology care program.

A semantic segmentation model to predict subcellular glycogen localization using transmission electron microscopy images

2026-06-17T14:00:00Z

by Anders A. Hansen, Jacob M. Egebjerg, Kristian Solem, Kristoffer J. Kolnes, Daniel Wüstner, Jørgen F. P. Wojtaszewski, Jørgen Jensen, Joachim Nielsen

Transmission electron microscopy (TEM) is the gold standard for assessing subcellular glycogen localization in skeletal muscle fibres, but conventional manual analysis is extremely time-consuming and limits large-scale studies. Here, we developed and validated a deep learning–based semantic segmentation approach to automate quantification of glycogen particles across defined subcellular compartments in human skeletal muscle. Skeletal muscle biopsies were obtained from seven healthy men under conditions of normal, depleted, and supercompensated glycogen content. TEM images were acquired from myofibrillar and subsarcolemmal regions and manually annotated to train two complementary attention U-Net models: a region model identifying subcellular structures (intermyofibrillar space, intramyofibrillar regions including A-band, I-band and Z-disc, and mitochondria) and a glycogen model detecting individual glycogen particles. Combining the two models enabled estimation of compartment-specific glycogen areal densities. The model’s outcome was evaluated against manual point-counting. At the fibre level, estimates based on 10–12 images per region achieved biases below 15% and coefficient of variation below 26% for all compartments. Importantly, model-derived total glycogen volume density showed strong concordance with biochemically determined muscle glycogen content across biopsies. In conclusion, this validated semantic segmentation workflow provides an objective and highly time-efficient tool for quantifying subcellular glycogen distribution in skeletal muscle. The model substantially reduces analysis time and enables high-throughput investigations of compartmentalized glycogen metabolism, with model weights and code made openly available.

Evaluating the knowledge of stroke management among the non-neurological healthcare professionals in an underdeveloped county in Southwestern China

2026-06-17T14:00:00Z

by Xia Huang, Yuanbin Zhao, Shiquan Wang, Chao Lin, Li Xie, Ping Li, Xilin Liu, Zihan He, Lili Yang

Objective

This study aims to investigate the knowledge of stroke management among non-neurological healthcare professionals (HCPs) in an underdeveloped county in western China.

Methods

The study proceeded in two phases. First, the Acute Stroke Management Questionnaire (ASMaQ) underwent a systematic intercultural adaptation into Chinese, followed by an evaluation of its psychometric properties. Second, a cross‑sectional survey using the adapted Chinese ASMaQ was administered to non‑neurological HCPs working in an underdeveloped county in southwestern China. A convenience sampling method was used in the recruitment. Demographic information, including age, gender, years of service, job position (doctor/nurse), department, professional level, medical facility level (comprehensive hospital/noncomprehensive medical facility), and whether the participant had a neurologist partner or not during routine practice, was collected. The internal consistency was then measured with Cronbach’s α. Further statistical analyses were conducted to identify potential influencing factors of the ASMaQ score.

Results

After a standardized intercultural adaptation and evaluation process, a reliable localized Chinese version of ASMaQ was obtained, with an overall Cronbach’s α value of 0.77. A total of 252 HCPs completed the questionnaires, and 225 qualified questionnaires were included in the statistical analysis. The results revealed that the rate of good performance of overall ASMaQ among non-neurological HCPs was 69.4%. For the three subscales of ASMaQ, the rates of good performance for general stroke knowledge (GSK), hyperacute stroke management (HSM), and advanced stroke management (ASM) were 73.3%, 64.7%, and 70.1%, respectively. Furthermore, we found that the factors influencing the overall ASMaQ score were primarily gender, job position, medical facility level, and with/without neurologist partners. Specifically, females performed worse than males did (106.7 ± 7.7 vs. 110 ± 8.1; P = 0.003), nurses performed worse than doctors did (106.3 ± 7.6 vs. 110.0 ± 7.9; P < 0.001), the HCPs in noncomprehensive medical facilities performed worse than those in comprehensive hospitals did (105.2 ± 9.3 vs. 108.5 ± 7.3; P = 0.02), and the HCPs without neurologist partner in the routine clinical practise performed worse than those with (106.1 ± 8.1 vs 109 ± 7.5, P = 0.005). Multiple regression analysis revealed that the job position and the level of medical facility were the independent influencing factors for the total ASMaQ score (P < 0.001).

Conclusion

The Chinese version of ASMaQ comprehensively assesses the understanding of stroke management knowledge among HCPs. This study reflected the lack of stroke management knowledge among non-neurological HCPs in underdeveloped western regions of China for the first time and revealed that nurses and HCPs in noncomprehensive medical facilities were more likely to have insufficient knowledge of stroke management. Strengthening their training will significantly help improve stroke treatment rates, thereby reducing the burden of stroke-related morbidity and mortality.

Factors affecting well-being among retired older adults: A protocol for an umbrella review

2026-06-17T14:00:00Z

by Yasin M. Yasin, Areej Al-Hamad, Kateryna Metersky, Emily Read, Richelle Witherspoon

Background

As global populations age, retirement has emerged as a critical life transition influencing well-being across physical, mental, social, financial, and spiritual domains. Although numerous systematic reviews have examined aspects of well-being in retirement, the evidence remains fragmented, with limited integration across domains. No umbrella review has comprehensively synthesized determinants and interventions influencing multidimensional well-being among retired older adults.

Methods

This protocol describes an umbrella review that will synthesize evidence from systematic reviews examining factors and policy, programmatic, community-based, or other supportive efforts associated with physical, mental, social, financial, and spiritual well-being among retired older adults. The review follows Joanna Briggs Institute (JBI) methodology for umbrella reviews and is reported in accordance with PRISMA-P guidance. The search strategy was developed in consultation with a knowledge synthesis librarian and peer reviewed using the PRESS guidelines. Database searches were conducted in MEDLINE (Ovid), CINAHL, PsycINFO, Scopus, and the Cochrane Database of Systematic Reviews for articles published from 2015 onward. Backward and forward citation searching will be undertaken. Two reviewers will independently screen records, extract data, and appraise methodological quality using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Findings will be synthesized narratively. This protocol has been registered with PROSPERO (CRD420251158970).

Discussion

This umbrella review will provide an integrated, high-level synthesis of existing evidence on well-being in retirement, informing future research, policy, and practice aimed at supporting holistic and equitable aging.