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 2026-09-04T03:53:50Z Pierre Charlier Mathieu Jeanne Maxence Hureau Julien De Jonckheere 10.1371/journal.pone.0357922 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Pierre Charlier, Mathieu Jeanne, Maxence Hureau, Julien De Jonckheere</p> Heart rate and cardiac dynamics can be monitored using several physiological signals, each with its own biophysical basis and signal characteristics. However, while individual properties of electrocardiogram (ECG), phonocardiogram (PCG), seismocardiogram (SCG), photoplethysmogram (PPG), and piezoplethysmogram (PiPG) are documented, systematic cross-modal comparisons remain scarce. This study aims to consolidate both the time and frequency domain features of these widely accessible technologies to provide practical guidelines for signal processing and multimodal integration. We simultaneously recorded ECG, PCG, SCG, PPG, and PiPG under standardized resting conditions and aligned all modalities on the ECG R-peak. Results highlight clear consistencies (e.g., reproducible morphology and spectra for ECG, PPG, and PiPG) as well as higher variability in PCG and SCG due to sensor coupling and anatomical factors. Temporal latencies relative to the ECG confirm known physiological conduction delays, while frequency analysis identifies modality-specific bands: ~ 30 Hz for PCG, 11–14 Hz for SCG, and 1–2 Hz for PPG/PiPG. Bandwidth analysis further emphasizes differences in spectral richness across modalities. By presenting these benchmarks in a unified framework, this work addresses the current gap between isolated characterizations and integrated signal knowledge. The outcome is a reference dataset and interpretation map that can guide filtering strategies, feature extraction, and the design of multimodal cardiac monitoring systems. Jingxia Dang Yuhui Geng Ting Pan Ping Zhang Mingbo Chen Dongfeng Pan Peifeng Liang 10.1371/journal.pone.0357884 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Jingxia Dang, Yuhui Geng, Ting Pan, Ping Zhang, Mingbo Chen, Dongfeng Pan, Peifeng Liang</p> Kexin Wei Ziyang Wang Xinyu Duan Wei Liu Yueling Xiao Rong Zhu 10.1371/journal.pone.0357793 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Kexin Wei, Ziyang Wang, Xinyu Duan, Wei Liu, Yueling Xiao, Rong Zhu</p> Online review data and traditional questionnaire data are common data sources in the current field of cultural heritage research. The former features a large data volume yet suffers from obvious limitations such as incompleteness, algorithm interference, dirty data and sensitivity; the latter enjoys a high degree of quantification but is constrained by high costs and limited sample size. To explore the complementary mechanism of the two types of data, this study selects 9 national-level former residences of celebrities in Yangzhou as cases and adopts a sequential mixed-methods design. First, content analysis and thematic coding are conducted on online reviews to identify 5 major categories of negative evaluations, based on the coding results, an indicator system is constructed, and offline questionnaire data are collected for AHP-FCE quantitative analysis. The results show that the two types of data exhibit partial correspondence in diagnosing core shortcomings, which, to a certain extent, reflects the inherent logic of the sequential design in which the questionnaire indicators were derived from the online review coding. Cultural expression, interactive experience, accessibility, and signage facilities are jointly identified as the weakest dimensions. Online data provide detailed descriptions and situational characteristics, while questionnaire data reflect the weight and severity of existing problems. Meanwhile, discrepancies exist between the two datasets. Complaints about service attitude appear frequently in online reviews, while this item scores well in questionnaires, reflecting the difference between extreme individual cases and overall public perception. Overall, online review data can truly and centrally reflect systematic defects, possessing unique advantages in capturing specific details and users’ real emotional perceptions. Questionnaire survey data can reflect the severity of problems with strong pertinence through weight analysis. The integrated management and diagnosis framework combining the two approaches provides timely and insightful decision-making support for the targeted optimization of cultural heritage sites, in which the granularity differences between the two data types offer a unique perspective for understanding tourist experiences. Saori Miura Shinji Horikawa Kana Morizono Miyu Miyazaki Hiroki Torii Hiromi Kuroda Emi Matsuura 10.1371/journal.pone.0357733 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Saori Miura, Shinji Horikawa, Kana Morizono, Miyu Miyazaki, Hiroki Torii, Hiromi Kuroda, Emi Matsuura</p> Objective <p>This study aimed to evaluate short-term physiological and psychological changes associated with participation in a community-based Kurort Health Walking program conducted in a forest environment.</p> Patients and methods <p>This study was conducted as part of a public health program in Saikai City, Nagasaki, Japan. A total of 90 participants who attended certified Kurort Health Walking courses between March 2024 and March 2025 were included. Physiological parameters, including systolic and diastolic blood pressure and pulse rate, and psychological status were assessed before and after the walking session. Autonomic nervous activity was evaluated using heart rate variability indices, including the low-frequency/high-frequency ratio and high-frequency power, measured at four time points before, during, and after the walk. Mood states were assessed using validated questionnaires.</p> Results <p>Systolic and diastolic blood pressure decreased significantly after the walking session (p < 0.001). Neither the low-frequency/high-frequency ratio nor high-frequency power showed significant changes across the measurement points. Negative mood states decreased significantly, whereas positive mood states, including vigor, friendliness, pleasure, and relaxation, increased, and anxiety decreased after walking (p < 0.001).</p> Conclusion <p>Participation in the community-based Kurort Health Walking program was associated with short-term changes in physiological and psychological measures. However, because this study did not include a control group, the independent contributions of the forest environment, physical activity, and other contextual factors could not be distinguished.</p> Belal Elmarhoumy Mahmoud Salloum Thamir Bahattab Hussein Alhelaly Mohammed Sghaireen Matheel AL-Rawas Johari Yap Abdullah A. S. M. Rafiul Haque Mohammed Mousa 10.1371/journal.pone.0357673 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Belal Elmarhoumy, Mahmoud Salloum, Thamir Bahattab, Hussein Alhelaly, Mohammed Sghaireen, Matheel AL-Rawas, Johari Yap Abdullah, A. S. M. Rafiul Haque, Mohammed Mousa</p> The present study evaluated the influence of 3% and 10% (by weight) silicon dioxide (SiO2) and titanium dioxide (TiO2) nanoparticles (NPs) on the tear strength, tensile strength, and elongation at break of a room-temperature vulcanizing (RTV) maxillofacial silicone elastomer (MFSE; A-2000) after two years of natural tropical weathering. A total of 160 specimens (80 dumbbell-shaped and 80 trouser-shaped) were allocated to non-weathered and weathered groups, each divided into five subgroups (n = 8): unfilled control, 3% SiO2, 10% SiO2, 3% TiO2, and 10% TiO2. Weathered specimens were exposed outdoors in a hot, humid tropical climate for two years. Mechanical properties were measured using a universal testing machine. Data were analyzed using two-way ANOVA followed by Tukey HSD post-hoc tests (α = 0.05). In non-weathered specimens, 3% SiO2 increased tear strength by 34% (17.89 ± 0.31 vs. 13.38 ± 1.07 N/mm; <i>P</i> < 0.001) and tensile strength by 35% (4.28 ± 0.27 vs. 3.16 ± 0.13 MPa; <i>P</i> < 0.001) compared with the unfilled control. After natural tropical weathering, only the 3% SiO2 group maintained a significantly higher tear strength (14.03 ± 2.10 N/mm) than the unfilled group (11.09 ± 1.53 N/mm; <i>P</i> = 0.007). Weathering significantly reduced tear strength in all NP-filled groups (<i>P</i> < 0.001) but increased tensile strength across all groups (P < 0.01), with the smallest increase observed in the 10% TiO2 group (+10.1%; <i>P</i> = 0.004). Elongation at break decreased significantly in all groups following weathering (<i>P</i> < 0.001); however, NP-filled groups retained substantially higher elongation values (losses of 13.1–17.6%) than the unfilled control (loss of 51.1%). In conclusion, the incorporation of 3% SiO2 NPs significantly enhanced the mechanical properties of A-2000 MFSE both before and after two years of natural tropical weathering, whereas higher loading (10%) offered no additional benefit. These findings support the use of low-content SiO2 NPs to improve the long-term durability of maxillofacial prostheses. Yuan Mao Wei Zheng Qian Chen 10.1371/journal.pone.0357672 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Yuan Mao, Wei Zheng, Qian Chen</p> Objective <p>To address the safety risk of mistaking tap water or purified water for acidic electrolyzed oxidizing water (AEOW) during manual cleaning in central sterile supply departments (CSSDs), this study aimed to develop a low-cost, rapid identification device based on electrical conductivity differences to ensure the accuracy and safety of the disinfection process.</p> Methods <p>A lighthouse-shaped rapid identification device (LRID) was fabricated based on the significantly higher electrical conductivity of AEOW compared with tap water and purified water. Centered on an Arduino Nano microcontroller, the device integrates a conductivity sensor, a wireless charging module, and an LED indication system. It achieves automatic discrimination by detecting liquid electrical conductivity: the green LED remains illuminated for AEOW, while the red LED lights up for tap water or purified water. Identification accuracy, battery life, and waterproof performance were evaluated, and the satisfaction of CSSD technicians with the conventional pH test strip method and the LRID was compared.</p> Results <p>The LRID achieved 100% identification accuracy (90/90) for AEOW, tap water, and purified water collected from the CSSDs of 10 hospitals. The average battery life was 83.75 ± 1.27 h, supporting a weekly charging schedule. All devices functioned normally after continuous immersion in AEOW for 30 days, confirming reliable waterproof performance. Scores from 28 CSSD technicians showed that the LRID was significantly superior to the pH test strip method in identification accuracy, ease of operation, and promotability (P < 0.001).</p> Conclusion <p>This study successfully developed and validated a low-cost (approximately 20 USD), highly reliable, and easy-to-operate AEOW rapid identification device. The LRID effectively prevents disinfection failures caused by liquid misuse in CSSDs and holds significant potential for its application and promotion.</p> Yuta Nemoto Fumie Otsuka Shihoko Suzuki Saori Kataoka Tomoko Nakanishi Takuya Ueda Susumu Ogawa Sumika Karasawa Mikiko Shimaoka Hiroto Narimatsu Ung-il Chung 10.1371/journal.pone.0357666 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Yuta Nemoto, Fumie Otsuka, Shihoko Suzuki, Saori Kataoka, Tomoko Nakanishi, Takuya Ueda, Susumu Ogawa, Sumika Karasawa, Mikiko Shimaoka, Hiroto Narimatsu, Ung-il Chung</p> Background <p>Esports (competitive and organised video gaming) may enhance physical and cognitive health in older adults. The aim of this study was to examine the feasibility and effects of a multicomponent program incorporating esports on physical and cognitive function in community-dwelling older adults.</p> Methods <p>This parallel, non-randomised controlled trial was conducted in Yokosuka, Kanagawa, Japan. Twenty-six participants who 1) were aged 60 years or older, 2) had no cognitive impairment, 3) had no major health problems, and 4) had no prior experience with digital games were allocated to either the intervention (n = 12) or the control (n = 14) group. Participants in the intervention group attended weekly 90-minute sessions consisting of health education, exercise, and esports for 12 weeks. The feasibility of the program was assessed based on adverse events, participant retention, adherence to the program, engagement in digital games outside the program, enjoyment of the program, and willingness to continue playing esports after the study period. Additionally, psychological status, physical and cognitive function, and body composition were assessed.</p> Results <p>No adverse events were reported; 10 of the 12 participants attended ≥80% of the sessions, all participants reported enjoying the program, and no participants dropped out during follow-up. Positive psychological status scores increased from before to after each session among participants in the intervention group. Furthermore, adjusted analyses showed more favourable changes in gait speed and balance in the intervention group than in the control group (<i>p</i> < 0.05). However, the effects on physical function remain uncertain because the analyses were exploratory.</p> Conclusions <p>The program showed potential for high retention and adherence among older adults, with no adverse events. Larger-scale trials are needed to confirm the effectiveness of this intervention program, as the analyses in this study were exploratory.</p> Trial registration <p>The study protocol was registered with the UMIN-CTR (ID: UMIN000055350; date of first registration: 27 August 2024).</p> Dhirendra Prasad Yadav Bhisham Sharma Julian L. Webber Abolfazl Mehbodniya 10.1371/journal.pone.0357664 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Dhirendra Prasad Yadav, Bhisham Sharma, Julian L. Webber, Abolfazl Mehbodniya</p> Colorectal cancer is the third most common malignancy worldwide. Manual screening requires expertise and resources. However, advancements in AI (artificial intelligence) have reduced the computation burden and time. Machine and deep learning have recently been used to diagnose colorectal lesions. The requirement of handcrafted features makes machine learning models expertise-dependent. At the same time, classical CNN (convolutional neural network) miss the global attention of the features. This work presents CDCTNet (colorectal diagnosis convolution transformer network), a hierarchical model for colorectal disease detection. Our model utilized two convolution blocks for the local high-dimensional spatial features from the lesion. In addition, the ViT encoder is used in parallel with the CNN block to provide a global correlation of the feature map. Furthermore, we designed an IEM block for the interaction of the features between the convolution block and ViT encoder to improve the attention on the features. The CDCTNet is evaluated on Kather and Kvasir datasets and obtained a precision and Kappa score of 96.60% and 95.02%, respectively. At the same time, CDCTNet has recall and F1 scores of 98.08% and 97.94%. The PLOS One Staff 10.1371/journal.pone.0357646 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by The PLOS One Staff </p> Siyi Song Jinfeng Du Huangkun Wei Muhamad Shamsul Ibrahim Hamedi Mohd Adnan 10.1371/journal.pone.0357611 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Siyi Song, Jinfeng Du, Huangkun Wei, Muhamad Shamsul Ibrahim, Hamedi Mohd Adnan</p> As social media platforms increasingly influence contemporary understandings of health and the body, fitspiration—a blend of “fitness” and “inspiration”—has become a widespread visual genre that promotes exercise, discipline, and culturally idealized physiques. Recent research has linked fitspiration content to negative body image among women, yet most studies focus on Western populations. Cultural differences in beauty ideals suggest that findings from Western contexts may not fully apply to Asian women. However, research on fitspiration in Asia, particularly China, remains limited. To address this gap, this study conducted an online experiment with 414 Chinese women aged 18–26, randomly assigned to view thinspiration, fitspiration, or neutral scenery images. Body appreciation and functionality appreciation were measured before and after exposure. Results showed that fitspiration images significantly reduced both body and functionality appreciation compared to neutral images. Thinspiration images produced even lower body and functionality appreciation than fitspiration. This study underscores the need to recognize and critically examine the potential risks of fitspiration content within the Chinese cultural context. Jiayu Zhu Anding Liu 10.1371/journal.pone.0357599 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Jiayu Zhu, Anding Liu</p> To explore the mechanisms underlying Gen Z consumers’ willingness to continue using slow fashion apparel, this study constructs a conceptual model based on SOR theory. The model considers personal and social fashion consciousness as stimulus variables, aesthetic, emotional, social, and green values as organism variables, and willingness to continue using as the response variable. Data were collected through a questionnaire based on a 7-point Likert scale, yielding 311 valid responses. SPSS and JASP were used to assess reliability and validity and examine direct and mediation effects. The results indicate that personal fashion consciousness, social value, and green value are all significantly and positively associated with willingness to continue using slow fashion apparel. Personal fashion consciousness is positively associated with perceived aesthetic and emotional values, whereas social fashion consciousness is positively associated with perceived social and green values. Furthermore, social and green values mediate the relationship between social fashion consciousness and willingness to continue using slow fashion apparel. However, the mediating effects of aesthetic and emotional values are not significant. This study suggests that in the context of sustainable consumption, value-related factors may better explain long-term use behavior than aesthetic experiences alone. These findings suggest that slow fashion brands should support individual expression and sustainability-related meanings and enhance Gen Z consumers’ perceptions of green and social value, thereby encouraging continued use of slow fashion apparel and promoting sustainable fashion development. Md. Golam Rabby Md. Nayim Hossain Maymuna Islam Keya Md. Ashrafuzzaman Zahid Rashida Parvin Md Syduzzaman 10.1371/journal.pone.0357592 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Md. Golam Rabby, Md. Nayim Hossain, Maymuna Islam Keya, Md. Ashrafuzzaman Zahid, Rashida Parvin, Md Syduzzaman</p> This study evaluated how Monkey jack pulp extract (MJPE) impacted the raw Pangasius (<i>Pangasianodon hypophthalmus</i>) fish balls physicochemical quality, microbiological safety, oxidative, and storage stability while being refrigerated. Fish balls were made with several antioxidants, including control (T0), butylated hydroxytoluene (BHT, T1), ascorbic acid (AA, T2), and MJPE at increasing concentrations (T3 and T4), and kept for 10 days at 4°C. On days 1, 5, and 10, changes in pH, cooking loss, color characteristics (<i>L*</i>, <i>a*</i>, <i>b*</i>, chroma, and hue angle), heme iron content, antioxidant activity (DPPH), lipid oxidation (TBARS), and total viable count (TVC) were assessed. All samples showed quality decrease with increasing storage time. However, antioxidants treated samples showed significantly (<i>P</i> < 0.05) higher stability than the control treated samples in every storage day. T4 successfully inhibited pH rise, decreased cooking loss, maintained higher heme iron levels, and preserved color characteristics rather than other treatments. Additionally, T4 showed higher DPPH scavenging capacity (ranged 72.44% to 65.79%), whereas the control showed the lower DPPH value (ranged 56.57% to 33.39%). TBARS value showed the lowest (0.31 to 0.41 mg MDA/kg sample) in T4 and the highest (0.49 to 0.67 mg MDA/kg sample) in the control. MJPE considerably reduced bacterial growth (0.80 to1.68 Log10 CFU/mL) compared to control and synthetic antioxidants treated samples. In terms of keeping the quality and enhancing the shelf life, MJPE demonstrated significantly improved antioxidant and antimicrobial effects compared to BHT and AA (<i>P</i> < 0.05). MJPE showed significant potential as a natural preservative for fish-based products by improving their physicochemical, microbiological, and oxidative stability during refrigerated storage. Afsaneh Omidimorad Fariba Kolahdooz Ghazal Kolahdooz Adrian Wagg Paul Veugelers André Corriveau Kami Kandola Stephanie Irlbacher-Fox Gina Ogilvie Carolyn Gotay Sangita Sharma 10.1371/journal.pone.0357586 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Afsaneh Omidimorad, Fariba Kolahdooz, Ghazal Kolahdooz, Adrian Wagg, Paul Veugelers, André Corriveau, Kami Kandola, Stephanie Irlbacher-Fox, Gina Ogilvie, Carolyn Gotay, Sangita Sharma</p> Objectives <p>Human papillomavirus (HPV) is a common sexually transmitted infection linked to several cancers, including cervical cancer, which ranks fourth in cancer incidence and mortality among women globally. Despite its significance, awareness of HPV and the HPV vaccine remains limited across many populations. This project assessed HPV and HPV vaccine awareness among Indigenous adults in Northwest Territories communities in Canada and explored factors influencing HPV vaccine utilization; such data have never been available or explored.</p> Methods <p>Using a community-based participatory research approach, quantitative and qualitative data were collected in 11 Indigenous communities in Northwest Territories. Indigenous adults aged 18 years and older were invited to complete a semi-structured questionnaire administered by trained local research assistants. Multiple logistic regression was used to examine potential associations among age, gender, education, and awareness of HPV and the HPV vaccine. A thematic analysis of qualitative data explored reasons for non-vaccination.</p> Results <p>Among the 221 participants (66.5% women; mean age 43.6 years (±13.9)), approximately half had heard of HPV, and fewer than one-third had heard of the HPV vaccine. Education emerged as a key factor, with individuals with lower educational attainment being significantly less aware of HPV (p < .000). Age (p < .033), gender (p < .019), and education (p < .004) predicted vaccine awareness, with women, individuals with higher education, and younger adults being more likely to have heard about the vaccine. Only 26.3% of participants aged up to 26 years had received the HPV vaccine. Qualitative data revealed that limited awareness and insufficient information about HPV and the vaccine are the main barriers to vaccination. Participants recommended enhancing vaccine promotion by raising awareness about the connection between HPV and cancer, as well as increasing educational efforts in schools and communities.</p> Conclusions <p>Limited awareness of the HPV vaccine may contribute to low vaccination rates. Tailored and targeted interventions are crucial to increasing HPV vaccine utilization in Indigenous communities in Northwest Territories.</p> Hongwei Zheng Wenbiao Chen 10.1371/journal.pone.0357585 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Hongwei Zheng, Wenbiao Chen</p> Background <p>High AUROC is often taken as evidence that a transcriptomic classifier is promising, but rank discrimination can conceal fixed-threshold failure after cohort or platform transfer.</p> Methods <p>We benchmarked four GEO whole-blood cohorts: GSE65682 for discovery, GSE95233 for external microarray validation, GSE154918 for cross-platform RNA-seq validation, and GSE28750 for non-infectious inflammation stress testing. We compared logistic-regression workflows using training-derived standard scaling, training-derived robust scaling, sample-wise rank normalization with training-derived scaling, and robust scaling using unsupervised external-cohort reference statistics. Internal performance used five-fold cross-validation with fold-contained imputation and scaling. External uncertainty used 2,000 stratified bootstrap replicates.</p> Results <p>Internal discrimination was very high for all strategies, but external validation revealed threshold collapse for training-derived standard and robust scaling. In GSE154918, both had balanced accuracy 0.50 at the 0.5 threshold despite very high AUROC, equivalent to random classification at that fixed threshold. The strict-inductive sample-rank strategy preserved fixed-threshold performance across external cohorts (balanced accuracy 0.95–1.00). Robust external-cohort adaptation also performed well (0.95–1.00) but uses unlabeled external-cohort distribution statistics and is therefore reported as adaptation rather than fixed single-sample transfer. Calibration and regularization sensitivity did not rescue the failing training-derived scaling strategies. In the sepsis-versus-non-infectious-inflammation stress test, robust external-cohort adaptation had the highest observed balanced accuracy (0.80, 95% CI 0.61–0.95), but its difference from sample-rank normalization was uncertain in paired bootstrap analysis.</p> Conclusions <p>High AUROC can mask fixed-threshold failure in sepsis transcriptomic classifiers. In this benchmark, strict-inductive sample-rank normalization was the most stable fixed external strategy, while robust external-cohort scaling was best interpreted as unsupervised cohort adaptation whose reliability depends on external reference-sample availability.</p> The PLOS One Editors 10.1371/journal.pone.0357531 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by The PLOS One Editors </p> The PLOS One Editors 10.1371/journal.pone.0357529 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by The PLOS One Editors </p> The PLOS One Editors 10.1371/journal.pone.0357518 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by The PLOS One Editors </p> Hung-Chih Yeh Chia-An Ho En-Yu Chang Hei-Tung Lau Chih-Wen Hsu Hsin-Yu Tu Pei-Hsuan Wang Chin-Shan Ho 10.1371/journal.pone.0357488 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Hung-Chih Yeh, Chia-An Ho, En-Yu Chang, Hei-Tung Lau, Chih-Wen Hsu, Hsin-Yu Tu, Pei-Hsuan Wang, Chin-Shan Ho</p> The isometric mid-thigh pull (IMTP) is a reliable method for assessing whole-body maximal isometric strength; however, the influence of lifting straps on IMTP performance remains unclear, particularly in sports such as judo that rely heavily on grip strength. This study recruited 30 male participants, including 15 judo athletes and 15 recreationally resistance-trained undergraduates, who completed IMTP tests under strapped and non-strapped conditions in a randomized order. Peak force (PF), rate of force development (RFD), and impulse (IP) were measured using a 1000 Hz force plate, and a two-way mixed ANOVA was used to examine the effects of group and strap condition. The results showed no significant interaction between group and condition. However, significant main effects of both group and strap condition were observed for most variables (<i>p</i> < 0.05), with higher PF, RFD, and IP recorded under the strapped condition. Judo athletes also demonstrated greater grip strength (51.3 ± 3.4 kg) than the resistance-trained group (44.7 ± 3.3 kg, <i>p</i> < 0.01). These findings suggest that the use of lifting straps enhances IMTP performance and may reduce the influence of grip strength limitations on maximal force expression. Therefore, when the purpose of IMTP testing is to assess maximal force production, the use of lifting straps may be considered to minimize the potential influence of grip-related limitations and to standardize testing procedures across athletes. Sangrak Son Jin Wei-Kocsis Amanda Deering Lori Hoagland Krishna Nemali 10.1371/journal.pone.0357482 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Sangrak Son, Jin Wei-Kocsis, Amanda Deering, Lori Hoagland, Krishna Nemali</p> Liquid organic fertilizers (LOF) are used to supply additional nutrients to crops. However, LOF are expensive to use regularly. In this research, a smart fertigation treatment (S), where LOF was applied based on lettuce plant growth, was compared to a manual treatment (M) in a greenhouse. Digital sensors with IoT capability were installed in S and M treatments. The sensor in S treatment was interfaced to a solid-state relay connected to a pump, to automatically regulate LOF application. Digital sensors in both treatments measured canopy area (CA) of plants once every three days using image analysis and remotely exchanged data. In the M treatment, LOF was applied every third day to plants, whereas the LOF application was regulated by the sensor in S treatment to happen only when CA of plants was lower by 10% than those in the M treatment. Results indicated no differences in fresh weight (33.4 vs. 32.3 g·plant⁻¹) and leaf area (770.2 and 772.6 cm⁻²) of plants between two treatments. Nutrient concentration in the root zone, measured as electrical conductivity of substrate, was significantly higher (21–69%) in M than S treatment. The number of fertigation events and cost of LOF applied were approximately four times higher in M than S treatment. This resulted in higher fertilizer-use-efficiency in S (1.159 kg ∙ m⁻² ∙ $⁻¹) than M (0.168 kg ∙ m⁻² ∙ $⁻¹) treatment. These results indicate that the smart fertigation method can optimize LOF application (i.e., reduce wastage and costs) while maintaining crop growth. Jozo Grgic Vanessa Kristina Wazny Dorian Varovic 10.1371/journal.pone.0357474 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Jozo Grgic, Vanessa Kristina Wazny, Dorian Varovic</p> We aimed to examine temporal changes in handgrip strength and develop reference values among adolescents (10–19 years; <i>n</i> = 4,867) in the Republic of Korea. A general linear model was used to explore differences in absolute and body size normalized (height and body mass) handgrip strength across survey years using data from KNHANES 2014–2022. Weighted percentiles were calculated to generate reference values. In some of the male age groups, handgrip strength was lower in 2016–2019 (−1.7 to −4.1 kg; −0.197 to −0.267 units) and higher in 2014–2015 (2.6 to 3.5 kg; 0.175 to 0.309 units), compared to 2022. In some of the female age groups, handgrip strength was lower in 2016–2019 (−1.6 to −2.6 kg; −0.123 to −0.302 units) and higher in 2014–2015 (1.4 kg; 0.178 to 0.316 units), compared to 2022. Reference values were lowest among 10–11‑year‑olds, showed progressive increases across older age groups, and differed according to sex. Overall, handgrip strength remained fairly stable over the 9-year period, even though in some of the years it was lower or higher compared to the most recent wave. However, these differences were generally small, did not occur at every survey year, and were completely absent for some of the sex and age groups. A similar pattern was observed for normalized values, although the results were not entirely consistent with absolute handgrip strength data. The provided reference values enable interpretation of absolute and body size normalized handgrip strength in Korean adolescents. Tancredo José Carlos Leonel Domingos Moiana Omar Jorge Sabbag Boniface Hussein J. Massawe Akwilina Wendelin Mwanri Kallunde Pilly Sibuga 10.1371/journal.pone.0357473 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Tancredo José Carlos, Leonel Domingos Moiana, Omar Jorge Sabbag, Boniface Hussein J. Massawe, Akwilina Wendelin Mwanri, Kallunde Pilly Sibuga</p> Agronomic biofortification with zinc (Zn) and iron (Fe) has emerged as a promising approach to enhance crop productivity while improving food and nutritional security. However, fertilizer recommendations based exclusively on maximum biological yield may not maximize farmers’ economic returns. This study integrated agronomic and economic analyses to identify the biologically and economically optimal Zn and Fe fertilization strategies for cowpea (<i>Vigna unguiculata</i> [L.] Walp.) under tropical field conditions in Mozambique. A randomized complete block design with a 3 × 4 × 4 factorial arrangement was used to evaluate three fertilization methods (soil, foliar, and combined soil + foliar) and four application rates of elemental Zn and Fe. Grain yield response was adequately described by a second-order polynomial regression model (R² = 0.767), with maximum technical efficiency predicted at 18.92 kg ha ⁻ ¹ Zn and 19.17 kg ha ⁻ ¹ Fe. In contrast, maximum economic efficiency was achieved at lower application rates (16.94 kg ha ⁻ ¹ Zn and 10.09 kg ha ⁻ ¹ Fe), reducing Fe input by 47.4% while maintaining more than 97% of the maximum predicted grain yield and increasing net profit. Across the evaluated treatments, the combined soil + foliar application produced greater grain yield and agronomic efficiency than either application method alone. Economic robustness was further evaluated through break-even, sensitivity, and stochastic risk analyses, which indicated positive economic performance across the evaluated treatnebts under the agronomic, environmental, and economic conditions considered in this study. Within the agronomic, environmental, and economic conditions evaluated in this single-site, single-season study, the economic optimum was reached before the biological optimum, demonstrating that integrating agronomic and economic optimization can substantially reduce micronutrient inputs while maintaining high productivity and profitability. These findings provide an evidence-based framework for developing economically efficient Zn and Fe fertilization strategies for cowpea under tropical smallholder farming systems. Patrick Addo-Fordjour Francis Emmanuel Awortwi Caleb Ezekiel Obodai Francis Boakye Aboagye Christine Naa Lamiley France Nana Serwaa Boakye Kusi-Appiah Derrick Oppong 10.1371/journal.pone.0357446 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Patrick Addo-Fordjour, Francis Emmanuel Awortwi, Caleb Ezekiel Obodai, Francis Boakye Aboagye, Christine Naa Lamiley France, Nana Serwaa Boakye Kusi-Appiah, Derrick Oppong</p> Reliable estimates of deforestation are essential for understanding the dynamics of forest change in order to guide conservation and land management policies. However, considerable variation exists among published estimates of forest loss in Ghana, creating uncertainty regarding the magnitude and drivers of deforestation. Furthermore, deforestation rates have largely been estimated for individual forest reserves or selected landscapes rather than for the entire country. To address this gap, the present study provided a nationally explicit assessment of deforestation rates and forest conversion pathways across Ghana between 2015 and 2025 using multi-temporal Sentinel-2 imagery and post-classification change detection techniques. Land use land cover maps were generated for 2015, 2020, and 2025 and used to quantify land cover transitions, estimate deforestation rates, and identify the dominant pathways through which forests were converted to other land uses. Our findings showed that the landscape was largely characterised by stable non-forest (73.82%) and stable forest (22.36%) cover over the study period. Nevertheless, Ghana lost approximately 279,227 ha of forest between 2015 and 2025, corresponding to a cumulative deforestation rate of 4.95% and an average annual deforestation rate of 0.40% yr ⁻ ¹. Forest loss increased from 130,878 ha during 2015–2020 to 149,984 ha during 2020–2025, indicating an acceleration in deforestation. Spatial analyses showed that stable forests were concentrated mainly within the southwestern high forest zone, whereas forest degradation was more widespread across the transition and savanna landscapes. Examination of forest conversion pathways revealed that agricultural expansion and mining were the predominant drivers of deforestation, accounting for 80.4% and 11% of total forest loss, respectively. Over the decade, mined area exhibited the greatest proportional increase (533.9%). The findings indicated that agricultural expansion remains the principal cause of forest loss in Ghana, although the rapid growth of mining activities constitutes an emerging threat to the country’s forest ecosystems. Continued forest loss is likely to undermine carbon sequestration capacity and compromise the contribution of Ghana’s forests to climate-change mitigation. By providing updated and spatially explicit estimates of forest change, this study fills a critical knowledge gap in national-scale deforestation assessment in Ghana. It also provides information relevant to national forest monitoring, land-use planning, and the development of strategies aimed at reducing deforestation and promoting sustainable landscape management. Rena Hidaka Akiko Kojo Yuji Masuda Shintaro Hata Misaki Tanaka Tona Watanabe Koichiro Matsuo 10.1371/journal.pone.0357410 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Rena Hidaka, Akiko Kojo, Yuji Masuda, Shintaro Hata, Misaki Tanaka, Tona Watanabe, Koichiro Matsuo</p> Background <p>Dental and oral health activities that promote awareness of oral health are essential in children’s nutrition education. We aimed to evaluate the effects of the Comprehensive Awareness Modification of Mouth, Chewing And Meal (CAMCAM) program for kids, in which participants gather monthly to learn about oral health and nutrition while consuming a textured meal at community children’s cafeterias.</p> Methods <p>This single-group pre–post pilot intervention without a control group included 52 children and 32 parents/guardians who regularly attended two community children’s cafeterias in Tokyo, Japan. They participated monthly in six sessions in which they were provided a “munchy” textured meal and a 10-minute lecture on chewing, oral health, and food and nutrition. Participants completed questionnaires assessing their awareness of the subject and food intake frequency, before and after the intervention. Changes in awareness and behaviors following participation in the program were analyzed.</p> Results <p>The median ages of the children and parents were 8.5 (6–16) and 43.0 (36–50) years, respectively. The frequency of self-observation of the oral cavity among children increased. Daily fluoride use frequency increased from 61.5% to 76.9% (p = 0.020). The number of children who reported not considering nutritional balance decreased from 63.5% to 38.5% (p = 0.022). The number of parents/guardians who actively practiced a nutritionally balanced diet non-significantly increased from 56.2% to 75.0%. Food intake frequencies for meat, dairy products, and tubers, among caregivers, and that for rice, tubers, and fruits among children increased post-intervention. The number of participants who did not consider the number of chewing cycles decreased.</p> Conclusion <p>Participation in CAMCAM-P for kids was associated with favorable changes in oral health awareness and attitudes toward nutritional balance among children and parents/guardians. As a pilot study without a control group, these findings should be considered preliminary. Larger controlled studies are warranted to confirm effectiveness.</p> Bilaal Wilson Matola Juliet Charity Yauka Nyasulu Edward Nicol 10.1371/journal.pone.0357408 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Bilaal Wilson Matola, Juliet Charity Yauka Nyasulu, Edward Nicol</p> Background <p>Despite major progress in HIV epidemic control, children in sub-Saharan Africa, particularly in Malawi, continue to experience poorer HIV outcomes than adults. While Malawi has made substantial progress toward the UNAIDS 95-95-95 targets, only 55% of children living with HIV are virally suppressed compared with 87% of adults. This study aims to identify and develop strategies to improve children`s access to HIV services in Malawi.</p> Methods <p>Guided by the Socio-Ecological Model and the HIV care cascade framework, this multi-method study comprises four sub-studies: (1) secondary analysis of national HIV program data and spectrum estimates (2012–2023) to assess trends and progress toward the 95-95-95 targets; (2) a scoping review of health system interventions that improve paediatric HIV service access in sub-Saharan Africa (2015–2025). (3) a modified e-Delphi process with 15–30 experts to develop a context-appropriate intervention package and (4) a feasibility and acceptability assessment of the package at Kabudula Community Hospital, Lilongwe, Malawi, involving healthcare workers, community health workers, and caregivers using questionnaires and qualitative interviews.</p> Ethical considerations <p>Ethical approval will be obtained from Stellenbosch University Health Research Ethics Committee (HREC) and the Malawi National Health Sciences Research Ethics Committee. Written informed consent and confidentiality will be ensured.</p> Conclusion <p>This study will identify gaps in HIV care access among children, synthesize evidence on effective interventions, and develop a feasible, context-specific intervention package to strengthern children`s access to HIV services and accelerate Malawi`s progress toward achieving UNAIDS 95-95-95 targets.</p> Jiaojiao Deng Baobao Ma Kaihua Wei Tao Wei Liping Xie Hong Zhang Changxu Wang 10.1371/journal.pone.0357372 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Jiaojiao Deng, Baobao Ma, Kaihua Wei, Tao Wei, Liping Xie, Hong Zhang, Changxu Wang</p> Objective <p>To evaluate the efficacy and safety of three oliceridine different doses for oliceridine for patient-controlled analgesia (PCIA) in patients undergoing during total laparoscopic hysterectomy, following the premature termination of the planned sufentanil control arm.</p> Methods <p>This prospective, randomized, double-blind trial was originally designed as a four-arm study. Due to operational challenges in patient recruitment and randomization within the single-center setting-specifically, significant reluctance among eligible patients to be randomized to receive a traditional opioid regimen when oliceridine was available, leading to unsustainable enrollment timelines—the sufentanil control arm was prematurely terminated. The final analysis therefore focused on three oliceridine doses: 0.1, 0.35, and 0.5 mg/kg, diluted to 100 ml with normal saline for 48-hour PCIA. The primary endpoint for sample size calculation was the incidence of postoperative nausea and vomiting (PONV) at 24 h. Efficacy and safety outcomes analyzed included: NRS pain scores (at rest and during cough), Ramsay sedation scores, incidence of rescue analgesia, various recovery indicators (time to first flatus, time to ambulation, QoR-15 scores), and opioid-related adverse events.</p> Results <p>Compared to the low-dose group, the moderate- and high-dose groups demonstrated significant improvements in cough-pain scores and bolus press attempts (“Bolus press attempts” were defined as the total number of patient-initiated demands for a supplemental dose, including attempts made within the lockout interval) (<i>p</i> < 0.0083). Further comparison revealed that the moderate-dose group showed the best recovery outcomes, including shorter time to first flatus and ambulation, and higher QoR-15 scores. In contrast, although the high-dose group provided more potent analgesia, it was associated with a higher incidence of nausea, delayed flatus, and a significantly lower quality of recovery (QoR-15) score at 48 hours postoperatively compared to the moderate-dose group (<i>p</i> < 0.0083).</p> Conclusion <p>Within the investigated PCA oliceridine dose range, the 0.35 mg/kg dose promotes early recovery in patients undergoing laparoscopic total hysterectomy through effective analgesia and reduced nausea, representing the best balance between efficacy and safety among the tested oliceridine-specific regimens.</p> William H. Livingston Adam L. Putnam Erin J. Wamsley 10.1371/journal.pone.0357370 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by William H. Livingston, Adam L. Putnam, Erin J. Wamsley</p> Real-life experiences are often incorporated into our dreams. Does dreaming about those experiences affect how we feel about them? Prior studies have suggested that dreaming may attenuate emotional reactivity overnight, with participants feeling less negative about an experience after dreaming about it. The present study used the 2024 US presidential election to examine the relationship between dreaming and emotional reactivity in the context of a real-life emotional experience. We hypothesized that dreaming about the election would be associated with reduced negative feelings toward it the following morning. N = 931 American participants completed an online survey on the day of and the day after the 2024 US election. Participants rated their feelings about the election, their personal future, and the collective future of the country before and after election night and reported their dreams from that night. Contrary to our hypotheses, dreaming about the election was associated with <i>intensified</i> negative affect the next morning, including a more negative outlook on the personal and collective future. This pattern was specific to Democrats and Independents – dreaming about the election was not associated with overnight changes in affect among Republicans. Contrary to emotional regulation theories of dreaming, these observations suggest that sleep and dreaming are associated with amplified emotional reactivity, at least in the short-term. Yue Sun Xinyue Hu Yue Huang Yuqin Yang Xiaoming Zhang Yi Li Ping Lyu Jing Li 10.1371/journal.pone.0357292 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Yue Sun, Xinyue Hu, Yue Huang, Yuqin Yang, Xiaoming Zhang, Yi Li, Ping Lyu, Jing Li</p> PEGylation is a well-established strategy used to enhance the pharmacokinetic and pharmacodynamic properties of peptide drugs. However, free polyethylene glycol (PEG) remains a critical process-related impurity. Conventional detection methods for nonchromophoric compounds such as PEG, which include the use of evaporative light scattering (ELS) and refractive index (RI) detectors, are limited by their low sensitivity and poor compatibility with the gradient elution. Herein, systematically optimized reverse-phase high-performance liquid chromatography (RP-HPLC) coupled with charged aerosol detection (CAD) was developed and validated for the quantification of free PEG in three representative PEGylated peptide therapeutics: PEG-loxenatide, pegmolesatide, and visepegenatide. The proposed method implements a co-optimization strategy for CAD parameters, with the power function value (PFV) applied during CAD signal acquisition and the power law(PL) setting adjusted during data processing.This dual optimization effectively linearizes the inherently nonlinear CAD response across a broad concentration range, enabling a linear relationship between PEG concentration and detector response. Method validation demonstrated satisfactory specificity, precision, linearity, accuracy, robustness, and solution stability in accordance with the applicable guidelines and pharmacopoeial requirements. Practical applicability was confirmed by analyzing multiple drug batches and accelerated stability samples.A Wilcoxon signed-rank test showed no statistically significant difference between the results obtained under the default and co-optimized settings (P > 0.05), indicating that the two settings produced comparable results under the conditions evaluated. The proposed HPLC-CAD method provides a practical analytical approach in the analysis of PEGylated peptide pharmaceuticals by achieving a linearized CAD response through PFV and PL co-optimization, providing an effective approach for free PEG quantification in routine quality control. Shahid Mohammad Ganie Pijush Kanti Dutta Pramanik Zhongming Zhao 10.1371/journal.pone.0357291 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Shahid Mohammad Ganie, Pijush Kanti Dutta Pramanik, Zhongming Zhao</p> Lung cancer remains one of the leading causes of cancer-related mortality worldwide, where early detection and reliable risk assessment are critical for improving outcomes. This study develops and evaluates a range of ensemble learning models for lung cancer prediction using lifestyle and clinical indicators, with an emphasis on both predictive performance and interpretability. Five base learners—logistic regression, k-nearest neighbors, naïve Bayes, support vector machine, and linear discriminant analysis—were used to construct multiple boosting and bagging models. Building on these, voting and stacking ensembles were designed by selectively combining high-performing models. All approaches were evaluated on the original dataset as well as on balanced and upsampled variants derived through synthetic augmentation. Model performance was assessed using accuracy, precision, recall, F1-score, Matthews correlation coefficient (MCC), and AUC-ROC. The results show that ensemble approaches consistently outperform individual models, with voting and stacking demonstrating superior performance over boosting and bagging methods. The stacking model achieved the strongest overall performance across all evaluated models. On the original dataset, which provides a more realistic representation of practical deployment conditions, it attained an accuracy of 93.53%. Performance further improved on the balanced and upsampled datasets on the upsampled dataset. To enhance transparency, SHAP and LIME were employed to provide global and local interpretability, respectively, enabling identification of key clinical factors and patient-specific risk drivers. The analysis highlights both alignment with known clinical patterns and dataset-driven variations, supporting informed interpretation of model outputs. The results suggest that stacking-based ensembles can improve risk prediction from lifestyle and clinical indicators while maintaining model transparency through SHAP and LIME explanations. These findings highlight the potential of interpretable ensemble learning as a decision-support tool for lung cancer risk assessment. Mengting Qian Chunshun Yan Xinyi Wang 10.1371/journal.pone.0357279 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Mengting Qian, Chunshun Yan, Xinyi Wang</p> Teachers’ perceptions of teacher-student relations in their school are linked to their job satisfaction, but whether positive teaching-related emotion constitutes a statistical indirect association between them, and whether school leadership context alters it, remains unclear. Using Teaching and Learning International Survey (TALIS) 2024 data for Shanghai (China), this study analyzed the OECD scales for teacher-student relations, joy of teaching, job satisfaction, and principal relational leadership in 1,338 teachers from 205 schools. A conditional process regression adjusted for teacher demographic and career characteristics; point estimates used the final teacher weight, and sampling variance was estimated from 100 Fay balanced repeated replication weights. Perceived school-wide teacher-student relations were positively associated with job satisfaction, and the indirect association through joy of teaching was supported. Principal relational leadership did not significantly alter the conditional direct association, whereas its interaction with joy of teaching was positive; this interaction was not reproduced when the constructs were scored as simple item means, so the moderation result is reported as exploratory. The pattern is consistent with the work environment-emotion-work attitude linkage proposed by Affective Events Theory. Conclusions are restricted to lower-secondary teachers in Shanghai and offer leads for longitudinal and intervention research. Laura Olivia Karika Ingrid Cipakova Miroslava Kretova Tomas Selicky Natalia Cmikova Daniela Nemcekova Lenka Kohutova Peter Barath Lubos Cipak 10.1371/journal.pone.0357276 2026-09-03T14:00:00Z 2026-09-03T14:00:00Z <p>by Laura Olivia Karika, Ingrid Cipakova, Miroslava Kretova, Tomas Selicky, Natalia Cmikova, Daniela Nemcekova, Lenka Kohutova, Peter Barath, Lubos Cipak</p> G-patch proteins are emerging as key regulatory cofactors of DEAH-box RNA helicases involved in pre-mRNA splicing, yet the functions of many family members remain poorly understood. Here, we characterize the conserved G-patch domain–containing protein Cwf28 from <i>Schizosaccharomyces pomb</i>e, an essential factor with a previously unclear molecular function, and define its role within the spliceosome. Tandem affinity purification coupled with mass spectrometry revealed that Cwf28 predominantly associates with components of the Prp19 complex (NTC) and factors involved in the catalytic activation and progression of the spliceosome, placing it within catalytically active spliceosomal assemblies. Gene ontology analysis showed enrichment of the Cwf28 interactome in factors involved in spliceosome assembly, activation, and catalytic remodeling. Notably, the DEAH-box RNA helicase Cdc28, the ortholog of human DHX16 and <i>Saccharomyces cerevisiae</i> Prp2, was identified as the most abundant interactor. Further analysis demonstrated that Cwf28 interacts with Cdc28 via its conserved G-patch domain, and domain mapping confirmed that this interaction is G-patch domain dependent. Together, these findings identify Cwf28 as a component of catalytically active spliceosomes and suggest a potential role for Cwf28 in modulating the activity of the RNA helicase Cdc28, providing insight into conserved mechanisms underlying RNA helicase regulation during splicing.