PLOS https://journals.plos.org/plosone/ customercare@plos.org https://journals.plos.org/plosone/feed/atom All PLOS articles are Open Access. https://journals.plos.org/plosone/resource/img/favicon.ico https://journals.plos.org/plosone/resource/img/favicon.ico 2026-07-21T01:42:14Z Xuexia Sheng Long Xu Donghua Xu Daihai Yuan Wenchao Xie Jiyuan Ge Yizhi Zhao Chaoyue Yang Zhigang Min 10.1371/journal.pone.0354301 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Xuexia Sheng, Long Xu, Donghua Xu, Daihai Yuan, Wenchao Xie, Jiyuan Ge, Yizhi Zhao, Chaoyue Yang, Zhigang Min</p> Purpose <p>This study investigated the properties of strip-shaped white matter hyperintensities (WMHs) by examining the relationship between their principal axes and maximum diffusion direction, and comparing their diffusion tensor metrics with punctate and early confluent WMHs to explore their pathological features and potential link to chronic axonal injury.</p> Methods <p>Eighty-seven participants with isolated WMHs were included and received diffusion tensor imaging (DTI) using a 3.0-T MR scanner. Lesions were classified by elongation (strip-shaped: ≥ 2; punctate: < 2). We recorded the maximum diffusion direction of punctate, strip-shaped, and early confluent WMHs and evaluated their consistency with the principal axial direction. Additionally, the diffusion tensor metrics of strip-shaped WMHs were measured and compared with those of punctate and early confluent WMHs.</p> Results <p>Among 996 WMHs, 57.5% of strip-shaped lesions showed principal axis alignment with the maximum diffusion direction, significantly higher than punctate (44.7%) and early confluent (42.1%) lesions (P < 0.05). Mixed-effects models showed significant lesion type effects on FA, MD, AD, and RD (all P < 0.05). Post-hoc comparisons revealed that stripe lesions had higher FA but lower MD and RD than confluence lesions (all P < 0.05), with no significant differences between stripe and punctate groups for MD or RD. No AD differences were found among groups. Fiber tracking confirmed alignment in most strip-shaped lesions.</p> Conclusion <p>Strip-shaped WMHs exhibit unique diffusion metrics and fiber alignment, suggesting chronic axonal injury due to neurodegeneration. These findings underscore the importance of morphological and microstructural analysis in understanding WMH heterogeneity and clinical significance.</p> Kimihiko Mori Tatsuya Teramae Masanori Wakida Naoto Mano Yuta Chujo Takayuki Kuwabara Meguru Taguchi Kimitaka Hase Tomoyuki Noda 10.1371/journal.pone.0354290 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Kimihiko Mori, Tatsuya Teramae, Masanori Wakida, Naoto Mano, Yuta Chujo, Takayuki Kuwabara, Meguru Taguchi, Kimitaka Hase, Tomoyuki Noda</p> Introduction <p>Hemiparetic gait is characterized by abnormal ground reaction forces (GRFs) with impaired control of the center of mass (CoM) relative to the center of pressure (CoP). Although both anteroposterior and mediolateral gait control have been examined separately, how their integrated stance-phase–derived CoP–CoM interactions and local CoP-based features relate to GRF characteristics remains unclear.</p> Objective <p>This exploratory study aimed to explore the relationships between CoP–CoM and CoP-based dynamics and GRFs and descriptively identify candidate gait subgroups of individuals with poststroke hemiparesis using a data-driven clustering approach.</p> Methods <p>Seventy-eight community-dwelling individuals with poststroke hemiparesis participated in a three-dimensional gait analysis. Stance-phase–derived CoP–CoM parameters of the transverse plane and local CoP-based loading metrics were extracted during the paretic stance phase. Relationships between these gait metrics and GRFs, particularly early braking force, propulsion, and late braking force, were examined using nonparametric correlation analyses. K-means clustering was performed to explore candidate gait subgroups, and inter-cluster differences were exploratorily examined.</p> Results <p>Across all participants, several CoP–CoM interaction metrics showed significant correlations with GRFs. In particular, insufficient forward progression of the CoM relative to the CoP during late stance showed a strong correlation with late braking force (r_s = 0.79). Clustering suggested the presence of four candidate gait subgroups characterized by differing combinations of anteroposterior and mediolateral CoP–CoM dynamics and local CoP loading features. However, the results of clusters with small sample sizes warrant cautious interpretation.</p> Conclusions <p>Integrated stance-phase–derived CoP–CoM dynamics and CoP-based parameters may highlight heterogeneity in hemiparetic gait and may have meaningful associations with GRF characteristics. The candidate gait subgroups should be interpreted as hypothesis-generating and may offer a descriptive framework for understanding diverse gait disorders.</p> Haoxian Shi Jiudong Shi Weigang Du Fulong Ning Wenwei Xie Ranli Zhang Yanjiang Yu 10.1371/journal.pone.0354268 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Haoxian Shi, Jiudong Shi, Weigang Du, Fulong Ning, Wenwei Xie, Ranli Zhang, Yanjiang Yu</p> Xiang Feng Youquan Dou Yuanyuan An Zheyao Xiong Qingsong Wang Tan Shi Rudan Chen 10.1371/journal.pone.0354266 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Xiang Feng, Youquan Dou, Yuanyuan An, Zheyao Xiong, Qingsong Wang, Tan Shi, Rudan Chen</p> Elucidating coal molecular structures is critical for studying its structure–property relationships and advancing efficient coal resource utilization. In this study, a bituminous coal (JSM_C) was selected from the coal-rich Inner Mongolia region of China as the research object. Multi-characterization technologies, including elemental analysis, ¹³C solid-state nuclear magnetic resonance spectroscopy (¹³C NMR), Fourier transform infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS), were integrated to characterize the elemental composition, carbon skeleton, functional groups, and nitrogen species in JSM_C. The results showed that the molecular formula of JSM_C is C₁₇₆H₁₂₈O₁₉N₂. The carbon skeleton is centered on mono-/bi-/tricyclic aromatics connected by aliphatic or oxygen-linked chains. The oxygen-containing functional groups are mainly phenols and ethers, while nitrogen species exist in the form of pyridine and pyrrole heterocycles. The simulated spectra of NMR and FTIR are consistent with the experimental data, confirming the reliability of the constructed structure. This study achieved the construction of complex coal macromolecules from the specific mine through “characterization analysis-model construction-simulation verification,” providing a feasible paradigm for coal molecular structure research. It also lays a molecular foundation for investigating structure-performance relationships and introducing related algorithmic models in coal research. Maliha Khan Majlish Mushfiqur Rahman Khan Majlish Sabrin Shohid Md Samiul Islam A. N. M. Shamsul Islam 10.1371/journal.pone.0354261 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Maliha Khan Majlish, Mushfiqur Rahman Khan Majlish, Sabrin Shohid, Md Samiul Islam, A. N. M. Shamsul Islam</p> As stress among medical students is a global health concern due to comprehensive academic engagements, this study aimed to assess the educational and psychological factors related to mental stress among medical students in Dhaka city. A descriptive type of cross-sectional study was conducted in two medical colleges in Dhaka city among 380 medical students from 3^rd year to 5^th year, using a pre-tested, self-administered, and structured questionnaire. The data obtained were analyzed using IBM SPSS Statistics (version 23) and Stata (version 14.2) employing the chi-square association test for bivariate analysis and subsequent multinomial logistic regression for the significant variables. Among 380 respondents, 68.7% were female, with 51.8% of respondents from Shaheed Suhrawardy Medical College. The mean stress score of medical students was 21.64 (SD = 6.64), with 67.9% and 22.6% as moderately and highly stressed, respectively. In bivariate analysis, 29 academic factors and 09 psychological factors were significantly associated with stress. In multinomial logistic regression analysis, three models were conducted, containing variables related to academic stress in model 1, variables related to psychological stress in model 2, and all stress variables in model 3. From model 1, academic performance, study and exam score anxiety, fear of future uncertainty and new living, administration satisfaction, and lack of entertainment facilities are significantly associated with stress. Additionally, the factors significantly associated with stress are time management, social life perception, and feeling lonely for model 2 and all stress-related variables, including study and exam score worry, difficulty in understanding context, fear of new living, administration and lecture satisfaction, teaching strategy satisfaction, time management, parental support in study, and feeling loneliness for model 3. Proper interventions for stressors of mental stress, further assessment, and rehabilitation for high and moderate-stressed respondents could be a prime concern to lessen the burden of stress among medical students. The PLOS One Staff 10.1371/journal.pone.0354250 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by The PLOS One Staff </p> Bibi Hajira Kimberley Jackson Roula Kteily Hawa Anam Shahil-Feroz 10.1371/journal.pone.0354152 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Bibi Hajira, Kimberley Jackson, Roula Kteily Hawa, Anam Shahil-Feroz</p> Perinatal mental health concerns are common and may be heightened among immigrant populations because of migration-related stressors, social isolation, stigma, language barriers, and limited access to culturally safe care. Although previous reviews have examined perinatal mental health among immigrants broadly, evidence focused specifically on South Asian immigrant women in Canada across pregnancy and the postpartum period has not been comprehensively mapped. South Asian women represent one of the largest and fastest-growing immigrant populations in Canada and may experience unique cultural, familial, linguistic, and migration-related factors that shape perinatal mental health experiences and access to care. This scoping review will map the extent, range, and nature of evidence on perinatal mental health among South Asian immigrant women in Canada by examining reported mental health outcomes, associated risk and protective factors, help-seeking experiences, and barriers and facilitators to accessing support services, and identify gaps to inform future research, practice, and policy. This protocol was developed in accordance with Joanna Briggs Institute guidance for scoping review protocols and reported using the PRISMA-P checklist, where applicable (see S2 Checklist). The completed scoping review will be reported according to the PRISMA-ScR checklist. MEDLINE, Embase, PsycINFO, CINAHL, and Scopus will be searched for literature published from January 2000 to the date of the final search. Grey literature will be identified through targeted searches of government, public health, professional, and community organization websites. Eligible sources will include qualitative, quantitative, mixed-methods, and relevant grey literature addressing perinatal mental health during pregnancy and up to 12 months postpartum among South Asian immigrant women residing in Canada. Inclusion criteria are immigrant women of South Asian origin from counties such as India, Pakistan, Bangladesh, Sri Lanka, Afghanistan, Nepal, Bhutan, and Maldives residing in Canada during the perinatal period. Two reviewers will independently screen titles, abstracts with disagreements resolved through discussion or third-reviewer adjudication. Data will be extracted using a standardized charting form and summarized using descriptive mapping and narrative synthesis. Protocols and planned studies will be charted separately from completed studies. Consistent with scoping review methodology, formal exclusion of studies based on methodological quality will not be undertaken; however, study characteristics and reported methodological limitations will be charted to support interpretation of the evidence base. Ethics approval is not required because the review will use publicly available sources only. Findings will be disseminated through a dissertation, peer-reviewed publication, and conference presentations. The review will provide a comprehensive overview of existing evidence and knowledge gaps to support culturally responsive perinatal mental health research, policy development, and healthcare practice for South Asian immigrant women in Canada. This protocol has been preregistered on the Open Science Framework:10.17605/OSF.IO/FZN4S. Md. Riyadh Arefin Shitosri Mondal Md. Fazle Rabbi Hafsa Tasnim Md. Alamgir Hossain Md. Sabibul Haque A. K. M. Golam Sarwar 10.1371/journal.pone.0354144 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Md. Riyadh Arefin, Shitosri Mondal, Md. Fazle Rabbi, Hafsa Tasnim, Md. Alamgir Hossain, Md. Sabibul Haque, A. K. M. Golam Sarwar</p> Tea is one of the major economic crops in Bangladesh, however, its productivity is severely constrained by waterlogging stress arising from erratic climatic changes. A significant knowledge gap persists regarding the morpho-physiological and biochemical determinants of waterlogging tolerance and post-stress recovery in tea, hindering the development of tolerant genotypes. Therefore, the present study aimed to investigate the integrated morpho-physiological and biochemical responses of tea genotypes under waterlogging stress to identify tolerant genotype(s) based on stress tolerance indices (STIs). Eight pre-screened tea genotypes—P/LAL/08/23, P/LAL/08/62, P/LAL/09/116, P/AFN/11/35, P/AFN/11/46, P/OTI/31, P/AFN/13/90, P/AFN/11/31, with two control clones, BT2 (popular variety) and TV9 (waterlogging-tolerant variety), were evaluated using 23 morpho-physiological and biochemical parameters maintaining a two-factorial completely randomized design experiment. One set of tea genotypes was exposed to a 14-day waterlogging phase, followed by a 14-day recovery phase (total 28 days of stress), while another set of plants was maintained under control (non-stress) conditions, for the same period, to calculate STIs. Root fresh weight (RFW), leaf number (NL), net photosynthesis (<i>Pn</i>), transpiration rate (<i>E</i>), stomatal conductance (<i>g</i>_s), relative leaf water content (RWC), and absolute growth rate (AGR) were significantly decreased under waterlogging condition compared to the control. Leaf chlorophyll <i>a</i> (CHA), chlorophyll <i>b</i> (CHB), and total carotenoids (CRTN), were reduced under stress, whereas proline content (of leaf: PRLF and root: PRRT), total antioxidant activity (of leaf: TACL and root: TACR), and lipid peroxidation (of leaf: LOPL and root: LPOR) increased as a part of adaptive responses. The traits such as RFW, NL, <i>Pn</i>, <i>E</i>, <i>g</i>_s, RWC, AGR, CHA, CHB, CRTN, and LPOL, were detected as most influential at both phases of stress conditions from principal component analysis. Ultimately, the P/AFN/13/90 was identified as the most waterlogging-tolerant genotype, exhibiting higher STIs for maximum traits during both the waterlogging and recovery phases. Ying-Ai Cui Yuan Li Liping Yang Zheng-Ai Cui 10.1371/journal.pone.0354119 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Ying-Ai Cui, Yuan Li, Liping Yang, Zheng-Ai Cui</p> Background <p>Human papillomavirus (HPV) infection poses a significant public health challenge, and HPV vaccination uptake among Chinese college students remains suboptimal. Therefore, it is essential to conduct ongoing, in-depth investigations into the psychological and cognitive mechanisms of HPV vaccination intention. This study aims to explore the associations among HPV vaccination intention, vaccine hesitancy, and health beliefs among Chinese medical college students.</p> Methods <p>A cross-sectional survey was conducted from June 16 to July 16, 2024, to assess sociodemographic characteristics, vaccine hesitancy, and health belief model (HBM) among college students at Guangdong Medical University. Descriptive statistics, univariate analysis, and binary logistic regression were performed to identify factors associated with HPV vaccination intentions among unvaccinated students.</p> Results <p>Among 3,584 unvaccinated participants, 73.16% expressed willingness to receive the HPV vaccine. The key significant associations identified included gender (male) (OR: 0.26; 95% CI: 0.22 ~ 0.31; <i>p</i>  <  0.001), parental occupation (employees in enterprises, commercial, and service industries (including self-employed)) (OR: 1.43; 95% CI: 1.18 ~ 1.75; <i>p</i>  <  0.001), and information sources (hospitals or doctors) (OR: 1.37; 95% CI: 1.15 ~ 1.64; <i>p</i>  =  0.001). Vaccination intention was also directly associated with the perceived necessity (OR: 0.91; 95% CI: 0.88 ~ 0.94; <i>p</i>  <  0.001) and importance (OR: 1.07; 95% CI: 1.03 ~ 1.10; <i>p</i>  <  0.001) of vaccine hesitancy, as well as the perceived benefits of behavior for the HBM (OR: 1.21; 95% CI: 1.12 ~ 1.32; <i>p</i> <  0.001).</p> Conclusions <p>In this sample, Chinese medical college students demonstrated a relatively high willingness to receive HPV vaccination. Willingness was positively associated with perceived necessity, importance, and benefits of vaccination. Integrating structured clinician-delivered counseling into curricula, using parental occupation data for targeted subsidies, and embedding classroom sessions comparing personal HPV risk with vaccine safety data may improve uptake. Government evaluation of gender-neutral vaccination policies and provision of male-inclusive campus services are also recommended.</p> The PLOS One Editors 10.1371/journal.pone.0354115 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by The PLOS One Editors </p> Alina Maryum Arslan Shaukat Ehsan Yousaf Ayesha Haque Shazia Yusuf Saif ul Haque Humaira Ali Soyiba Jawed Muhammad Usman Akram 10.1371/journal.pone.0354038 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Alina Maryum, Arslan Shaukat, Ehsan Yousaf, Ayesha Haque, Shazia Yusuf, Saif ul Haque, Humaira Ali, Soyiba Jawed, Muhammad Usman Akram</p> Osteoporosis is a chronic skeletal disorder characterized by progressive bone mineral density (BMD) loss and structural deterioration, significantly increasing fracture risk. Despite its high prevalence, early detection remains challenging due to its asymptomatic progression and the limitations of conventional diagnostic techniques, such as Dual-Energy X-ray Absorptiometry (DXA). While DXA remains the clinical benchmark for BMD assessment, its high cost, limited accessibility, and inability to directly detect vertebral fractures necessitate the development of alternative, cost-effective, and widely deployable diagnostic methodologies. A dataset of 159 patient records was collected from NORI and CDA Hospital, incorporating 17 input features spanning demographics, genetic/blood type, clinical history and lab tests parameters. To bridge this gap, we developed a practical machine learning model tailored for clinics with limited resources. Instead of relying on expensive imaging, our framework uses only basic, highly accessible clinical markers—specifically ABO blood groups, serum calcium, and potassium levels. Because these tests are inexpensive and easily processed in standard laboratories, our approach removes the financial and technical hurdles of advanced diagnostics, making early screening possible in remote or underfunded healthcare settings. Data preprocessing involved rigorous feature selection, standardization, hyper-parameters tuning, clinically relevant features derivation and biomarker combinations. For classification, ensemble voting classifier was trained on key biomarkers— Weight, Potassium, Calcium and Total Vitamin D—achieving an accuracy of 90% and an AU-ROC score of 0.93 in predicting osteoporosis severity. In parallel, extreme gradient boosting Regressor trained on Age, Weight, ABO Group and Total Vitamin D demonstrated an R² of 0.536 for lumbar spine BMD estimation. The proposed framework demonstrates the viability of leveraging machine learning for non-invasive osteoporosis screening and fracture risk assessment, offering a radiation-free and clinically accessible complementary pre-screening tool. Henry K. Mensah Ralieva A. K. Nortey Isaac K. Asante Felicia Oppong-Adjei 10.1371/journal.pone.0354037 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Henry K. Mensah, Ralieva A. K. Nortey, Isaac K. Asante, Felicia Oppong-Adjei</p> This study investigated the mutagenic effects of ethyl methane sulfonate (EMS) on the M₁ generation of cowpea (Vigna unguiculata (L.) Walp.) cultivar ‘Wang Kae.’ A total of 275 M₀ seeds were treated with EMS concentrations of 20 mM, 40 mM, and 80 mM (75 seeds per treatment) by soaking for six hours, while 50 untreated seeds served as the control (0 mM). Phenological, yield-related and yield traits were recorded, and data were analysed using Jamovi 2.7.15 and JASP 0.95.4.0 through one-way ANOVA with post hoc contrast, principal component biplot, and cluster analyses. No optimal mutagenic concentration (LD50) was identified. Seed germination and seedling survival rates increased with increasing EMS concentration, ranging from 70.00% and 62.00% in the control (0 mM) to 89.33% and 74.67% at 80 mM, following the trend 0 mM < 20 mM < 40 mM < 80 mM. Significant differences (P < 0.05) were observed among treatments for all phenological traits, pod length, locule number, seed traits, and yield per plant. Yield was significantly higher (P = 0.047) at 20 mM (61.19 ± 3.34 g) compared to the control. Contrast analysis identified genotypes B33 and D56 as the most productive mutants, with yields of 125.44 g and 111.85 g, respectively. Principal component analysis extracted eighteen components, with the first four cumulatively explaining 50.60% of total variation. Biplot analysis of PC1 and PC2 captured all phenological traits, key seed traits, and yield attributes, highlighting the superior performance of B33 and D56. Cluster analysis partitioned the 190 genotypes into six groups, with B33 and D56 constituting distinct clusters. EMS mutagenesis effectively induced heritable phenotypic variation, with putative superior genotypes identified for advancement to M₂ and evaluation in replicated multi-environment trials toward the development of farmer- and consumer-preferred cowpea varieties. Oscar Hernán Rodríguez-Bejarano David Santiago Padilla Daniel Alzate Lucía Botero Giovanni Vargas Hernández Liliana López-Kleine Manuel Alfonso Patarroyo Carlos A. Parra-Lopez 10.1371/journal.pone.0354033 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Oscar Hernán Rodríguez-Bejarano, David Santiago Padilla, Daniel Alzate, Lucía Botero, Giovanni Vargas Hernández, Liliana López-Kleine, Manuel Alfonso Patarroyo, Carlos A. Parra-Lopez</p> Background <p>Canine mammary carcinoma (CMC) is a common tumor in unspayed dogs and poses a significant health concern for animals. This study aimed to identify differentially expressed genes (DEGs) between CMC and adjacent healthy mammary tissue through an integrated RNASeq bioinformatics analysis that combined an independently generated dataset from the present study, CPA-UN (CPA-UN), composed of RNA-seq data obtained from CMC and matched normal mammary tissue samples, with publicly available GEO datasets generated using next-generation sequencing (NGS). Candidate genes associated with diagnostic and prognostic potential were subsequently explored through integrative downstream analyses.</p> Methods and findings <p>DEGs were identified using DESeq2 and further analyzed for functional enrichment (ClusterProfiler, Pathview, and GSEA), co-expression gene networks, and tumor immune infiltrate deconvolution (CIBERSORTx). The GSE119810 dataset was used for exploratory overall survival (OS) analysis. Transcriptomic data from 88 CMC cases and adjacent healthy mammary tissue samples identified eight DEGs common across all four datasets. Among these, <i>ACAN</i>, <i>COL11A1</i>, <i>EDIL3</i>, <i>NDUFA4L2</i>, and <i>IGFBP5</i> showed higher transcript levels in CMC tissues than in healthy mammary tissue, whereas <i>TNNC1</i>, <i>PCK1</i>, and <i>METTL24</i> showed lower transcript levels in CMC tissues than in healthy mammary tissue. Functional enrichment analyses indicated that DEGs with higher transcript levels in CMC were predominantly associated with extracellular matrix remodeling, cell adhesion, tumor microenvironment interactions, immune and inflammatory responses, and signaling pathways involved in tumor progression and metastasis. In contrast, DEGs with lower transcript levels were mainly enriched for cytoskeletal organization and tissue structural integrity, suggesting a loss of normal mammary gland architecture and myoepithelial-associated functions during tumor progression. GSEA further demonstrated coordinated enrichment of hallmark gene sets related to cell-cycle dysregulation, proliferation, epithelial–mesenchymal transition, metabolic adaptation, inflammatory signaling, and stromal remodeling, supporting the presence of integrated transcriptional programs that drive tumor progression and TME remodeling in CMC. Co-expression gene network analysis revealed a highly modular organization, with densely interconnected clusters of co-expressed genes that may reflect coordinated biological processes and regulatory programs. Exploratory CIBERSORTx analysis found no significant differences in the relative proportions of the 22 infiltrating immune cell types between CMCs and paired healthy controls after multiple-comparison corrections. Nevertheless, dataset-specific trends were observed in regulatory T cells, M1 macrophages, activated CD4 memory T cells, plasma cells, dendritic cells, and mast cells, though these findings should be interpreted cautiously. An exploratory survival analysis of 1,759 DEGs from the GSE119810 dataset identified 53 genes nominally associated with overall survival in CMC. However, none remained statistically significant after multiple-testing correction, underscoring the exploratory nature of these findings and the need for validation in larger cohorts.</p> Conclusion <p>This study provides a preliminary transcriptomic framework for CMC, identifying candidate genes and pathways associated with tumor-related processes and supporting future functional validation to clarify their roles in tumorigenesis, progression, and tumor aggressiveness. However, these findings remain exploratory and require validation in larger cohorts to confirm their diagnostic and prognostic relevance, given the limitations of secondary data analyses and potential variability in tissue collection and processing across studies.</p> Yue Chang 10.1371/journal.pone.0354018 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Yue Chang</p> Cracks on the surface of concrete structures are an obvious indication of their condition. However, traditional visual inspection methods are significantly influenced by human factors. They are accurate for larger cracks. However, they introduce subjective judgment when detecting smaller cracks. They also pose safety risks. Automated detection methods face challenges in achieving lightweight implementation due to limited annotated data and difficulties in complex environments. This paper proposes a method for detecting and measuring concrete cracks. The method uses a generative adversarial network (GAN) to augment data and a U-Net segmentation network. Conditional GAN (cGAN) is proposed to generate high-fidelity crack images using training-set data only, avoiding data leakage and effectively solving insufficient sample issues. A U-Net segmentation network that has been enhanced performs crack segmentation. This network incorporates channel attention modules and dilated residual blocks. A hybrid loss function that combines the Dice coefficient and binary cross-entropy resolves class imbalance. Fractal theory quantifies the geometric features of the detected cracks. The crack segmentation model that was trained on cGAN-augmented datasets achieved an average precision (AP) of 82.03% and an F1 score of 83.24%, as demonstrated by experimental results. The fractal dimension–based crack measurement method achieves an accuracy of ≤4% error for complex crack networks (fractal dimension >1.6). The proposed method provides a reproducible, automated, high-precision solution for concrete crack detection and quantification, with verified stability and engineering applicability. Lei Ma Dongfeng Wang Zhenqiang Li Gengfan Ye Maosong Chen 10.1371/journal.pone.0354014 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Lei Ma, Dongfeng Wang, Zhenqiang Li, Gengfan Ye, Maosong Chen</p> Background <p>Alzheimer’s disease (AD) is a degenerative central nervous system disorder characterized by progressive cognitive and behavioral impairment. As nanoscale intercellular communication vesicles that carry AD-related pathological molecules, exosomes are promising biomarkers and therapeutic carriers for AD. In this study, we downloaded AD-related gene expression profiles and clinical data from the Gene Expression Omnibus (GEO) database (datasets GSE138260, GSE29378, GSE36980, and GSE5281). Through a series of bioinformatics analyses, clinical predictive model construction, pharmacological network analysis, and molecular docking simulations, we developed an exosomal gene-based predictive model for AD pathogenesis and identified potential pharmacological networks and molecular docking targets for AD treatment.</p> Materials and methods <p>AD-related gene expression and clinical data were retrieved from the GEO database. Bioinformatics analyses, clinical model construction, drug-gene network analysis, and molecular docking were subsequently performed to explore exosomal gene models for predicting AD pathogenesis, as well as potential pharmacological networks and molecular docking targets for AD therapy.</p> Results <p>A five-exosomal-gene predictive model was established, comprising CD44, CXCR4, TUBB, PSMA5, and PSMB3. Pharmacological network analysis of these five genes revealed their significant associations with chelidonine, 2-chloro-1,4-dinitrobenzene, oxazolone, phencyclidine, thioridazine, and etodolac. Further molecular docking simulations identified key binding targets, including R41, Y42, R78, Y79, C77, I88, C97, A98, I96, I72, L70, E67, G103, I91, and T102.</p> Conclusions <p>Our comprehensive analyses successfully established a reliable exosomal gene-based model for predicting AD pathogenesis, and identified relevant pharmacological networks and core molecular docking targets, providing novel insights for AD diagnosis and targeted therapy.</p> The PLOS One Editors 10.1371/journal.pone.0353999 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by The PLOS One Editors </p> Wen-Yu Jao Chih‐Cheng Lai Chi-Sheng Chien Wei-Ting Lin 10.1371/journal.pone.0353956 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Wen-Yu Jao, Chih‐Cheng Lai, Chi-Sheng Chien, Wei-Ting Lin</p> Objectives <p>Sodium-glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated metabolic and anti-inflammatory benefits, which may influence the risk of osteoarthritis (OA) in patients with type 2 diabetes mellitus (T2DM). However, their comparative impact on OA incidence remains unclear. This study aimed to evaluate and compare the effects of SGLT2 inhibitors and GLP-1 RAs on the risk of developing OA in patients with T2DM.</p> Methods <p>A retrospective cohort study was conducted using the TriNetX database, including adults with T2DM who were newly prescribed either SGLT2 inhibitors or GLP-1 RAs between January 2017 and December 2019. After propensity-score matching, 452,445 patients were included in each group. The primary outcome was OA incidence over five years. Secondary outcomes included knee OA, hip OA, total knee arthroplasty (TKA), total hip arthroplasty (THA), and major joint injections.</p> Results <p>The SGLT2 inhibitor group had a significantly lower risk of OA compared with the GLP-1 RAs group (HR, 0.921; 95% CI, 0.895–0.946), with a greater reduction observed for knee OA (HR, 0.831; 95% CI, 0.783–0.882). No significant differences were observed in THA or TKA risk. SGLT2 inhibitor users also had fewer major joint injections (HR, 0.915; 95% CI, 0.882–0.951).</p> Conclusions <p>Among patients with T2DM, SGLT2 inhibitors were associated with a lower risk of OA, particularly knee OA and joint injections, compared to GLP-1 RAs. These findings support further investigation into the potential association between SGLT2 inhibitor use and lower OA-related outcomes.</p> Yanhua Xiao Shuixiang Yu Wenfeng Li Huafei Xiao Yiling Chen Huayan Zhou Long Yang 10.1371/journal.pone.0353888 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Yanhua Xiao, Shuixiang Yu, Wenfeng Li, Huafei Xiao, Yiling Chen, Huayan Zhou, Long Yang</p> Change detection (CD) can detect changes in the earth’s surface. However, the existing Siamese network-based CD methods usually calculate the Euclidean distance (ED) between two branches to obtain difference features, ignoring the deeper feature disparities captured by the CNN. In addition, the patch obtained in the CD method using spatial information may have the phenomenon that the adjacent pixels and the pixels to be classified are not the same object or change type. To deal with the aforementioned challenges, we propose FDS-BINet, a multi-spatial resolution network integrating a Feature Difference Structure (FDS) and Bicubic Interpolation (BI). The FDS module progressively extracts deep pixel-level differences through residual-enhanced Siamese branches, while BI interpolates the absolute distance spectrum to recover subpixel-level changes. The main contributions of this article are as follows: 1) A change detection framework called FDS-BINet has been proposed that fuses pixel-level and subpixel-level change information. 2) A feature difference structure (FDS) is designed to obtain deep difference features of pixel-level spatial information of bitemporal HSIs; 3) The bicubic interpolation (BI) algorithm is used for absolute distance (AD) spectrum interpolation. We can effectively boost the spatial resolution of AD spectrum data, enabling us to extract feature differences at the subpixel level from bitemporal hyperspectral images (HSIs). The experimental results demonstrate that the proposed FDS-BINet has better performance compared with representative methods in the field of HSI CD. Mette Thrane Øhrstrøm Michael Dyrehauge Schultz Claus Bistrup Henrik Birn 10.1371/journal.pone.0353887 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Mette Thrane Øhrstrøm, Michael Dyrehauge Schultz, Claus Bistrup, Henrik Birn</p> Background <p>Recurrent immunoglobulin A nephropathy after kidney transplantation remains a major clinical challenge, but risk factors are not fully defined. This study aimed to evaluate the incidence of biopsy-proven recurrent IgAN and identify risk factors for recurrence in a contemporary Scandinavian cohort.</p> Methods <p>We conducted a multicenter cohort study including adult patients with biopsy-proven immunoglobulin A nephropathy who received a first kidney-only transplantation between 1990 and 2020 across two Danish transplantation centers. Recurrence incidence and associations with clinical and donor-related characteristics were assessed during follow-up.</p> Results <p>A total of 118 recipients were followed for a median of 5.5 years. Biopsy-confirmed recurrence occurred in 14% of patients, corresponding to a cumulative incidence of 16% at 10 years post-transplantation. Younger age at immunoglobulin A nephropathy diagnosis, faster progression to kidney failure, and receipt of a kidney from a living or genetically related donor were independently associated with an increased risk of recurrence. Maintenance post-transplant steroid use was not associated with recurrence. Recurrent immunoglobulin A nephropathy was associated with an increased risk of graft failure compared with non-recurrent disease (unadjusted HR 3.8; adjusted HR 6.7).</p> Conclusions <p>Recurrence of IgAN after kidney transplantation remains a clinically significant challenge, associated with younger age, rapid progression to KF, and transplantation from living or genetically related donors. Maintenance post-transplant steroid use was not associated with recurrence risk in this cohort. Larger and more diverse cohorts are warranted to clarify donor-related risk, strengthen the evidence on immunosuppressive protocols and guide strategies to improve graft outcomes.</p> Andras Dobos Balazs Meresz Inez Bosnyak Dorottya Molitor Bela Kocsis Edina Szabo Dora Reglodi Ildiko Vajda Tamas Atlasz Alexandra Vaczy 10.1371/journal.pone.0353866 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Andras Dobos, Balazs Meresz, Inez Bosnyak, Dorottya Molitor, Bela Kocsis, Edina Szabo, Dora Reglodi, Ildiko Vajda, Tamas Atlasz, Alexandra Vaczy</p> Ocular inflammation is a leading cause of visual impairment and blindness worldwide. Systemic bacterial infections can spread hematogenously, resulting in endogenous endophthalmitis. These infections present significant diagnostic and therapeutic challenges due to their systemic origin and involvement of multiple ocular structures such as the retina and cornea. Pituitary adenylate cyclase-activating polypeptide (PACAP), acting through its selective receptor PAC1, exerts potent anti-inflammatory, anti-edema, and regenerative effects in various ocular conditions. This study aimed to assess the protective role of maxadilan, a selective PAC1 receptor agonist, in reducing corneal inflammation in a mouse model of lipopolysaccharide (LPS) -induced ocular inflammation. Mice received systemic LPS injections followed by intravitreal administration of maxadilan. Animals were monitored in vivo using optical coherence tomography (OCT) and tonometry. Post-mortem analyses included evaluation of cytokine expression profiles and routine corneal histological assessment. OCT revealed significantly reduced corneal edema and improved tissue structure with maxadilan administration. Additionally, maxadilan lowered intraocular pressure and reduced inflammatory cell infiltration into the aqueous humor. Cytokine profiling showed decreased expression of critical pro-inflammatory mediators such as GM-CSF, IL-6, MIP-1a, TNF-a, and TREM-1 in the maxadilan-treated group. Histological analyses confirmed that maxadilan preserved normal corneal architecture and effectively prevented pathological keratinization compared to untreated controls. These findings suggest that PAC1 receptor activation has therapeutic potential for controlling inflammation and maintaining corneal health in ocular inflammation. Nik Zatul-Iffah N. Mohd Nabil Mohd Effendi Ewan Mohd Matore Mohd Syazwan Zainal 10.1371/journal.pone.0353781 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Nik Zatul-Iffah N. Mohd Nabil, Mohd Effendi Ewan Mohd Matore, Mohd Syazwan Zainal</p> Dyslexia is a specific learning difficulty marked by persistent challenges in reading accuracy, fluency, and word recognition despite adequate intelligence and instruction. In secondary schools, many cases remain unidentified due to the absence of screening instruments designed for older students. Early identification is essential for timely intervention, which requires valid and reliable tools. This study evaluated the face validity of a newly developed dyslexia screening instrument for secondary students through expert and test-taker assessments. The 28-item instrument, which focused on cognitive manifestations of dyslexia, was reviewed by ten experts and ten students. Items were rated on a 4-point Likert scale assessing clarity and comprehensibility, with analyses conducted using the Item-Level Face Validity Index (I-FVI), Scale-Level Face Validity Index by Average Agreement (S-FVI/AVE), and Scale-Level Face Validity Index by Universal Agreement (S-FVI/UA). Expert evaluation demonstrated that 85.7% of items achieved full agreement (I-FVI = 1.00), while scale-level indices exceeded recommended benchmarks (S-FVI/AVE = 0.96; S-FVI/UA = 0.86). Student evaluation also yielded high scale-level agreement (S-FVI/AVE = 0.92; S-FVI/UA = 0.82). A small number of items required linguistic refinement. Consequently, the findings indicate high agreement on the instrument’s clarity, comprehensibility, and acceptability, supporting face validity as a preliminary validation step for subsequent psychometric validation. Svenja Hehn Julia Gutbrod Maxi Gutjahr Andreas Marx 10.1371/journal.pone.0353775 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Svenja Hehn, Julia Gutbrod, Maxi Gutjahr, Andreas Marx</p> Bacteriophage T7 RNA polymerase (T7 RNAP) is a key enzyme for <i>in vitro</i> transcription (IVT) and plays a central role in the production of synthetic mRNA for research and therapeutic applications. However, IVT frequently generates double-stranded RNA (dsRNA) as an undesired by-product, which can trigger innate immune responses and compromise mRNA quality. Increasing reaction temperatures reduces dsRNA formation, however, the wild-type T7 RNA polymerase exhibits limited stability under such conditions. Therefore, polymerase variants with enhanced thermotolerance enable more robust transcription at elevated temperatures while minimizing dsRNA generation. To address this limitation, we aimed at obtaining T7 RNA polymerase variants with increased thermotolerance using the Protein Repair One Stop Shop (PROSS) web server. Four crystal structures of T7 RNA polymerase, comprising a promoter complex, an initiation complex, and two elongation complexes were used as input for independent PROSS runs. Mutations shared across all four designs for each PROSS index were then combined to generate multi-structure PROSS Combined Designs (PCDs). In the subset evaluated experimentally, PCD9 retained full-length transcription activity at temperatures up to 48 °C, whereas wild-type T7 RNA polymerase showed strong loss of activity under the same buffer conditions. At 48 °C, PCD9 supported the synthesis of kilobase-length scale transcripts and produced no detectable dsRNA signal in a dot blot assay. In contrast, the wild-type enzyme generated strong dsRNA signals at 37 °C and failed to produce detectable RNA at 48 °C. Additional PROSS variants derived exclusively from the elongation complex structure were inactive at both 37 °C and 48 °C. Together, these results show that multi-structure PROSS design can yield a thermotolerant T7 RNA polymerase with improved performance at elevated temperature and reduced dsRNA byproduct formation. The findings also suggest that restricting stability design to a single structural state may not fully capture the requirements of a highly dynamic enzyme. Leila Ghazaleh Nader Farahpour Peyman Aghaie Ataabadi Seyyed Morteza Kazemi Bahram Saleh-Sedghpour Paul Allard 10.1371/journal.pone.0353774 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Leila Ghazaleh, Nader Farahpour, Peyman Aghaie Ataabadi, Seyyed Morteza Kazemi, Bahram Saleh-Sedghpour, Paul Allard</p> There is obscurity about the role of the knee joint during quiet standing (QS) postural control. Examining the knee joint’s contribution during QS in individuals with damaged knee proprioception can help resolve the ambiguity. We investigated whether anterior cruciate ligament reconstruction (ACLR) changes the relative contribution of lower-limb joint motions and postural control during QS. This study included 12 individuals with ACLR and 12 able-bodied individuals. A motion capture system and two force plates were used. The acceleration of the joints, the acceleration of the body center of mass (COM), and the COP parameters were calculated during QS under eyes open (EO) and eyes closed (EC) conditions. In the control group under the EO condition, ankle, knee, and hip accelerations, and under the EC condition, ankle and hip accelerations were primary predictors of COM acceleration. In the ACLR group, under the EO condition, the knee and hip accelerations, and in the EC condition, the ankle, knee, and hip accelerations were prominent predictors. The ACLR group exhibited higher COP parameters than the control group in the closed-eyes condition. The knee plays a vital role in QS postural control. Improving knee proprioception modalities and lower-limb joint coordination is important in ACLR rehabilitation. Natthapon Inta Annmarie Grealish Mary Leamy 10.1371/journal.pone.0353706 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Natthapon Inta, Annmarie Grealish, Mary Leamy</p> Introduction <p>Strong community-based services and healthcare providers with a clear understanding and positive attitudes towards recovery, are central to delivering good quality mental health care in collaboration with service users. Although recovery has been explored in several Asian contexts, its interpretation remains diverse, and consensus on the definition and meaning of personal recovery in Thailand is limited. Further research is needed to explore how mental health service users, carers, and healthcare professionals understand and experience recovery and recovery support, in order to advance recovery-oriented practice within the local sociocultural context.</p> Aim <p>To explore thoughts, perceptions, and experiences of mental health service users, carers, and healthcare professionals on mental health recovery and recovery support in Thailand.</p> Methods <p>A qualitative descriptive study using reflexive thematic analysis, which forms the experience gathering phase of an Experience Based Co-Design (EBCD) study. Thirty semi-structured interviews and two feedback workshops with three service users and eight healthcare professionals were conducted.</p> Results <p>Four themes were identified: (i) conceptions of mental health recovery, (ii) attitudes towards recovery, (iii) characteristics of a successful recovery journey, and (iv) factors impeding recovery. Participants viewed recovery as beginning with clinical and functional improvement, progressing to personal recovery characterised by hope, meaning, and social connectedness. Family support, community acceptance, and supportive healthcare relationships were central to recovery, while barriers operated at individual, family, service, and community levels.</p> Conclusion <p>This study integrates the perspectives of mental health service users, carers, and healthcare professionals to generate new insights into personal recovery within Thai community mental health care. From these findings, we propose a culturally situated Recovery Support Model that foregrounds the interconnected roles of personal agency, family involvement, professional engagement, and community support as drivers of recovery-oriented practice within the Thai mental health system.</p> Yu Wang Jing Zheng Qun Lv Guang-Min Xu Hao Xie Bo-Fei Dong Xue Wang 10.1371/journal.pone.0353675 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Yu Wang, Jing Zheng, Qun Lv, Guang-Min Xu, Hao Xie, Bo-Fei Dong, Xue Wang</p> Background <p>Postoperative sepsis is a significant complication following ovarian cancer surgery. However, limited studies have explored the risk factors associated with postoperative sepsis following ovarian cancer surgery in this context. This study aimed to assess the prevalence of postoperative sepsis and identify its associated risk factors.</p> Methods <p>This study retrospectively analyzed data from patients who underwent ovarian cancer surgery between January 2010 and December 2019 using the Nationwide Inpatient Sample (NIS) database. The age range of the study population is between 18 and 99 years old. Patients were categorized into two groups based on the presence or absence of postoperative sepsis. Data on patient demographics (e.g., race, age), hospital characteristics (e.g., insurance type, bed size, teaching status, region), preoperative comorbidities, and postoperative complications were extracted for comparison. Univariate and multivariable logistic regression analysis were conducted to identify factors associated with postoperative sepsis.</p> Results <p>A total of 39,049 patients were identified in the NIS database. Among them, 1,288 cases of postoperative sepsis were observed, representing an incidence rate of 3.3%. Patients with postoperative sepsis exhibited higher hospital charges, advanced age, prolonged length of stay (LOS), and increased in-hospital mortality. Preoperative risk factors for postoperative sepsis included congestive heart failure, coagulopathy, metastatic cancer, etc. Postoperative sepsis was associated with major complications, including electrolyte imbalance, urinary tract infection, thrombocytopenia, etc.</p> Conclusions <p>The incidence of postoperative sepsis following ovarian cancer surgery has shown a slight increase over time. Postoperative sepsis is associated with advanced age, race, prolonged LOS, higher hospital charges, in-hospital mortality, preoperative comorbidities, and perioperative complications. Recognizing these risk factors is essential for improving patient prognosis.</p> Hannah Pearl Glucksman Andrew Shin Lawrence Yoo Luis Alberto Carvalho Claire Shelley Barnes 10.1371/journal.pone.0353667 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Hannah Pearl Glucksman, Andrew Shin, Lawrence Yoo, Luis Alberto Carvalho, Claire Shelley Barnes</p> Purpose <p>We performed a prospective study to assess the repeatability and reproducibility of the novel Brillouin Optical Scanning System (BOSS^®) in measuring the biomechanical properties of the cornea and crystalline lens in vivo, to determine device utility in a clinical setting.</p> Methods <p>Adult study participants underwent standard ophthalmic exams to confirm eligibility. At two separate visits to the clinic, monocular lens scans and corneal scans (one point and seven points, respectively) were performed three times on each of three BOSS devices, operated by different technicians. The measured Brillouin parameters per person included the lens stiffness and the stiffnesses (e.g., “Mean”, “Minimum”) across the seven corneal points. Results were combined across participants to calculate the coefficients of variation (CVs) for repeatability (within each device) and reproducibility (across devices), along with the repeatability and reproducibility limits (2.8 times the respective standard deviations).</p> Results <p>Eleven of the 33 participants (ages 24–72 years; 15 females) had keratoconus (5 with prior crosslinking, 3 without crosslinking, and 3 post-keratoplasty); the other 22 participants were visually normal. There were no adverse events. The average lens stiffness was 3.33 ± 0.052 GPa (mean ± SD), with an overall repeatability CV of 1.6%, with values ranging from 3.35 ± 0.037 GPa with a CV of 1.1% to 3.30 ± 0.071 with a CV of 2.1% across the separate devices. The mean corneal stiffness was 2.83 ± 0.031 GPa, with an overall repeatability CV of 1.1%, ranging from 2.85 ± 0.015 with a CV of 0.5% to 2.81 ± 0.036 with a CV of 1.3% across devices. The reproducibility CVs were 2.1% and 1.6% for lenses and corneal Means, respectively.</p> Conclusions <p>The study results demonstrated consistent stiffness values for both lenses and corneas within and between the three BOSS devices tested. The study shows that this device could be a useful new biomechanics-measuring tool for applications in ophthalmology.</p> Raeon Jang Changsop Yang Jae-Hong Kim Dongwoo Nam Jeong-Cheol Shin Gwang-Cheon Park Byoung-Kab Kang Kyung-Min Shin Ae-Ran Kim 10.1371/journal.pone.0353654 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Raeon Jang, Changsop Yang, Jae-Hong Kim, Dongwoo Nam, Jeong-Cheol Shin, Gwang-Cheon Park, Byoung-Kab Kang, Kyung-Min Shin, Ae-Ran Kim</p> <p>This pilot study explored the safety and efficacy of invasive laser acupuncture (ILA) using two wavelengths (650 and 830 nm) compared with a sham laser in patients with knee osteoarthritis (KOA). This randomized, parallel-arm, patient- and outcome assessor-blinded, placebo-controlled, single-center clinical trial was designed with three groups (control, 650, and 830 nm), and 45 participants were randomly allocated in a ratio of 1:1:1. All participants were treated with ILA on the more affected side at SP9, SP10, ST34, ST35, EX-LE2, EX-LE4, and GB34 for 10 minutes per session, twice weekly, for a total of 12 sessions over 6 weeks. The primary outcome was the change in pain visual analog scale (VAS) score at rest and during activity at baseline (Visit 1) versus 1 week after intervention completion (Visit 13). Secondary outcomes included VAS scores after six treatments (Visit 7) and 6 weeks after intervention completion (Visit 14), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L), patient’s global assessment, rescue medication dosage, and responder rate. Changes in the VAS scores at rest (p = 0.0044, Visit 13; p = 0.0001, Visit 14) and during activity (p = 0.0038, Visit 13; p < 0.0001, Visit 14) were significantly different among the three groups. Significant differences were also observed in WOMAC total (p = 0.0278, Visit 7; p = 0.0485, Visit 13; p = 0.0051, Visit 14), pain (p = 0.0073, Visit 7; p = 0.0210, Visit 13; p = 0.0038, Visit 14), function subscale (p = 0.0055, Visit 14), and EQ-5D-5L scores (p = 0.0131, Visit 14). No ILA-related adverse events or significant changes in vital signs or laboratory results were observed during the study. ILA at 650 and 830 nm showed preliminary signals of short-term pain reduction. However, these preliminary findings should be confirmed in larger, rigorously designed clinical trials.</p> Trial registration <p>CRIS registration number: KCT0008860; registered on 10/11/2023 (https://cris.nih.go.kr/cris/search/detailSearch.do/25506).</p> Charlotte E. Lee Hollie Birkinshaw Matthew Garner Tamar Pincus 10.1371/journal.pone.0353615 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Charlotte E. Lee, Hollie Birkinshaw, Matthew Garner, Tamar Pincus</p> Managing chronic pain involves cognitive and emotional challenges that may affect treatment adherence. Patients’ ability to remember clinician advice is therefore important. Clinician behaviours may influence these processes. To investigate whether recounting autobiographical memories of perceived validating (vs. invalidating) healthcare experiences influences subsequent recall of health-related information in people living with chronic pain, 245 adults with chronic pain (≥3 months) were recruited online. Eligibility criteria included: age ≥ 18 years, fluent in English, no hearing difficulties or mental health conditions, and at least one healthcare visit in the previous two years. Participants were quasi-randomly assigned to describe either a validating or invalidating consultation they had previously experienced. Before and after this task, participants rated their pain intensity and pain-related fear. Participants then listened to 20 health messages and were later asked to recall them in an incidental memory test. The primary outcome was incidental recall of health messages, operationalised as the likelihood of recalling each of the 20 messages. Secondary outcomes included pain intensity and pain-related fear. Recall was analysed using a binomial generalized linear mixed-effects model accounting for individual differences (pain intensity, pain-related fear, immersion in the task, age, sex, and pain duration).Participants who described a validating consultation were more likely to recall health messages than those in the invalidating condition (19% higher odds of recalling each message, based on model estimates). The association was not mediated by change in pain-related fear. These findings indicate that remembering validating consultations might boost retention of health information, highlighting clinician-validation as a potential strategy to support cognitive functioning in people living with chronic pain. Alina Savinova Theerakarn Srisangsung Pipob Suwanchaikasem Waranyoo Phoolcharoen 10.1371/journal.pone.0353563 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Alina Savinova, Theerakarn Srisangsung, Pipob Suwanchaikasem, Waranyoo Phoolcharoen</p> Agrobacterium-mediated transient expression in <i>Nicotiana benthamiana</i> is widely used for recombinant biopharmaceutical production. To investigate the host plant response upon human cytokine production with contrast accumulation, we expressed codon optimized human IL1 beta, serving as a high expression benchmark with a yield of approximately 80 μg/g leaf fresh weight, and IL15 with undetected signal on western blot, representing protein with low level of accumulation, using the geminiviral vector system. A combined proteomics and metabolomics technique was applied to elucidate underlying cellular mechanisms. Quantitative proteomics revealed that IL1-His was robustly detected (9 unique peptides, 83% coverage), whereas no IL15-His–derived peptides were identified. Based on pathway analysis, the expression of IL15-His induced chaperone expression, with downregulation of photosynthetic and primary metabolism pathways. Additionally, metabolomic pathway analysis revealed that IL1-His preferentially drives the branched chain amino acid biosynthesis, but IL15-His shifts metabolism towards phenylpropanoid biosynthesis routes. These findings underscore that the characteristics of the target protein and its interaction with the host's physiology could influence the yield of the recombinant protein production in plants. Da Zhang Han Song Pingzhi Li Yixi Guo Yating Luo Sheng Mao Zijia Feng Shuwen Zheng Zhuoyan Jiang 10.1371/journal.pone.0353417 2026-07-20T14:00:00Z 2026-07-20T14:00:00Z <p>by Da Zhang, Han Song, Pingzhi Li, Yixi Guo, Yating Luo, Sheng Mao, Zijia Feng, Shuwen Zheng, Zhuoyan Jiang</p> Current research on toponymic cultural landscapes lacks systematic attention to geographical transition zones and often neglects the interpretation of long-term evolutionary processes and driving mechanisms. This study examines 1,854 township-level place names in Hebei Province, China, by integrating methods such as kernel density estimation, geographic detectors, and spatial autocorrelation analysis. Focusing on the transition zone along the Taihang Mountains–Great Wall corridor, patterns of spatiotemporal differentiation and the dual mechanisms shaping changes in place names are investigated. The findings reveal significant spatiotemporal variation in Hebei’s place names. Natural environment names have contracted toward northeastern mountainous and coastal regions, while cultural names have shifted northward. The transition zone exhibited a “military-to-civilian” transformation characteristic during the Ming and Qing dynasties. Slope gradient and vegetation coverage are identified as primary natural drivers, whereas ethnic integration and migration during the Ming Dynasty constitute the key social factors. This study enriches interdisciplinary research on human–land relationships and toponymic landscapes in transition zones, proposes region-specific conservation strategies, and provides a scientific basis for the protection of toponymic cultural heritage in similar transition zones across Hebei and North China.