PLOS ONE Alerts: New Articles

Impact of socioeconomic, demographic, maternal, infant and healthcare factors on early initiation of breastfeeding in Bangladesh: Evidence from Bangladesh demographic health survey (BDHS) 2022 data

2026-07-10T14:00:00Z

by Nihar Ranjan Sikder, Bijoy Rajbongshi, Monir Hosen, Md. Mohibul Nasir Sopon, Afsana Mimi

Background

Introducing an infant to the breast within an hour of birth is known as early initiation of breastfeeding (EIBF). Early initiation of breastfeeding (EIBF) was measured using BDHS 2022 data and defined as initiation of breastfeeding within one hour of birth, based on maternal self-report of the time elapsed between delivery and first breastfeeding. Using maternal self-reported timing of first breastfeeding from the Bangladesh Demographic and Health Survey (BDHS) 2022, this study examined factors associated with EIBF among mothers in Bangladesh.

Methods

Data from 4,758 women who were fertile and had given birth were included in the study. To investigate the prevalence of EIBF and its association with different factors (socioeconomic, demographic, maternal, infant, and healthcare-related), descriptive analysis, and bivariate analysis using Pearson chi-square tests were carried out. Significant EIBF factors were found using binary logistic regression analysis.

Results

Skin-to-skin contact within one hour of birth was significantly associated with higher odds of EIBF (OR = 1.62; 95% CI: 1.39–1.89). Cesarean delivery was associated with substantially lower odds of EIBF (OR = 0.40; 95% CI: 0.33–0.49). Compared with home deliveries, births in government facilities (OR = 0.58; 95% CI: 0.47–0.71) and private/NGO facilities (OR = 0.53; 95% CI: 0.42–0.66) were associated with reduced likelihood of EIBF. Significant regional variation in EIBF was observed across administrative divisions. Maternal age, education, and household wealth index were not consistently associated with EIBF after adjustment. Based on the univariate analysis, the prevalence of EIBF among mothers in Bangladesh is 63.3%. The 95% Confidence Interval for this prevalence is (61.9% – 64.7%).

Conclusion

The significance of skin-to-skin contact for EIBF in Bangladesh is demonstrated in this study. The results indicate the necessity of focused initiatives to support EIBF, especially in medical settings and after cesarean deliveries. To understand the geographical differences in EIBF rates and create strategies to deal with them, more investigation is required. These discoveries can influence practice and policy to raise EIBF rates among Bangladesh’s varied demographics, improving the health of mothers and their offspring in the process.

Physical activity and quality of life in children: Findings from the Health Oriented Pedagogical Project (HOPP)

2026-07-10T14:00:00Z

by Rein Magnus Jensen, Asgeir Mamen, Christoffer Wang, Per Morten Fredriksen

Purpose

The purpose of this study was to examine the associations between a 5-year school-based physical activity (PA) intervention and quality of life (QoL) in children aged 6–12 years.

Methods

Data were collected through the Health Oriented Pedagogical Project (HOPP), a longitudinal study conducted in Norway. HOPP involved children and their parents from nine elementary schools (n = 2,140 children and 1,639 parents completed the QoL-questionnaire). Seven schools received the intervention (an additional 225 minutes of physical activity per week), while two schools served as controls following the standard curriculum. QoL was measured using the Inventory of Life Quality in Children and Adolescents (ILC), and physical activity (PA) was assessed using accelerometers. Covariates included father’s education level as a proxy for socioeconomic status (SES) and children’s waist-to-height ratio (WHtR).

Results

The analysis revealed a significant positive association between MVPA and QoL (β = 0.008, p < 0.001), although the effect size was small. SES was significantly associated with QoL in intervention schools (β = 0.249, p < 0.001), while WHtR was negatively associated with QoL in both groups, with a stronger association in control schools (β = −4.344, p = 0.010). The control schools exhibited higher QoL scores than the intervention schools, with an average 0.5-point advantage (β = 0.458, p < 0.001), likely reflecting underlying SES differences.

Conclusion

This study highlights the complex interplay between MVPA, SES, WHtR, and QoL in children. While MVPA was associated with better QoL, these associations varied according to factors such as age, SES, and WHtR, with no significant association observed for sex. The findings suggest that sustained and varied physical engagement in school settings may be relevant for children’s QoL. Moreover, school-based initiatives should consider multiple individual and environmental factors, particularly SES and physical health metrics, when interpreting or targeting QoL-related outcomes.

Trial registration

The study is registered at ClinicalTrials.gov (Identifier: NCT02495714). The trial was retrospectively registered on June 20, 2015. Baseline data collection was initiated in mid-January 2015.

Clinico-epidemiological insights and treatment practices of bovine lumpy skin disease in Bangladesh

2026-07-10T14:00:00Z

by Md. Khalid Hasan Sumon, Sumya Binte Salam, Jesmin Sultana, Sharmin Aqter Rony, Farzana Yeasmin, AKM Anisur Rahman, Md. Amimul Ehsan, Md. Aminul Islam

Background

Lumpy skin disease (LSD) is an emerging viral disease of cattle in Bangladesh, first reported in 2019. Given the critical role of veterinarians in disease detection, management, and control, it is essential to evaluate their knowledge, attitudes, and practices (KAP) regarding the clinical and epidemiological aspects of LSD and its treatment strategies.

Methods

A cross-sectional survey was conducted among early-career veterinarians using a cluster random sampling technique to assess epidemiological insights and clinical practices regarding the LSD outbreak in the field.

Results

All veterinary practitioners were aware of LSD, and 83.67% had previously managed LSD cases. Approximately 92% of cases of LSD are diagnosed clinically, primarily by observing circumscribed skin nodules, either alone or with other characteristic lesions. Nearly 69% considered clinical signs alone sufficient for diagnosis, although 73.62% reported diagnostic confusion with other diseases, including cowpox (29%) and papillomatosis (21%). Various treatment strategies were reported, with 43.22% of veterinarians supporting the use of antibiotics, and 60.5% using antibiotics in combination with other drugs. Notably, 62.06% recognized the potential for antibiotic resistance due to frequent use during LSD treatment. While 55.78% observed no drug-related side effects, 81.16% acknowledged occasional adverse effects. Regarding epidemiological perceptions, 85.56% believed that LSD affects cattle of all ages, 94.67% associated it with both sexes, and 67.03% reported no breed predisposition. Most (75.28%) linked disease occurrence to the hot and humid season. Perceived modes of transmission included mechanical transmission by arthropod vectors (33.69%), direct contact (22.19%), and a combination of both (16.84%).

Conclusion

Bangladeshi veterinarians demonstrated sound knowledge, positive attitudes, and practical experience with LSD that aligns with current global scientific understanding. However, gaps remain in differential diagnosis and antimicrobial stewardship, warranting targeted training and policy interventions to address these needs.

Assessment of cognitive performance and fatigability in elite athletes: Short and portable protocols for field monitoring under hypoxia

2026-07-10T14:00:00Z

by Giorgio Varesco, Nicolas Bourrel, François Bieuzen, Guido Simonelli

Purpose

This study aimed to evaluate whether short (~15 min) cognitive protocols can detect fatigability in normoxia versus normobaric hypoxia in elite youth athletes, using tasks directly transferable to the field.

Methods

Elite youth mogul skiers (18 ± 2 y) completed two studies. In Study I, 17 athletes (7 women) performed a cognitive test after a repeated tuck-jump protocol designed to mimic mid-training physical demands under two conditions in fixed order: sham normoxia (simulated 200 m) and normobaric hypoxia (3500 m, blood saturation ~88%). In Study II, 16 athletes (6 women) performed the same cognitive test without the jump task, with conditions randomized. In both studies, response time and accuracy during a 10-min color Multisource Interference Task (cMSIT) were used to assess cognitive performance, and a 3-min Psychomotor Vigilance Task (PVT) was administered before and after the cMSIT to quantify fatigability. Cognitive tests were performed on portable tablet devices.

Results

After adjusting for baseline cognitive performance, cMSIT response time was greater in hypoxia than in normoxia in both Study I (10 ± 2%, p = 0.004) and Study II (4 ± 1%, p < 0.001). Accuracy remained high and similar across conditions in both studies (Study I: 96 ± 3%; Study II: 96 ± 0.5%; p > 0.09). In Study I, PVT response time increased only in hypoxia, from 363 ± 74 ms to 375 ± 89 ms (p = 0.021), and lapses increased from 1 ± 0.5 to 3 ± 2.5 (p < 0.001), whereas lapses remained unchanged in normoxia and in Study II (p > 0.82). In Study I, jump task performance showed a condition×set interaction (p = 0.048), with lower performance in the third set in hypoxia (19806 ± 2464 N·s) than in normoxia (20130 ± 3016 N·s; p = 0.012).

Conclusions

In elite youth athletes, hypoxemia reduces cognitive performance and could lead to increased fatigability. Importantly, hypoxia-related impairments are detectable with short portable cognitive assessments, which are promising tools for field monitoring, particularly when tasks combines cognitive and physical demands.

Correction: Assessing body position through experimental cremation: A pilot study using colorimetry and FTIR-ATR analyses

2026-07-10T14:00:00Z

by Paula Becerra Fuello, Javier Lescure, Aaron Lackinger, María Sedeño Ráez, Jesús Gámiz Caro, Gonzalo Aranda Jiménez

Correction: Do we still need a canary in the coal mine for laboratory animal facilities? A systematic review of environmental health monitoring versus soiled bedding sentinels

2026-07-10T14:00:00Z

by Megan R. LaFollette, Caroline S. Clement, Kerith R. Luchins, Christopher A. Manuel, Patricia L. Foley, Wai H. Hanson, Christina Pettan-Brewer, Caroline B. Winn, Joseph P. Garner

Leadership, teamwork and work outcomes in healthcare: A test of a model

2026-07-10T14:00:00Z

by Elaine R. Neiva, Ricardo S. S. Durães, Gardênia da Silva Abbad, Andreas Xyrichis

Effective teamwork in healthcare improves patient outcomes, staff well-being, and service delivery. To enhance these benefits, NHS teams should implement targeted leadership training, routinely assess and clarify roles to reduce ambiguity, and encourage staff participation in decision-making to boost autonomy. Researchers analysed 2022 and 2023 NHS Staff Survey data using Structural Equation Modelling. Main findings: (1) Effective leadership boosts teamwork and, in turn, engagement and well-being; (2) Teamwork can raise role ambiguity and lessen autonomy, leading to stress; (3) Leadership is key to managing these issues. Thus, boosting autonomy and reducing ambiguity support better team performance and staff well-being. The study highlights the need for leadership programmes to strengthen team dynamics and reduce uncertainty.

Dual paths of information behavioral choice influenced by information and emotion: The moderating effect of user credibility

2026-07-10T14:00:00Z

by Na Wang, Yaming Zhang, Yaya Hamadou Koura

In public opinion events, social media is often used as an important channel for the public to collect, process, and share information, and the topics and information on social media stimulates people to behave in creating related contents. This study integrates the elaboration likelihood model (ELM) to examine how information topics (central cue) and emotional responses (peripheral cue) shape user information behavior (likes, comments, forwards), and how user credibility moderates these effects. 56,663 Weibo posts (August 22 to September 5, 2023) about “Japan’s announcement of nuclear contaminated water discharge” were used for empirical analysis. Topics were identified via Latent Dirichlet Allocation (LDA), yielding four categories: Japanese aquatic products trade (Topic 1, 1.850%), seawater blackening (Topic 2, 8.822%), radioactivity exceedance (Topic 3, 13.286%), and global impact (Topic 4, 76.043%). Seven emotions were scored using the Dalian University of Technology affective lexicon. User credibility was coded from verification type. Baseline regression controlling for richness, mention, hashtags, URL, and text length showed that information topics significantly increased likes (β range: 0.164 to 0.333, p < 0.001), comments (β range: 0.063 to 0.138, p < 0.001), and forwards (β range: 0.083 to 0.156, p < 0.001), with the largest effects on likes. For emotions, anger, disgust, good and surprise positively influenced information behaviors (β range: 0.004 to 0.060, p < 0.01 to p < 0.001), while sadness, happy and fear showed negative or non‑significant effects. User credibility positively moderated all these relationships, with interaction β values ranging from 0.010 to 0.066 for topics and from 0.006 to 0.040 for emotions. Likes were the most influenced behavior, followed by forwards, then comments. The study demonstrates that information topics and emotions, moderated by user credibility, drive distinct information behaviors. Authorities should leverage high‑credibility users, highlight impactful topics, and monitor emotional tones, especially negative ones, to guide public opinion effectively.

Evolutionary patterns of the mitochondrial control region in vertebrates: A large-scale comparative analysis

2026-07-10T14:00:00Z

by Mauricio Ochoa Capera, Natalia S. Medina, Paula Montaña-Lozano, Manuela Moreno-Carmona, Antonio Baeza, Carlos Prada-Quiroga

The mitochondrial control region (CR) is the largest non-coding region in the vertebrate mitogenome and contains essential elements for replication and transcription. Despite its functional relevance, its evolutionary dynamics remain poorly understood. Here, we analyzed 5,235 complete vertebrate CRs spanning 11 classes to investigate how conserved sequences blocks (CSBs) and Extended Termination-Associated sequences (ETAS) shaped CR evolution. We hypothesized that CR length is positively associated with repeat accumulation, with tetrapods exhibiting longer and more complex CRs than fishes, while core elements remain conserved. Our analyses revealed marked inter- and intra-class variability, with longer CRs in tetrapods (1,283.27 ± 489.6 bp) than in fishes (969.25 ± 239.5 bp). Duplication events were restricted to tetrapods, especially birds and reptiles. Nucleotide composition was heterogeneous among orders, and structural divergence of CSBs was inferred across lineages. Repetitive elements were present in ~43% of CRs, with their abundance strongly correlated with CR length. Importantly, longer CRs were associated with higher GC content and greater variation in copy number of ETAS and CSBs. These results demonstrate that mitogenome CR expansion in vertebrates is largely driven by repeat proliferation, whereas key motifs required for replication and transcription are retained. We further identify lineage-specific trends, including pronounced CR elongation in amphibians and reptiles, contrasted with progressive reduction and simplification in birds and mammals. Our study provides the first comprehensive comparative framework of vertebrate CR evolution, highlighting how repetitive elements, conserved motifs, and nucleotide composition jointly contribute to both functional regulation and lineage-specific diversification.

Editorial Note: Damage and failure of underground subway stations under different soil constraint conditions

2026-07-10T14:00:00Z

by The PLOS One Editors

Editorial Note: Why are they eco-friendly? Attributing eco-friendly descriptive norms to intrinsic motivation increases pro-environmental purchase intention

2026-07-10T14:00:00Z

by The PLOS One Editors

Editorial Note: Study on optimization of inspection mechanism of concrete beam bridge

2026-07-10T14:00:00Z

by The PLOS One Editors

Editorial Note: Heat health risk assessment analysing heatstroke patients in Fukuoka City, Japan

2026-07-10T14:00:00Z

by The PLOS One Editors

Editorial Note: Provincial division of economic zones based on the improved urban gravity model: A case study of Hunan Province, China

2026-07-10T14:00:00Z

by The PLOS One Editors

Editorial Note: Response of vegetation to submergence along Jingjiang Reach of the Yangtze River

2026-07-10T14:00:00Z

by The PLOS One Editors

Daily variability in mood and subjective cognitive function: An experience sampling study in young adults

2026-07-10T14:00:00Z

by Melanie A. Butt, Todd C. Handy

In older adults, greater day-to-day fluctuations in cognitive function appear to be associated with higher rates of cognitive decline, relative to those showing less daily cognitive variability. Such findings suggest that within-person daily deviations from an individual’s typical functioning do not simply represent measurement noise, but rather, vitally inform on cognitive status in older adults. But what about these dynamics in younger adults? Does daily variability in cognition potentially inform on cognitive wellness for those in their neurocognitive prime? Here we addressed this question using an experience sampling method to assess participants’ subjective sense of their cognition and mood three times a day over 14 days in a sample of 215 young, healthy adults. After controlling for four baseline measures of subjective cognition (metacognitive awareness, executive function, propensity for cognitive failures, and memory failures) and four baseline measures of mood (depression, state and trait anxiety, and loneliness), we found that not only did subjectively-assessed cognitive function show significant within-person day-to-day variability across the sample population, but greater person-level cognitive variability across the two-week period predicted lower mean perceived function across the two weeks. While daily cognitive variability also showed a significant correlation with daily measures of both negative and positive mood, notably, some individuals were more resilient to these daily mood impacts on subjective cognition than others. Taken together, our findings suggest that daily variability in subjective cognition and mood may be important predictors for understanding cognitive wellness in younger adult populations.

Impact of vagus nerve cross-sectional area on electrocardiogram parameters in community-dwelling older adults: The YAHABA study

2026-07-10T14:00:00Z

by Nao Onodera, Kazumasa Oura, Hiroshi Akasaka, Naoki Ishizuka, Tohru Fujiwara, Ryo Itabashi, Tetsuya Maeda

Objectives

The aim of this study was to investigate the association between vagus nerve cross-sectional area (VN-CSA) using carotid ultrasonography and electrocardiogram (ECG) parameters in community-dwelling older adults, thereby clarifying the influence of VN-CSA on cardiac electrical activity.

Methods

A cross-sectional study examining the association between VN-CSA and ECG parameters. We prospectively enrolled participants aged ≥65 years who underwent both 12-lead ECG and carotid ultrasonography from the 2023 survey of a community-based cohort study (YAHABA study). The VN-CSA was measured offline at the thyroid level using carotid ultrasonography with a 3–8 MHz linear probe. Participants were divided into tertiles of each side; right tertile (RT)1 (<1.0 mm), RT2 (1.0–1.1 mm), and RT3 (>1.1 mm²). and left tertile (LT)1 (<0.9 mm²), LT2 (0.9–1.0 mm²), and LT3 (>1.0 mm²). ECG parameters were compared among the three groups on each of the left and right sides. Furthermore, linear regression analysis was performed to examine the association between left and right VN-CSA and ECG parameters.

Results

Finally, 183 participants enrolled in this study. In the analysis of covariance in multiple comparisons among tertiles of each side, RT1 had a higher heart rate (p = 0.021), a shorter R–R interval (p = 0.037), and a higher P-wave amplitude (p = 0.008) than RT2, while no significant differences were observed between RT1 and RT3. No significant associations were observed for the left VN-CSA. In the linear regression analyses, significant associations were observed between the left VN-CSA and QRS duration (p = 0.038), while there was no significant association between the right VN-CSA and ECG parameters.

Conclusion

The size of the vagus nerves had different effects on cardiac electrical activity in the left and right sides. The right VN-CSA may be associated with the electrical activity of the sinus node and atria, while the left VN-CSA may be associated with the electrical activity of the ventricles.

Corrosion assessment in aluminum pipe based on nonlinear ultrasonic technique using macro fiber composite transducers

2026-07-10T14:00:00Z

by Rong Wang, Hanqi Zhang, Heng Chen, Yahong Wu, Ke Xiong, Qi Wu, Liqing Zou

Pipe corrosion, specifically pitting corrosion, is the main cause of destructive pipe leakage, driven by the harsh working environment of liquid and gas transportation. Therefore, detecting pitting corrosion is essential for ensuring the safe operation of metal pipes. This study investigates a nonlinear ultrasonic technique using macro fiber composite transducers, aiming to assess pitting corrosion in metal pipes at an early stage, with a focus on characterizing the influence of temperature on the ultrasonic nonlinearity. Macro fiber composite transducers with flexibility and high ultrasonic performance were used to actuate and detect ultrasonic guided waves propagating in pipes with curved surfaces. Considering the multi-mode propagation characteristics, the 1.4 MHz second-harmonic ultrasonic component generated by the nonlinear interaction between ultrasonic guided waves and pitting corrosion was extracted. Repeated experiments revealed that both the second-harmonic amplitude and relative nonlinear parameter exhibited a monotonic increase with the number of cycles and area of pitting corrosion. For comparison with the nonlinear results, statistical metrics including the mean slopes, coefficient of determination, and relative standard deviation of the linear fitting parameter were determined alongside the linear ultrasonic experiments. These results indicate that, despite some inherent data variability, the proposed nonlinear ultrasonic technique exhibits comparatively better sensitivity, goodness-of-fit and repeatability than linear ultrasonic methods for identifying pitting corrosion. Thus, the proposed nonlinear ultrasonic technique using macro fiber composites offers a promising complementary alternative for early corrosion assessment in metal pipes.

Real‑world safety evaluation of tranexamic acid: Signal detection from FAERS and VigiAccess databases

2026-07-10T14:00:00Z

by Jing Feng, Chiwei Guo, Shujuan Zhao

Background

Tranexamic acid (TXA) is an antifibrinolytic agent commonly used to mitigate blood loss across various medical indications. Despite its widespread use, comprehensive data on its safety profile remain limited. This study aimed to systematically evaluate adverse events (AEs) associated with TXA.

Methods

Adverse event reports were extracted from the U.S. Food and Drug Administration’s Adverse Event Reporting System (FAERS) and the VigiAccess databases. Disproportionality analyses were conducted using reporting odds ratio (ROR), proportional reporting ratio (PRR), the Medicines and Healthcare products Regulatory Agency (MHRA) method, Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS).

Results

A total of 17,787 TXA-related AE reports were identified. A higher proportion of reports involved females, with older adults (≥ 65 years) accounting for the largest proportion in FAERS and younger individuals (18–44 years) in VigiAccess. Overlapping PTs, including seizures, pulmonary embolism and anaphylactic reactions, were identified. Significant differences for TXA-related AEs were found by gender, age and death outcomes. Most AEs occurred within the first month, with an early failure pattern.

Conclusion

This study provides evidence to weigh risks and benefits of TXA by comprehensive assessment of safety profile for TXA. These findings provide valuable references for future pharmacovigilance research on TXA.

Phytochemical and biological evaluation of methanolic extracts as a preventive measure for antioxidant and Anticoccidial Eimeria columbae Oocysts

2026-07-10T14:00:00Z

by Mutee Murshed, Jameel Al-Tamimi, Khalid Elfaki Ibrahim, Saleh Al-Quraishy

Background

Herbal products are rich in the source of bioactive ingredients, including phenols, flavonoids, tannins, and essential oil components such as cinnamaldehyde, eugenol, and 1,8-cineole, and have significant potential for therapeutic applications that are associated with antioxidant and anticoccidial activities.

Aims

This study aimed to investigate the phytochemical quantification and antioxidant anticoccidial assay in methanolic extracts of Cinnamomum verum and Laurus nobilis.

Methods

Total phenol, flavonoid, and tannin content was measured using standard spectrophotometric methods. Phytochemical properties were characterized using Fourier transform infrared spectroscopy (FTIR). Antioxidant activity was assessed using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and (2,2-diphenyl-1-picrylhydrazyl (ABTS) free radical scavenging assays. In vitro anticoccidial activity was assessed using seven concentrations: 10, 25, 50, 100, 150, and 200 mg/mL of C. verum and L. nobilis, in addition to K₂Cr₂O₇ as the control at 24, 48, 72, and 96 hours.

Results

FTIR analysis revealed characteristic absorption bands in the C. verum and L. nobilis extracts, indicating the presence of diverse functional groups associated with phenolic and related phytochemical constituents, as evidenced by their characteristic absorption bands across the 400–4000 cm ⁻ ¹ range. All extracts contained measurable levels of phenols, flavonoids, and tannins. The highest total phenolic content was recorded in C. verum (63.56 ± 0.552 mg/g dry weight) and L. nobilis (57.40 ± 6.05 mg/g dry weight). All extracts exhibited strong antioxidant activity, with IC₅₀ values for DPPH (12.59 ± 0.51 and 30.32 ± 3.22 μg/mL) and ABTS (13.95 ± 0.35, 19.56 ± 4.89 μg/mL) assays to C. verum and L. nobilis. The extracts exhibited dose- and time-dependent inhibition of E. columbae sporulated oocysts, at 200 mg/ml, 75.67% at C. verum and 72.57% at L. nobilis (p < 0.05) at higher concentrations at 96 h, alongside increased oocyst destruction of ~12%.

Conclusion

The findings demonstrated that the extracts of C. verum and L. nobilis leaves contain bioactive phytochemicals that inhibit coccidia oocysts in vitro, suggesting a potentially effective and safe natural option for managing coccidiosis in Domestic Pigeons.

Characteristics, management, and outcomes of segmental and subsegmental pulmonary embolism in ICU patients: A retrospective cohort study

2026-07-10T14:00:00Z

by Nuanprae Kitisin, Nattaya Raykateeraroj, Yukiko Hikasa, Jonathan Nübel, Alessandro Caroli, Glenn Eastwood, Emily Harman, Sandra Lussier, Derick Adigbli, Jane E. Lewis, Numan Kutaiba, Daryl Jones, Sikarin Upala, Ary Serpa Neto

Objective

To describe the incidence, management, and outcomes of segmental and subsegmental pulmonary embolism (PE) in intensive care unit (ICU) patients and to explore associations between therapeutic-dose anticoagulation and clinical outcomes.

Design

Single-center retrospective cohort study.

Setting

Tertiary academic hospital ICU between January 2019 and June 2025.

Patients

Critically ill adults (≥18 years) who underwent computed tomography pulmonary angiography (CTPA) during ICU admission and had radiologically confirmed segmental or subsegmental PE.

Interventions

None.

Measurements and main results

Radiology reports of all CTPA examinations performed in ICU-admitted patients were screened to identify the most proximal level of thrombus. Clinical records were reviewed for demographics, illness severity, radiologic characteristics, anticoagulation practice, bleeding, venous thromboembolism (VTE) recurrence, and mortality. Among 896 CTPA examinations performed in 804 patients, 164 examinations (18.3%) identified PE. Of these, 115 scans (12.8% of all CTPAs) demonstrated distal PE only, corresponding to 104 patients (12.9%) (61 segmental, 43 subsegmental). Overall, 96% of patients with distal PE received anticoagulation and 86% of anticoagulated patients received therapeutic-dose regimens. Bleeding occurred in 15% (major bleeding 12%), 90-day VTE recurrence in 7.8%, and 90-day mortality in 24%. No statistically significant association was found between the use of therapeutic-dose anticoagulation and 90-day mortality (adjusted odds ratio [OR], 0.70; 95% CI, 0.21–2.45), bleeding episodes (adjusted OR, 2.34; 95% CI, 0.47–19.2), or VTE recurrence (adjusted OR, 0.69; 95% CI, 0.11–6.22).

Conclusions

In critically ill adults, segmental and subsegmental PE are commonly detected on CTPA and are usually treated with therapeutic-dose anticoagulation. Although VTE recurrence was less frequent than bleeding episodes and mortality, our study did not find a significant association between therapeutic-dose anticoagulation and bleeding episodes, recurrent VTE, or mortality. Larger prospective studies are needed to define optimal anticoagulation strategies for ICU patients with distal PE.

Prevalence, virulence profiles and antibiotic susceptibility patterns of Shiga toxin producing Escherichia coli O157:H7 among children 6–59 months in Longido, Arusha-Tanzania

2026-07-10T14:00:00Z

by Martin Michael Martin, Haikael David Martin, Beatus Modesty Lyimo

Shiga toxin producing Escherichia coli (STEC) is a zoonotic pathogen associated with diarhoeal disease and severe complications in children, yet its epidemiology in pastoral settings of Tanzania remains insufficiently characterized. This study determined the prevalence, virulence gene profiles and antibiotic susceptibility patterns of STEC among children aged 6‍-59 months with diarhoea in Longido District, northern Tanzania. A hospital based cross-sectional‍ study was conducted between July and August 2025, enrolling 150 participants from four health facilities. Stool samples were collected and analyzed using culture, serological conformation and multiplex polymerase chain reaction targeting five genes; rfbE, stx1, stx2, eaeA and hlyA. STEC was operationally defined by detection of stx1 and/or stx2. Antibiotic susceptibility was assessed using the Kirby-Bauer disk diffusion method. The prevalence of STEC was‍ 13.3% (20/‍150). All stx2 positive isolates co-occurred with stx1. Virulence genes showed a heterogeneous but significantly clustered distribution, with rfbE (20.0%) and stx1 (13.3%) predominating. Significant co-occurrence was observed‍ between stx1 and eae and between stx1 and hlyA (p < .001). Animal contact, raw milk consumption and use of untreated water were significantly associated with STEC infection. Firth penalized logistic regression confirmed these exposures as independent predictors. Antibiotic susceptibility profiles were uniform, with complete susceptibility to ciprofloxacin,‍ gentamicin, cefotaxime and ceftazidime while ampicillin and trimethoprim showed complete resistance. These findings indicate that STEC transmission in pastoral communities is strongly driven by zoonotic and environmental exposures, characterized by clustered virulence determinants and consistent antibiotic profiles. Limitations include the cross-sectional design and short sampling period, which may not capture seasonal variation. Strengthened surveillance and integrated One Health interventions are needed to reduce disease burden.

Edge-intelligent safelink-V2X: A low-latency cooperative framework for real-time vulnerable road user protection

2026-07-10T14:00:00Z

by Fayez Alanazi, Ammar Armghan, Ahmed Jamal Abdullah Al-Gburi, Amr Yousef

The protection of Vulnerable Road Users (VRUs) remains a major challenge in modern transportation safety, as onboard line-of-sight and adverse weather conditions limit conventional onboard sensors. Existing systems that rely solely on vehicle-based sensing or on isolated communication struggle to provide timely, accurate alerts in dynamic urban environments. To address these shortcomings, this paper introduces SafeLink-V2X, a comprehensive Vehicle-to-Everything Cooperative Warning Framework designed to enhance safety for pedestrians, cyclists, and scooter riders. SafeLink-V2X employs Cellular Vehicle-to-Everything (C-V2X) and Dedicated Short-Range Communications (DSRC) protocols to enable direct data exchange of location, velocity, and heading between connected vehicles, smart infrastructure, and VRUs via smartphones or wearable tags. By applying sensor fusion and machine learning–based conflict prediction, the system identifies potential collision points and issues real-time, context-aware warnings through vehicle HMIs and VRU devices, promoting immediate evasive action. Evaluation on urban intersection simulations (detailed in Section 5) demonstrates that SafeLink-V2X reduces simulated collision probability by up to 91.4%, increases situational awareness measures by 44%, and lowers end-to-end alert latency by 30% compared to baseline onboard-only and communication-only systems under the same conditions.

Field evaluation of spring wheat genotypes reveals differential resistance to Zymoseptoria tritici in Ethiopia

2026-07-10T14:00:00Z

by Habtewold Kifelew, Habtamu Terefe, Bekele Kasa, Tilahun Mekonen, Zelalem Bekeko, Bulti Tesso

Septoria tritici blotch (STB), caused by Zymoseptoria tritici, is a major disease of spring wheat in Ethiopia and worldwide. This study evaluated 45 spring wheat genotypes for adult plant resistance under natural infection at Holetta Agricultural Research Center during the 2022 and 2023 seasons. Disease was assessed using two methods: (i) visual estimation of disease severity (DS) as the percentage of leaf area with necrotic lesions bearing pycnidia; and (ii) pycnidial density within lesions scored on a 0–5 scale to classify resistance levels. Combined analysis of variance across years showed significant effects (P ≤ 0.01) of year, genotype, and genotype × year interaction. Genotype accounted for 42.81% of the total variance in mean disease severity (from early grain filling to 70% flag leaf infection with pycnidia-bearing necrosis) and 42.3% of the variance in AUDPC. Mean severity ranged from 46.46% to 73.49% in 2022 and 8.73% to 71.71% in 2023, while pycnidial density ranged from 2.23% to 35.7% and 1.21% to 45.47% in 2022 and 2023, respectively. Four reaction classes were identified: resistant (24.4% and 25.2%), moderately resistant (30.4% and 24.4%), moderately susceptible (22.2% and 20.7%), and susceptible (22.96% and 29.63%) in 2022 and 2023, respectively. ‘Catbird’ was the most susceptible cultivar, whereas ‘Gondo’ was the most resistant. Cluster analysis grouped the cultivars into eight clusters based on STB severity and AUDPC, including two clusters (six genotypes) with resistant responses. These clusters did not include the differential lines used to characterize Z. tritici races, suggesting that the underlying resistance genes require further molecular characterization. The resistant genotypes (Blouk #1, 6B662, Coulter, Erik, Gondo, and ETW17–115) were effective against pathotypes virulent to major Stb genes present in Veranopolis (Stb2, Stb6), Shafir (Stb6), and Estanzuela Federal (Stb7). Disease severity and AUDPC were negatively correlated with plant height, number of tillers per plant, spike length, number of seeds per spike, thousand kernel weights, and grain yield. Correspondence and principal component analyses identified three major groups among the 45 genotypes: resistant, high-yield potential, and susceptible. The resistant genotypes identified here provide valuable material for breeding programs targeting improved resistance to Z. tritici.

Clinical characteristics and outcomes of Hodgkin Lymphoma: A single institution retrospective cohort study

2026-07-10T14:00:00Z

by Anwar Rjoop, Rania Al-Samama’h, Taima Sari Al-ullemat, Rahaf Alshamali, Batool El-Dwakat, Roaa Al-Saidi, Noor Abdalhakem, Saja Alsarhan, Asmaa Ajarmeh

Hodgkin lymphoma (HL) is a highly curable B-cell lymphoma, but a group of patients may experience resistance to initial treatment or progress to refractory disease. Moreover, they may experience relapses or long-term complications such as infertility and secondary neoplasms. In this retrospective cohort study, 257 patients diagnosed with HL between 2002 and 2022 were included to identify clinical and laboratory predictors of survival that may contribute to managing patient treatment and follow-up strategies. Demographic, clinical, treatment, and laboratory data at diagnosis were collected from patients’ e-records. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier curves and log-rank tests. Univariable and multivariable Cox proportional hazards models were used to identify independent predictors of death. The median age at diagnosis was 29 years, with 54.9% males. Nodular sclerosis was the most common subtype (34.6%). Univariable Cox regression analysis showed that high creatinine levels (HR 7.55, 95% CI 2.62–21.81, p < .001), low platelet count (HR 4.87, 95% CI 1.58–14.94, p = .006), and high total bilirubin (HR 3.76, 95% CI 1.34–10.55, p = .012) are factors associated with poor survival. In the exploratory multivariable Cox regression analysis, poor response to treatment was strongly associated with poor survival (HR 7.89, 95% CI 2.39–26.06, p=<.001), followed by low platelet count (HR 4.72, 95% CI 1.28–17.46, p = 0.020). This may suggest that poor treatment response and low platelet count are independent predictors of poor survival in HL patients but require confirmation in a larger cohort. Early detection of high-risk patients based on these clinical and laboratory results may improve patient treatment and follow-up strategies.

Degree of hypertension and subclinical coronary atherosclerosis in asymptomatic individuals without cardiovascular disease

2026-07-10T14:00:00Z

by Mi-Hee Jang, Sangwoo Park, Soe Hee Ann, Yong-Giun Kim, Young-Jee Jeon, Soyeoun Lim, Woon-Jung Kwon, Seong Hoon Choi, Hyun Woo Park, Gyung-Min Park

Objective

This study sought to evaluate the association between degree of hypertension and subclinical coronary atherosclerosis.

Design and method

We analyzed 7,332 asymptomatic individuals (mean age 52.8 ± 7.8 years; 4,680 [63.8%] men) without cardiovascular disease who voluntarily underwent coronary computed tomography angiography (CCTA) as part of a general health examination. Hypertension classification was adapted from the American College of Cardiology/American Heart Association 2025 guidelines. The degree of coronary artery disease (CAD) was evaluated using CCTA and classified as normal coronary arteries, non-obstructive CAD (diameter stenosis <50%), and obstructive CAD (diameter stenosis ≥50%).

Results

The participants were classified into 4 groups: normal (systolic blood pressure [SBP] <120 mmHg and diastolic blood pressure [DBP] <80 mmHg; n = 2,500), elevated (SBP 120–129 mmHg and DBP < 80 mmHg; n = 969), stage 1 hypertension (SBP 130–139 mmHg or DBP 80–89 mmHg; n = 2,841), and stage 2 hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg; n = 1,022). After adjusting for cardiovascular risk factors, the stage 1 hypertension group was significantly associated with non-obstructive CAD (adjusted odds ratio [aOR] 1.335; 95% confidence interval [CI], 1.156–1.541). Furthermore, the stage 2 hypertension group had a significant association with both non-obstructive CAD (aOR, 1.483; 95% CI, 1.234–1.784) and obstructive CAD (aOR, 1.696; 95% CI, 1.194–2.409).

Conclusions

In this large cross-sectional study, the degree of hypertension was associated with an increased risk and severity of subclinical coronary atherosclerosis. These findings highlight the potential importance of early recognition of blood pressure elevation and cardiovascular risk stratification in asymptomatic individuals.

Association of nurse-led targeted sedation-analgesia management with ventilation duration and sedation quality in mechanically ventilated patients

2026-07-10T14:00:00Z

by Xin Li, Huiyi Zhang, Hongyan Zhang, Ruxin Jiang, Su Wu, Shaoru Chen, Hui Zhi

Purpose

Variability in sedation–analgesia assessment and titration is common in mechanically ventilated ICU patients and may contribute to unnecessary deep sedation and delayed ventilator liberation. This study examined the association between a nurse-led targeted sedation-analgesia management workflow and clinical outcomes in an Intensive Care Unit (ICU).

Methods

This single-center retrospective observational cohort study was conducted and reported in accordance with the STROBE statement. Adult patients receiving invasive mechanical ventilation for ≥24 hours in the ICU from January 1, 2024 to December 31, 2025 were included. Patients were classified into a usual-care group (physician-directed care) or a nurse-led targeted management group using prespecified documentation-based operational criteria, including daily RASS targets, assessment frequency, nurse-driven titration, and closed-loop reassessment. Primary outcomes were duration of invasive mechanical ventilation and sedation target attainment (proportion of RASS assessments within target). Secondary outcomes included deep sedation exposure (RASS ≤ −3), agitation exposure (RASS ≥ +1), ICU length of stay, delirium, unplanned extubation, reintubation within 48 hours, tracheostomy, and 28-day mortality.

Results

A total of 102 patients were analyzed (usual-care group, n = 48; nurse-led group, n = 54). The nurse-led group had shorter mechanical ventilation duration (4.3 [3.2–6.3] vs 5.9 [4.3–8.7] days; P < 0.01) and higher sedation target attainment (74.0% ± 11.5% vs 61.5% ± 12.8%; P < 0.01). Deep sedation exposure and agitation exposure were lower in the nurse-led group (16.1% ± 9.1% vs 27.6% ± 10.9%; P < 0.01, and 9.1% ± 6.0% vs 12.4% ± 7.3%; P = 0.03, respectively), and ICU length of stay was shorter (8.0 ± 4.2 vs 9.7 ± 4.9 days; P = 0.02). Delirium was numerically lower but not statistically significant (22.22% vs 35.42%; P = 0.19), and no significant differences were observed in unplanned extubation, reintubation within 48 hours, tracheostomy, or 28-day mortality. After adjustment, nurse-led targeted management was associated with shorter ventilation duration (adjusted ratio, 0.79; 95% CI, 0.67–0.93; P = 0.004), whereas the association with delirium was not significant (adjusted OR, 0.58; 95% CI, 0.26–1.30; P = 0.190).

Conclusion

In this retrospective cohort study, nurse-led targeted sedation-analgesia management was associated with higher sedation target attainment, lower exposure to deep sedation and agitation, shorter invasive mechanical ventilation duration, and shorter ICU stay. No increase in measured safety events was detected. Given the retrospective design, small sample size, and limited adjustment, these findings should be interpreted as associations rather than evidence of causal effectiveness.

Transcriptomic meta-analysis identifies dysregulated pathways and potential therapeutic targets in Vestibular Schwannoma

2026-07-10T14:00:00Z

by Ebrar Altınalan, Aleksandra Panina, Robert Fredriksson, Ayse Arzu Şakul, Helgi B. Schiöth

Vestibular schwannoma (VS) is a benign Schwann cell–derived tumor that frequently causes progressive hearing loss and vestibulocochlear dysfunction, substantially impacting quality of life. The molecular mechanisms underlying VS pathobiology remain poorly defined, and reliable biomarkers or targeted therapies are lacking. This study aimed to delineate the molecular landscape of VS through a transcriptome-wide meta-analysis. We performed a genome-wide random-effects meta-analysis of four independent Affymetrix microarray datasets from the Gene Expression Omnibus (GEO) database. Differential expression analyses were conducted with and without covariate adjustment. Gene Ontology enrichment and DrugBank-based drug–gene interaction analyses were subsequently applied to characterize biological pathways and assess translational potential. Across the meta-analysis, more than 3,200 differentially expressed genes were identified in the covariate-free model. After applying a more stringent threshold (|metaLFC| > 1 and FDR < 0.05), 1,095 genes remained differentially expressed, with high concordance between the covariate-free and covariate-adjusted models. Downregulated genes included extracellular matrix and stromal components (MFAP5, FABP4, DCN), and sensory- and synapse-related transcripts (SLC22A3, LGI1). Upregulated genes included immune- and inflammation-associated genes (TREM2, CCL3, CCL4, L1CAM) and proliferative regulators (CCND1, RAB31, MOXD1). Functional enrichment highlighted extracellular matrix remodeling, immune modulation, sensory signaling, and cell cycle pathways. Notably, many of the most strongly dysregulated genes have not previously been associated with VS. Drug–gene interaction analysis identified multiple dysregulated genes with known pharmacological targets, suggesting potential translational relevance. This transcriptome-wide meta-analysis provides a comprehensive overview of gene expression patterns in VS, highlighting alterations related to extracellular matrix organization, sensory and synaptic processes, immune-associated signaling, and cell cycle–related pathways. The study highlights novel disease-associated genes and pathways and may help prioritize candidates for further investigation, including those with potential relevance for therapeutic targeting.

The effect of social media interaction on consumer engagement: The role of psychological ownership

2026-07-10T14:00:00Z

by Yue Yin, Chunjia Han, Yushan Chen

Social media interaction plays a crucial role in shaping consumer–brand relationships and enhancing engagement behavior. Drawing on social exchange theory, this study investigates how social media interaction fosters psychological ownership, thereby strengthening consumer engagement. An online questionnaire survey is conducted among 590 social media users via the Wenjuanxing platform to collect empirical data, which is analysed using a structural equation model. The results show that consumer–consumer interaction and consumer–seller interaction are positively related to four dimensions of consumer engagement: purchases, referrals, influence, and knowledge. In addition, psychological ownership mediates the effects of consumer–consumer interaction and consumer–seller interaction on influence and knowledge. The study also shows that the professionalism of opinion leaders positively moderates the impact of consumer–seller interaction on psychological ownership. This study contributes to theory by clarifying the psychological mechanisms underlying social media interaction and providing actionable insights for companies seeking to enhance consumer engagement and improve marketing performance.

NLOS/LOS identification with LightGBM ensemble

2026-07-10T14:00:00Z

by Xiaofeng Yang, Zhao Wu, Danlei Mo

Non-Line-of-Sight (NLOS)/Line-of-Sight (LOS) identification is crucial to accurate Ultra-Wideband (UWB) positioning. The current Machine Learning solutions to this problem have either too many parameters to tune or too simple features to input, which lead to unsatisfactory performance. To address this issue, this paper proposed a novel binary classifier called LightGBM Ensemble which integrates multiple LightGBMs in parallel with multi-scale patch extraction. The heterogeneous LightGBM ensemble architecture boosts the prediction power of individuals. The multi-scale patch extraction scheme extracts informative features from time-frequency domains. Extensive experiments on an open-source dataset were conducted to evaluate the proposed approach, which proves its superior classification performance and generalization performance with feasible complexity compared to the state-of-the-art Deep Learning and Decision Trees methods.