PLOS ONE Alerts: New Articles

Correction: CAFusion: A progressive ConvMixer network for context-aware infrared and visible image fusion

2026-06-23T14:00:00Z

by Hafiz Tayyab Mustafa, Hamza Mustafa, Hassan Alhuzali, Mujtaba Asad, Zhonglong Zheng

Correction: A protocol for using human genetic data to identify circulating protein level changes that are the causal consequence of cancer processes

2026-06-23T14:00:00Z

by Lisa M. Hobson, Richard M. Martin, Karl Smith-Byrne, George Davey Smith, Gibran Hemani, Joseph H. Gilbody, James Yarmolinsky, Sarah E. R. Bailey, Lucy J. Goudswaard, Philip C. Haycock

Correction: Telemedicine via data glasses in CBRN protection suit—Evaluation of medical qualification and technical feasibility

2026-06-23T14:00:00Z

by Sarah Bovenkerk, Anna Mueller, Rolf Rossaint, Michael Czaplik, Andreas Follmann

Mitochondrial oxidative stress promotes the accumulation of advanced glycation end products

2026-06-23T14:00:00Z

by Firoz Akhter, Sourav Samanta, Alexandre A. Sosunov, Huawei Wu, Ethan Kim Tieu, Shi Fang Yan, Shirley ShiDu Yan

Advanced glycation end products (AGEs) are a class of toxic metabolites that contribute to disease progression. In our previous study, we demonstrated that age-related AGE accumulation is associated with mitochondrial dysfunction. However, the direct link between mitochondrial dysfunction and AGE accumulation within the context of AD pathogenesis has not yet been fully explored. It also remains unclear whether mitochondrial stress and mitochondrial reactive oxygen species (ROS) drive the accumulation of AGEs. This study, for the first time, provides evidence of progressive AGE accumulation in the cortical mitochondria of AD mice exhibiting mitochondrial dysfunction and Aβ pathology. AGE levels were significantly correlated with Aβ-induced mitochondrial dysfunction, oxidative stress, and amyloid pathology. Notably, mitochondrial stress induced by a mitotoxin significantly increased the accumulation of AGEs in cellular and mitochondrial compartments. Scavenging mitochondrial ROS using the mitochondria-targeted antioxidant reduced AGE accumulation and improved mitochondrial function. Our findings highlight the role of mitochondrial dysfunction in AGE metabolism and provide new insights into the pathogenesis of AD.

Revisiting the relationship between impulsivity, apathy, and action control: Bayesian inference from a stop-signal task study

2026-06-23T14:00:00Z

by Emma Michel, Axel Garnier-Allain, Mariia Kaliuzhna, Djamila Bennabi, Mathieu Servant, Matthieu Béreau

Apathy and impulsivity are multidimensional constructs that shape goal-directed behavior. Although the motivational dopaminergic spectrum hypothesis frames them as opposing ends of a single continuum, questionnaire-based studies consistently show that they positively co-occur in both healthy and clinical populations. An emerging theoretical resolution of this paradox is that apathy and impulsivity relate to distinct components of goal-directed behavior, with co-occurrence potentially arising from domain-general factors and/or partially overlapping neurophysiological networks. Here, we examined this proposal in the domain of action control using the stop-signal task, which provides separable indices of action inhibition (stop-signal response time, SSRT) and action initiation (go response time, goRT) within the independent race model. Based on prior findings and theoretical considerations, we expected SSRT to covary with urgency-related impulsivity and goRT with action-initiation apathy. A large sample of healthy young adults (N = 144) completed a stop-signal task implemented in accordance with consensus recommendations, alongside validated multidimensional measures of impulsivity (UPPS-P impulsive behavior scale) and apathy (Lille Apathy Rating Scale). Bayesian analyses replicated a positive association between global apathy and impulsivity scores. However, SSRT was not associated with urgency, and goRT was not associated with action-initiation apathy, with moderate evidence for the null. Additional exploratory analyses provided moderate evidence against the majority of correlations between stop-signal indices and the remaining scale dimensions, including global scores. Thus, stop-signal indices did not dissociate apathy and impulsivity in action control, highlighting limits of task-based accounts of their co-occurrence.

Bidirectional associations between mental health conditions and cognitive impairment in patients with pain conditions of the back, neck, and spine: A population-based study

2026-06-23T14:00:00Z

by Mohammad Alipour-Vaezi, Jyoti Savla, Margaret R. Rukstalis, Daniel B. Rukstalis, Kwok-Leung Tsui, Donald B. Penzien, Robert S. McNamara, Huaiyang Zhong

Background

Pain conditions (PCs) of the back, neck, and spine are frequently accompanied by psychiatric and cognitive comorbidities in older adults. However, the directionality and magnitude of the associations between psychiatric disorders and cognitive impairment in this population remain insufficiently characterized.

Objective

This population-based study examines the bidirectional relationship between Mental Health Conditions (MHCs) and Cognitive Impairment (CI) among patients with back, neck, and spine pain. It assesses whether MHCs—including depression, Bipolar Disorder (BD), Generalized Anxiety Disorder (GAD), Post-Traumatic Stress Disorder (PTSD), Panic Disorder (PaD), Persistent Mood Disorder (PMD), Suicidal Behavior (SB), Schizophrenia (SCZ), and Substance Use Disorder (SUD)—are associated with subsequent incident CI, and conversely, whether prior CI is associated with subsequent incident MHCs.

Methods

Data were drawn from the TriNetX US Collaborative Network (2016/01/01–2021/12/31), comprising over 119 million patients. Cohorts of patients with PCs were defined using ICD-10 codes. Propensity score matching was applied to balance demographics and comorbidities. Kaplan-Meier survival analysis assessed risks over a three-year follow-up.

Results

A bidirectional association was observed between MHCs and CI. PC Patients with MHCs had a higher three-year risk for CI, with the largest risk ratios (RR) observed for SCZ (RR: 4.594; 95% Confidence Interval [3.974, 5.312]) and BD (RR: 3.761[3.247, 4.356]). Other MHCs, including depression, PMD, GAD, PTSD, PaD, and SUD, were also associated with higher CI risk. Conversely, patients with pre-existing CI exhibited a higher three-year risk for subsequent MHCs, particularly BD (RR: 4.818 [3.045, 7.624]), SCZ (RR: 3.398 [2.874, 4.017]) and SB (RR: 1.913 [1.340, 2.732]).

Conclusion

Our findings indicate a bidirectional relationship between MHCs and CI among older adults with documented back, neck, and spine pain. Integrated screening and coordinated multidisciplinary care may help identify psychiatric and cognitive comorbidities earlier and support more comprehensive management of this medically complex population.

Additive effect of tDCS and neuromotor recruitment on functional recovery in chronic paraplegia: A randomized controlled trial

2026-06-23T14:00:00Z

by Ahmad Rifai Sarraj, Jihan Allaw, Eliane Rached, Joy Khayat, Hassan Karaki, Ahmad Diab, Antonio Pinti

Functional recovery in chronic spinal cord injury (SCI) is traditionally viewed as limited, particularly after the spontaneous recovery window has closed. This single-blind randomized controlled trial investigated whether adding anodal Transcranial Direct Current Stimulation (tDCS) to the Neuromotor Recruitment Method (NEUROM)—a protocol combining motor imagery with intensive peripheral sensory stimulation—provides a additive benefit for sensorimotor recovery. Fifty participants with chronic paraplegia (mean time since injury: 15.4 ± 3.2 months; ASIA Impairment Scale A, B, or C) were recruited and randomized into three arms: Reference (standard care, n = 10), NEUROM (n = 20), or NEUROM+tDCS (n = 20). The intervention was administered over 10 days. Outcomes included the Lower Extremity Motor Score (LEMS), Light Touch and Pin Prick sensory scores, and the Assessment of Movement Attempt (AMA). The Reference group showed no significant recovery. Both active groups (NEUROM and NEUROM+tDCS) achieved substantial and statistically identical improvements in sensory function compared to the Reference group (p < 0.001), suggesting that peripheral recruitment alone is sufficient for afferent restoration. However, a significant dissociation was observed in motor function: the NEUROM+tDCS group demonstrated superior LEMS recovery (Mean change: 18 points) compared to the NEUROM group (14 points; p = 0.01) and reported significantly higher volitional drive (p < 0.001). These findings indicate a clear dissociation between sensory and motor plasticity in chronic SCI; while peripheral somatosensory recruitment drives afferent sensory restoration, the addition of central stimulation via tDCS is critical for maximizing efferent motor output. This suggests that restoring motor function in chronic paraplegia requires a “top-down” cortical prime to complement “bottom-up” peripheral signaling. Trial Registration: ClinicalTrials.gov NCT04790149.

Synergistic anticancer activity of antimicrobial peptide nisin and doxorubicin against breast cancer cells via modulation of membrane permeability

2026-06-23T14:00:00Z

by Chanita Phetdee, Suwatjanee Naephrai, Malinee Pradain, Yanisa Panporm, Ubaid Ahmad, Panchika Prangkio

Breast cancer is the most frequently diagnosed cancer and remains the leading cause of death among females. Despite the rapid advancement in cancer therapy, the development of more effective therapeutic strategies and anticancer agents with a new mode of action remains a critical challenge. Combination of therapeutic agents is an attractive approach to enhance drug efficacy. Nisin, a cationic antimicrobial peptide, has been reported for its cytotoxicity against some cancer cell lines via several mechanisms, particularly membrane disruption. Nisin can bind preferentially to the negatively charged phospholipids, causing pore formation in cell membranes. In this study, we demonstrated that nisin exhibited membrane permeabilization preferentially with anionic lipids using liposomal leakage assay. Moreover, anticancer activity of nisin and doxorubicin (DOX) was investigated against two breast cancer cell lines, MCF-7 and MDA-MB-231, using MTT assay. Nisin demonstrated cytotoxic effect against breast cancer MCF-7 and MDA-MB-231, with IC₅₀ values of 5–8 µM, while exhibiting lower cytotoxicity toward normal cells. Based on Bliss independence analysis, the synergistic effect between nisin and DOX was markedly observed in MCF-7 when treated with 10 μM nisin and 1 μM DOX for 24–48 h treatment. Furthermore, as demonstrated by fluorescent-based high-content analysis, nisin clearly caused cell membrane permeability and promoted DOX-induced DNA damage in both cell lines. Flow cytometry with Annexin-V staining revealed that co-treatment of nisin and DOX significantly enhanced apoptosis, as compared to individual treatments, particularly in MCF-7 cells, suggesting a key mechanism of action for anticancer activity. Cationic nisin can interact with biological membrane and modulate membrane permeability and fluidity, consequently facilitating DOX entry, inducing apoptosis and DNA damage. Overall, this study demonstrates that the combination of nisin and DOX could offer a new therapeutic approach for breast cancer treatment with a reduced chemotherapeutic drug dosage.

A novel m7G RNA methylation-related signature associated with MAPK signaling pathways in acute ischemic stroke

2026-06-23T14:00:00Z

by Wei-Gang Gong, Jian-Wei Lou, Sen Yin, Fang-Pu Yu, Wei Wu

Objectives

Ischemic stroke represents a major global cause of disability and death. Timely recanalization of occluded vessels to salvage the ischemic penumbra is the cornerstone of acute ischemic stroke (AIS) treatment. Nevertheless, the molecular mechanisms driving the transition from salvageable penumbra to infarct core in early AIS remain poorly understood. Recent evidence highlights the role of post-transcriptional methylation, especially N7-methylguanosine (m7G) modification, in stroke pathogenesis. This study aimed to systematically characterize transcriptome-wide m7G methylation changes in the ischemic penumbra during early AIS and to explore their potential functional relevance.

Methods

We performed middle cerebral artery occlusion in 8-week-old male BALB/c mice and applied MeRIP-seq to profile the transcriptome-wide m7G methylome in penumbra tissue. Bioinformatics analyses were conducted to elucidate the functional relevance of m7G-methylated transcripts.

Results

Compared with controls, AIS penumbra exhibited significant alterations in m7G-modified mRNAs. Specifically, upregulated m7G modifications were notably enriched in mRNAs associated with the mitogen-activated protein kinase (MAPK) signaling pathway, whereas downregulated modifications were significantly linked to axon guidance pathways.

Conclusions

This study provides the first systematic landscape of m7G methylation in AIS and m7G RNA methylation-related alterations in the MAPK signaling pathway may serve as potential therapeutic targets for stroke intervention.

Correction: Health insurance enrollment and maternal health service utilization using Ghana Demographic and Health Survey, 2022

2026-06-23T14:00:00Z

by The PLOS One Staff

Correction: Determining farm surface porcine reproductive and respiratory syndrome virus (PRRSV) contamination through viability RT-qPCR

2026-06-23T14:00:00Z

by Claudio Marcello Melini, Amanda Palowski, Declan C. Schroeder, Cesar A. Corzo

A computational model of spatial politics: Hotelling-downs model as statistical physics

2026-06-23T14:00:00Z

by Christopher Campbell, Graeme J. Ackland

The Hotelling-Downs model considers parties changing policy to maximise their vote-share. Where policy position lies on a left-right axis, it describes a tendency for political parties to move towards centrist platforms. This is in contrast with widely observed political polarisation. We extend the model to two dimensions, with many parties and with single and multiple-peaked voter distribution. We find that a two party system reduces polarisation, even if voters are polarised with a bimodal distribution. By contrast, multiparty systems induce polarisation, even when most voters favour moderate position. We model the effect of turnout and activists as influences on the parties, showing that this results in more polarisation, even in a two-party system. This suggests that polarisation of parties can be driven by abstention, intra-party politics and turnout on the extremes. In the two-party case, the winning party’s positions are more moderate than the views of their supporters but better representative of the electorate as a whole. With polarisation, individual voters are better able to find a party which represents their views, but the government (winning part or coalition) is less representative of the population, even when the population has a clear consensus on all issues.

Retraction: Evaluating modern intrusion detection methods in the face of Gen V multi-vector attacks with fuzzy AHP-TOPSIS

2026-06-23T14:00:00Z

by The PLOS One Editors

Retraction: The effect of biosynthesized silver nanoparticles on Pseudomonas aeruginosa-infected dogs wounds

2026-06-23T14:00:00Z

by The PLOS One Editors

The impact of cancer therapy-related oral complications on the quality of life and well-being of childhood cancer survivors: A scoping review

2026-06-23T14:00:00Z

by Nona Attaran Kakhki, Apoorva Sharma, Tara Balador, Franco A. Carnevale, Beatriz Ferraz Dos Santos, Mary Ellen Macdonald

Objective

This study aimed to review the scientific literature on the effects of cancer treatment-related oral complications on the quality of life and well-being of children surviving cancer. This study updates a previous review, from 2012, evaluating the oral health related quality of life and well-being of childhood cancer survivors and exploring the extent to which children’s perspectives are considered in research.

Methods

We used a scoping review methodology informed by established frameworks: Arksey and O’Malley, Levac et al. and the Joanna Briggs Institute. Articles were retrieved from five electronic databases (MEDLINE/PubMed, Scopus, Embase, Web of Science, and PsychInfo) using a predefined search strategy. Screening and study selection were performed independently by two reviewers using Rayyan software (QCRI), with a third reviewer resolving disagreements. Reporting followed the PRISMA-ScR guidelines. Inclusion criteria included articles focused on the impact of oral complications on the quality of life and well-being of child cancer survivors (aged 0–17 years at the time of diagnosis), written in English or French, and published from 2012–2025. Exclusion criteria included articles involving non-childhood cancers, and with non-specific disease categories. The protocol for this review was published in PLOS ONE (https://doi.org/10.1371/journal.pone.0290364).

Results

79 articles were included in this scoping review. The majority of studies had quantitative designs. In contrast to the original review, a substantial number of studies (47) reported children-reported symptoms and completed assessment tools rather than relying solely on their parents and health care providers to provide this information. Furthermore, since the original review, reporting of oral health-related quality of life (OHRQoL) measures has increased, however they were reported in a limited number of studies.

Conclusion

Our review suggests that there is growing implementation of patient-reported outcomes and subjective measures of OHRQoL in assessing oral complications in pediatric cancer patients. Future studies should incorporate qualitative approaches to capture children’s or parents’ perspectives on cancer therapy, thereby complementing quantitative findings and providing a more comprehensive understanding of the multifaceted impact of oral complications on children’s quality of life.

Leveraging design thinking to tackle contemporary admissions challenges in health professions education

2026-06-23T14:00:00Z

by Adina O. Davidson, Wendy C. Cox, Heather Azzu, Kelly Womack-Adams, Jacqueline E. McLaughlin

Purpose

This study illustrates the use of design thinking (DT) as a structured, participatory approach to explore contemporary complex challenges in health professions admissions, including the rise of generative AI, remote interviews, and the elimination of standardized admissions tests. This work focuses on stakeholder-driven problem framing and idea generation rather than evaluating outcomes.

Methods

A two-hour workshop engaged 15 purposively sampled stakeholders, including faculty, staff, application readers, and student ambassadors, in collaborative problem framing, ideation, and rapid prototyping of admissions concepts. Generative artifacts (brainstorming outputs, reflection worksheets, facilitator notes) and post-session surveys were analyzed using thematic synthesis and descriptive statistics to characterize emergent ideas and participant perspectives.

Major findings

Participants generated ideas that clustered into three major themes: interview restructuring, GenAI integration and compliance, and broadening of admissions criteria, illustrating how stakeholders reframed challenges and proposed diverse solution pathways. Survey responses reflected descriptive indicators of participant experience, suggesting the workshop supported creative problem solving (Mean 4.7 ± 0.5), idea generation (4.8 ± 0.4), and collaboration (4.4 ± 0.5).

Conclusions

Findings suggest that DT offers a structured, iterative framework for stakeholder-driven idea generation and problem reframing in an evolving admissions context. The workshop demonstrates the potential of collaborative, reflective processes to surface assumptions and generate diverse perspectives to inform future exploration of admissions practices.

Bayesian Uncertainty-aware Deep Learning with noisy labels: Tackling annotation ambiguity in EEG seizure detection

2026-06-23T14:00:00Z

by Deeksha M. Shama, Archana Venkataraman

Deep learning is advancing EEG processing for automated epileptic seizure detection and onset zone localization, yet its performance relies heavily on high-quality annotated training data. However, scalp EEG is susceptible to high noise levels, which in turn leads to imprecise annotations of the seizure timing and characteristics. This “label noise” presents a significant challenge in model training and generalization. In this paper, we introduce Bayesian UncertaiNty-aware Deep Learning (BUNDL), a novel algorithm that informs a deep learning model of label ambiguities, thereby enhancing the robustness of seizure detection systems. By integrating domain knowledge into an underlying Bayesian framework, we derive a novel KL-divergence-based loss function that capitalizes on uncertainty to better learn seizure characteristics from scalp EEG. Thus, BUNDL offers a straightforward and model-agnostic method for training deep neural networks with noisy training labels that does not add any parameters to existing architectures. Additionally, we explore the impact of improved detection system on the task of automated onset zone localization. We validate BUNDL using a comprehensive simulated EEG dataset and two publicly available datasets collected by Temple University Hospital (TUH) and Boston Children’s Hospital (CHB-MIT). Results show that BUNDL consistently identifies noisy labels and improves the robustness of three base models under various label noise conditions. We also conduct ablation experiments on uncertainty quantification, evaluate cross-site generalizability to Siena EEG dataset, and quantify computational cost of all methods. Furthermore, we demonstrate that BUNDL improves seizure onset zone localization accuracy. Ultimately, BUNDL presents as a reliable method that can be seamlessly integrated with existing deep models used in clinical practice, enabling the training of trustworthy models for epilepsy evaluation.

Contamination of Hospital Inanimate Surfaces with Methicillin-Resistant Staphylococcus aureus and Extended-Spectrum Beta-Lactamase producing bacteria at Ocean Road Cancer Institute, Dar es Salaam, Tanzania

2026-06-23T14:00:00Z

by Donath Mkenda Valerian, Mtebe Majigo, Ninael Jonas, Loveness Urio, Emanuel Magembe, Reuben Abednego, Modest Benard, Doreen Kallanga, Ibrahim Mauki, Agricola Joachim

Background

Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) producing bacteria are the most common contaminants on hospital surfaces. Hospitalized patients, especially those with cancer, have a higher likelihood of acquiring hospital-associated infections in a contaminated environment. Outbreaks of MRSA and ESBL-producing bacteria linked to contaminated inanimate hospital surfaces are a well-documented threat. Cancer patients, who often have prolonged hospital stays, are particularly at risk of acquiring these multidrug-resistant (MDR) infections. The immunosuppressed state of cancer patients further increases their susceptibility, resulting in higher morbidity and mortality associated with these infections. This study assessed the prevalence, antimicrobial resistance, and factors associated with contamination of inanimate hospital surfaces by MRSA and ESBL-producing bacteria.

Materials and methods

This was cross-sectional study conducted at Ocean Road Cancer Institute, Dar es salaam, Tanzania in March and April 2023. The surfaces were conveniently selected, and a total of 247 inanimate surface samples were collected using a sterile swab pre-moistened with sterile Trypticase soy broth. A structured data collection checklist was used to record key variables for each sampled surface. The samples were cultured on Mannitol salt agar and MacConkey agar containing 2 mg/ml of ceftazidime. Identification of the isolates were done by using VITEC MS. Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) producing bacteria were confirmed phenotypically through testing with a 30 µg cefoxitin disk and the combination disk method, respectively. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Logistic and modified Poisson regression analyses were performed to determine factors associated with contamination.

Results

A total of 247 swab samples were collected from six predetermined items; bed rails, computer keyboards, door handles, hand-washing sinks, nursing station tables, and trolleys. The proportions of MRSA and ESBL producing bacteria’ contamination were 21 (8.5%) and 63 (25.5%), respectively. Acinetobacter baumannii and Klebsiella pneumoniae were the predominant ESBL producing bacteria each accounting for 38 of the 84 isolates (45.2%). All Staphylococcus aureus isolates were identified as MRSA and were non-susceptible to at least one antimicrobial agent in three or more antibiotic classes; however, all isolates showed 100% susceptibility to linezolid. Klebsiella pneumoniae demonstrated resistance to piperacillin-tazobactam, cefepime, and ciprofloxacin, with rates ranging from 92.1% to 97.4%. Resistance to meropenem was observed in 52.6% of Klebsiella pneumoniae isolates. Hand-washing sinks were the only surface independently associated with contamination by ESBL-producing bacteria (APR 5.8, P < 0.001).

Conclusion

A significant proportion of inanimate hospital surfaces were contaminated with MRSA and ESBL-producing bacteria. The findings imply a need to improve infection prevention and control practices.

Bridging the biomass data gap: A literature-based Length-Weight Relationship framework for estimating representative dry weights of freshwater invertebrates in Korean rivers

2026-06-23T14:00:00Z

by Jaehoon Yeom, Minji Kim, Sang Don Kim

Representative species weight is a critical ecological index for modeling, vulnerability assessment, and toxicity prediction, yet scientifically validated data for aquatic invertebrates remain limited. To address this gap, we present the first literature-based strategy to estimate and validate representative dry weights of freshwater invertebrate species in Korean rivers using Length-Weight Relationships (LWRs). Species length and dry weight records were compiled from domestic field guides, while dry weight records were compiled from both domestic and global literature. LWR coefficients (a and b) were then calculated at genus, family, and order levels and preprocessed under control conditions. Among the taxonomic levels tested, averaging genus-level coefficients yielded the highest concordance with field-measured dry weights (R² = 0.6633, n = 240), outperforming broader taxonomic levels. Furthermore, a logarithmic correlation analysis confirmed that greater numbers of LWR sources improve predictive accuracy, particularly at the genus level. Based on this optimal strategy, representative dry weights were estimated for 563 taxa. This methodology fills a critical data gap by leveraging existing literature to generate reliable species-specific weight indices without additional field measurements. Our approach provides a quantitative foundation for biomass estimation in data-limited freshwater ecosystems and supports improved ecological modeling, conservation planning, and machine learning-based impact prediction.

Data-driven climate-smart strategies for boosting crop yield and minimizing greenhouse gas emissions by optimizing cropping systems and fertilization practices

2026-06-23T14:00:00Z

by Wentao Wu

The conflict between food production and environmental protection calls for climate-smart agricultural solutions. This study investigated data-driven climate-smart strategies for optimizing cropping systems and nitrogen management to increase crop yield and cut greenhouse gas emissions in China’s Beijing-Tianjin-Hebei (BTH) region, which is grappling with pronounced climatic and environmental challenges. The study evaluated three cropping systems: spring maize monoculture (M), winter wheat followed by summer maize double-cropping (WM), and a triple-cropping system encompassing winter wheat, summer maize, and spring maize (WMM). Additionally, four nitrogen fertilization treatments were assessed to understand their impacts. The crop climate resilient index was created to identify the optimal management practices. Leveraging the Agricultural Production Systems sIMulator (APSIM) model, this study simulated the daily dynamics of crop yields, soil organic carbon (SOC) content, and nitrous oxide (N₂O) emissions over a comprehensive 40-year period spanning from 1981 to 2020. The findings revealed intriguing insights into SOC dynamics and nitrogen fertilizer efficiency. Across all cropping systems, the SOC content augmented with increased nitrogen application, with peak levels reaching 294.9 kg·ha ⁻ ¹ under the highest fertilization treatment. The N₂O emissions displayed an upward trend over time, positively correlated with escalating fertilizer use. Regarding crop yields, higher nitrogen inputs generally correlated with enhanced productivity. Overall, the WM system, when coupled with F2 treatment (90 kg·ha ⁻ ¹ for wheat and 60 kg·ha ⁻ ¹ for maize), emerged as the optimal scenario, achieving the highest climate resilient index value of 0.65. These findings underscore the profound importance of integrating cropping systems with judicious nutrient management in developing agricultural systems that are adaptive, productive, and environmentally sustainable. By adopting such practices, farmers in the BTH region and similar climates can achieve agricultural clean production that is robust enough to withstand climate variability and contribute to global efforts towards food security and ecological preservation. As the climate continues to evolve, the precision and holistic application of these strategies will be crucial in maintaining the vitality and productivity of agricultural landscapes.

Cost-effectiveness of bubble continuous positive airway pressure in treating severe pneumonia and hypoxaemia in under-five children in Ethiopia

2026-06-23T14:00:00Z

by Abdi Gari Negasa, Firew Tekle Bobo, Meseret Gebre, Tsinuel Nigatu, Mirkuzie Woldie, Mideksa Adugna Koricho, Mohammod J. Chisti, Peter Berman, Girmaye Dinsa

Background

Pneumonia is preventable and treatable, yet it remains the leading infectious cause of illness and death among under-five children. Bubble continuous positive airway pressure (bCPAP) offers a promising option for oxygen therapy combined with appropriate antibiotics and other supportive care. However, the cost-effectiveness of bCPAP in resource-limited settings such as Ethiopia is not documented. We aimed to evaluate the cost-effectiveness of bCPAP in treating severe pneumonia and hypoxaemia in under-five children in Ethiopia.

Methods

We developed a decision-analytical model (decision tree) to determine the cost-effectiveness of a locally made bCPAP compared with the standard of care (WHO-recommended low-flow oxygen therapy) in general hospitals. Effectiveness was measured as the number of child deaths and disability adjusted life years (DALYs) averted. Cost data were extracted from published literature and local markets. The incremental cost-effectiveness ratio (ICER) was calculated and evaluated against the willingness-to-pay (WTP) thresholds set at multiples (0.34, 1, and 3) of Ethiopia’s GDP per capita. Sensitivity analyses were performed to test the robustness of the results.

Results

For every 10,000 children with severe pneumonia and hypoxaemia, providing oxygen using locally made bCPAP will save an additional 31 children compared to the standard of care. A locally made bCPAP has an ICER of 139.5 USD per DALY averted. These results were robust in the sensitivity analysis performed, showing a 100% probability of being cost-effective at one times the GDP per capita of Ethiopia.

Conclusion

A locally made bCPAP is a highly cost-effective intervention for treating severe pneumonia and hypoxaemia in under-five children in Ethiopian general hospitals. These findings provide critical evidence for decision-makers to support and scale-up use of bCPAP in Ethiopia and other similar low and middle income countries.

Omipalisib reduces hyperphosphorylated tau protein by modulating mTOR-autophagy pathway

2026-06-23T14:00:00Z

by Haeun Hwang, Namkwon Kim, Subyn Jeon, Yoojin Lee, Jeongmin Son, Seung Ho Jeon, Yeongae Lee, Min Sung Gee, Kyung-Soo Inn, Jong Kil Lee

Tauopathies are neurodegenerative diseases characterized by the presence of hyperphosphorylated tau (p-tau) and neurofibrillary tangles. Autophagy is a critical self-degradation mechanism that preserves cellular homeostasis and function, including the clearance of misfolded proteins. Autophagy is impaired in tauopathies, resulting in excessive accumulation of p-tau. Omipalisib, a dual phosphatidylinositol 3-kinase/mammalian target of rapamycin (PI3K/mTOR) inhibitor, was explored in a phase I clinical trial involving solid tumors and lymphoma. In this study, we aimed to investigate the effects of omipalisib on tauopathy both in vitro and in vivo. Omipalisib increased the levels of protein LC3B and decreased that of p62 in human tau (P301L)-expressing SH-SY5Y stable (SH-Tau) cells by inhibiting mTOR activation in a time-dependent manner. In our study, we hypothesized that omipalisib, a PI3K/mTOR inhibitor, could remove accumulated tau and inhibit memory decline by activating autophagy. Additionally, omipalisib reduced tau phosphorylation in SH-Tau cells without inducing cytotoxicity. Upon administration of 6-month-old PS19 mice with omipalisib (1 mg/kg) for 2 months, the levels of both RIPA-soluble and RIPA-insoluble p-tau were decreased, and spatial memory dysfunction was alleviated in omipalisib-treated PS19 mice. Overall, these results show that omipalisib decreases the expression of p-tau by modulation mTOR-autophagy pathway, resulting in the amelioration of spatial memory deficits. This study highlighted the potential of omipalisib as a candidate treatment for tauopathies.

Physical and emotional health among nurses in protracted crisis settings in Lebanon and Jordan: A cross-sectional study

2026-06-23T14:00:00Z

by Nuhad Dumit, Gladys Honein-AbouHaidar, Muntaha K. Gharaibeh, Ibtisam M. Al-Zaru, Reem Hoteit, Imad Bou-Hamad, Patricia Davidson, Nancy Reynolds

Objectives

Nurses working in crisis-affected and refugee-hosting settings face demanding conditions that may compromise their physical and emotional health. Evidence on the prevalence and determinants of these outcomes in such contexts remains limited. This study assessed nurses’ physical and emotional health in Lebanon and Jordan and identified key associated factors using regression and random forest models.

Methods

A cross-sectional survey was conducted among hospital nurses providing care to Syrian refugees in Lebanon (n = 976; response rate 52%) and Jordan (n = 2,012; response rate 80.5%). Back pain, general weakness and emotional exhaustion outcomes were assessed alongside sociodemographic, work-related, and psychosocial work variables. Logistic, linear regression and random forest models were performed on merged and country-specific datasets.

Results

Nearly six in ten nurses in Lebanon and more than seven in ten in Jordan reported strong general weakness, and over 60% in both countries experienced strong back pain. Emotional exhaustion was prevalent and higher among Jordanian nurses (4.13, SD = 1.39) compared to Lebanese nurses (3.49, SD = 1.70). Age, gender, working hours, and work unit were significant demographic and occupational predictors, while job conflict, self-perceived workload, lack of job preparation, and workload stress emerged as important work environment factors. Nursing resources and teamwork were consistently protective. Random forest models confirmed the relative importance of workload-related factors and highlighted the close association between physical health and emotional exhaustion.

Conclusion

Hospital nurses caring for refugees in Lebanon and Jordan experience high levels of physical and emotional health strains associated with workload, work unit, psychosocial strain, and organizational resources. Findings highlight the need for system-level workforce policies, including workload regulation, staffing optimization, and strengthened organizational support to promote nurse well-being and enhance health system resilience in refugee-hosting and resource-constrained settings.

Learning variable-order time fractional diffusion equations using Physics-Informed Neural Networks

2026-06-23T14:00:00Z

by Lei Ren, Shixin Jin

This paper introduces a novel approach using physics-informed neural networks (PINNs) to simultaneously solve variable-order time fractional diffusion equations and infer the time-dependent fractional order from data. By embedding the governing equations into the neural network’s loss function, our method achieves high accuracy and flexibility, even with sparse or noisy data. We present a dual-network architecture where one network approximates the solution u(x,t) while another learns the fractional order α(t). Numerical experiments demonstrate the effectiveness of our approach, achieving mean squared errors below 10⁻⁴ for solutions and 10⁻³ for fractional orders in smooth cases, while also handling noisy data and non-smooth orders robustly.

Improving the field accuracy of a malaria diagnostic algorithm combining sequential interpretation of rapid diagnostic test detecting PfHRP2 and pLDH in febrile children in a seasonal hyperendemic malaria transmission area in Burkina Faso

2026-06-23T14:00:00Z

by Diane Yirgnur Some, Francois Kiemde, Berenger Kabore, Daniel Valia, Toussaint Rouamba, Seydou Sawadogo, Athanase M. Some, Hermann Sorgho, Macaire Nana, Yacouba Nombre, Nadine A. Kone, Adelaide Compaore, Fadima Yaya Bocoum, Massa dit Achille Bonko, Georges Some, Gautier Tougri, Sylvie Yeri Youl, Konseibo Noellie, Yeri Esther Hien, Aly Savadogo, Fla Koueta, Henk D. F. H. Schallig, Halidou Tinto

Objective

To evaluate the field accuracy of a malaria diagnostic algorithm combining sequential interpretation of two-step malaria RDT detecting PfHRP2 and pLDH with information on previous antimalarial treatments within the past four weeks for the diagnosis of malaria in febrile children under 5 years compared to standard diagnosis using a PfHRP2 only based RDT.

Methods

Febrile children aged 6–59 months attending outpatient clinics were randomized to either the control group, which received the standard RDT (PfHRP2 only), or the intervention groups (an e-algorithm or a decisional algorithm), which was subjected to the diagnostic algorithm combining an RDT detecting PfHRP2 and pLDH with information on previous antimalarial treatment. Malaria diagnosis with PfHRP2-based RDT was reported as positive or negative. The sequential interpretation was reported as (i) positive when the pLDH line appeared, regardless of the PfHRP2 results, (ii) negative when both lines did not appear and (iii) undetermined when only the PfHRP2 line appeared, and information on previous antimalarial treatment within the past 4 weeks was used as a decision-support tool to classify active malaria from past infection. Blood samples were also collected for expert microscopy as the gold standard, and for qPCR to further evaluate undeterminate results and potential false-positive RDT outcomes.

Results

In total 1176 children were included, with 66.7% (784/1176) assigned to the intervention arms and 33.3% (392/1176) to the control arm. In patients assigned to the sequential algorithm, the number of undetermined cases was 12.7% (100/784). Considering microscopy as the gold standard, PfHRP2-based RDT reported a sensitivity of 96.5% and a of specificity 79.1%, with positive and negative predictive values of 78.3% and 96.7%, respectively. For the sequential algorithm, the sensitivity, specificity, positive and negative predictive values of the conclusive-only results (i.e., PfHRP2±/pLDH+ and PfHRP2-/pLDH-) were 97.4%, 98.4%, 98.0% and 97.9%. However, when undetermined result were combined with conclusive results, the sensitivity, specificity, positive and negative predictive values were 89.7%, 96.8%, 95.6% and 92.4% respectively. Among recently antimalarial treated participants in sequential algorithm arm, 59.5% (50/84) were qPCR-positive, compared to 68.7% (11/16) qPCR-positivity in those without recent treatment.

Conclusions

The sequential diagnostic approach improves the diagnosis of malaria in a real world setting, compared to the use of PfHRP2-(only) based RDT. However, relying only on history of antimalarial treatment in undetermined cases may decrease algorithm’s sensitivity, which could result in missing active or recurrent malaria infections.

Exploring the potential of community health workers in type-2 diabetes and hypertension management in Cambodia

2026-06-23T14:00:00Z

by Savina Chham, Por Ir, Josefien Van Olmen, Veerle Buffel, Ngovlily Sok, Vannith Hay, Willem van de Put, Wim Van Damme, Edwin Wouters

The burden of type-2 diabetes (T2D) and hypertension (HTN) in Cambodia is a major concern. The government and donors have introduced several interventions, yet human resource shortages hamper their implementation. Community health workers (CHWs) can be a valuable additional resource for health in T2D and HTN management. The current study aimed to assess (1) CHWs’ knowledge, attitude, and practices (KAP) in T2D and HTN management and (2) the potential health system barriers for incorporating CHWs in T2D and HTN management. This mixed-method study comprised a survey among 153 active CHWs to assess their KAP towards T2D and HTN, and semi-structured interviews with key informants were conducted to understand the challenges of the health system and propose solutions in incorporating CHWs in T2D and HTN management. Approximately 90% of CHWs correctly answered general knowledge questions on NCDs, risk factors, and prevention; however, only around 20–40% correctly answered questions on family history or tobacco use as risk factors. Most respondents appeared to have positive attitudes and have been practicing some activities related to T2D and HTN. Both financial and non-financial resource constraints were cited as challenges of the health system; therefore, re-structuring the definition of CHWs’ roles and responsibilities, and assessing the need and workload have been proposed as ways forward to effectively incorporate CHWs in T2D and HTN care. CHWs in Cambodia have shown their potential in T2D and HTN management; however, a well-designed strategy, including technical training, clearly defined roles and responsibilities, and strong support structure, is important to maximize their potential in the health system.

Retraction: Biogenic sunflower oil-chitosan decorated fly ash nanocomposite film using white shrimp shell waste: Antibacterial and immunomodulatory potential

2026-06-23T14:00:00Z

by The PLOS One Editors

Retraction: In silico investigation of novel Plasmodium Falciparum glycogen synthase kinase (pfGSk3β) inhibitors for the treatment of malaria infection

2026-06-23T14:00:00Z

by The PLOS One Editors

Potential intervention targets to promote physical activity among people with multiple sclerosis: A scoping review protocol for evidence of moderation

2026-06-23T14:00:00Z

by Emily R. Jakob, Steve Amireault, Jason B. Reed, Shih-Chun Kao, Robert W. Motl, Elizabeth A. Richards, Reese C. Kerschner

Introduction

Although currently available behavioral interventions can be effective at promoting physical activity among people with multiple sclerosis (MS), there is inconsistency in the magnitude of reported intervention effects. This highlights the importance of exploring the available evidence of moderation, which can help inform decisions about whether a specific set of behavior change techniques and strategies should be adopted for different contexts or segments of the population. Therefore, we propose a scoping review protocol to guide a summary of the body of work that has attempted to understand, explain, predict, or change physical activity behavior (context) among people with MS (population), with an eye on evidence of moderation (concept).

Methods and analyses

Studies that report on a sample of people with MS in the context of physical activity will be included for review. The search strategy includes the combing of eight electronic databases, a hand search of the reference lists for all included studies and relevant knowledge syntheses, and a citing reference search for all included studies using Web of Science. Two reviewers will single-screen titles and abstracts and independently assess each study based on a full text review. Types of multiple sclerosis populations included, and types of research methodologies used in the studies will be presented using a waffle chart. Results pertaining to the evidence of moderation will be presented using a tree graph.

Dissemination

Results will be published in a peer-review journal.

Evaluation of a novel role proposal for the use of a physiotherapist navigator in an acute cancer care setting in Ontario: Protocol for a pilot randomized controlled trial

2026-06-23T14:00:00Z

by Holly Edward, Luciana Macedo, Sarah Wojkowski, Som D. Mukherjee, Jenna Smith-Turchyn

Background

An increasing number of Canadians are living beyond cancer, with many individuals experiencing long-lasting side effects of cancer and its treatments. Research shows that engaging in rehabilitation during and after cancer treatment can reduce side effects and improve quality of life. However, less than 30% of individuals with cancer have access to rehabilitation services. The purpose of this pilot trial is to assess the feasibility of a novel PT Navigator role in an acute cancer care setting for individuals undergoing treatment for cancer.

Methods

Study Design: Pilot randomized controlled trial. Eligibility: Adults aged ≥18 years who are currently undergoing cancer treatment for any type of cancer. Intervention: The intervention group includes six consultative sessions by a PT Navigator over a maximum of eighteen weeks. Randomization: Participants will be randomly allocated using a 1:1 allocation ratio to receive the intervention with the PT Navigator or usual care. Outcomes: The primary feasibility outcome is adherence rate. Secondary outcomes include recruitment rate, retention rate, satisfaction and preliminary effectiveness, including health-related quality of life, self-reported exercise volume, health care utilization, activity limitation, functional strength, exercise capacity, and overall impairment score. Analysis: Outcomes will be assessed at baseline, post-intervention, and two month follow up. Feasibility and preliminary effectiveness will be assessed using descriptive statistics.

Discussion

This study aims to assess the feasibility of a novel PT Navigator role in an acute cancer care setting in Ontario, Canada. This pilot trial will evaluate process and resource capabilities before testing the role within a larger scale randomized controlled trial. The overall project goal is to facilitate regular assessment by a rehabilitation professional to promote early identification of physical impairment and early intervention to manage impairment as a standard component of cancer care in Canada.

Trial registration

ClinicalTrials.gov ID NCT07045740.