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 2026-08-24T01:54:17Z Niroshan Chandrajith Lokunarangoda Akhila Rakshitha Wimalasundera Manikka H. M. Thisara S. Perera Damayanthi Idampitiya H. Naveen Tharaka Perera K. Gayana Dilki Kothalawala Arunasalam Pathmeswaran Namal P. M. Liyanage Ananda Wijewickrama U. Arjuna Bandara Medagama 10.1371/journal.pone.0356838 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Niroshan Chandrajith Lokunarangoda, Akhila Rakshitha Wimalasundera, Manikka H. M. Thisara S. Perera, Damayanthi Idampitiya, H. Naveen Tharaka Perera, K. Gayana Dilki Kothalawala, Arunasalam Pathmeswaran, Namal P. M. Liyanage, Ananda Wijewickrama, U. Arjuna Bandara Medagama</p> Background and Aim <p>Dengue is a major arboviral disease in tropical and subtropical regions, traditionally regarded as an acute, self-limiting illness. However, emerging evidence suggests that its consequences may extend beyond the acute phase, especially involving the cardiovascular system. Reported manifestations include major adverse cardiovascular events, arrhythmias, thromboembolic complications, subclinical myocardial dysfunction, endothelial dysfunction, and vascular changes. Evidence remains fragmented due to variation in study designs, population characteristics, outcome definitions, and follow-up durations. This systematic review aims to appraise and synthesise evidence on post-acute and long-term cardiovascular outcomes following dengue infection, including their spectrum, comparative risk, and determinants.</p> Methods and analysis <p>This protocol outlines a systematic review of cardiovascular outcomes in the post-acute and long-term phases of dengue infection. Human studies of any age group will be included if they report cardiovascular outcomes at least 4 weeks after acute dengue illness. Laboratory-confirmed dengue will be prioritised for primary comparative synthesis; clinically diagnosed dengue will contribute to descriptive synthesis and, where appropriate, subgroup or sensitivity analyses. Studies using cohort, case-control, cross-sectional, or case-series designs will be eligible. Comparative studies with dengue-negative or clearly defined reference controls will estimate effects where available, while non-comparative follow-up studies will contribute to descriptive synthesis. Outcomes will include major clinical cardiovascular events, including stroke or transient ischaemic attacks, subclinical cardiac or vascular abnormalities, and cardiovascular-related biomarkers. Searches will be conducted in PubMed/MEDLINE, Scopus, Cochrane Library, CINAHL, ScienceDirect, ProQuest, and Google Scholar. Two reviewers will independently perform screening, data extraction, and risk-of-bias and critical appraisal assessments. Evidence will be synthesized narratively; where comparable, random-effects meta-analysis and Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment will be conducted. PROSPERO registration: CRD420261354181.</p> Discussion <p>This review will summarize post-dengue cardiovascular sequelae and identify evidence gaps. Findings may clarify post-dengue cardiovascular risk and inform future research, clinical follow-up, and public health planning in dengue-endemic settings.</p> Tanchun Wang Qin Huang Yan Wang Cong Li Juan Ni Fang Xie 10.1371/journal.pone.0356820 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Tanchun Wang, Qin Huang, Yan Wang, Cong Li, Juan Ni, Fang Xie</p> Background <p>Age-related molecular trajectories of metabolic dysfunction-associated steatotic liver disease (MASLD) remain insufficiently characterized, limiting age-stratified risk assessment and intervention.</p> Objective <p>To test whether MASLD-related molecular changes with age merely reflect accelerated physiological aging or represent a disease-specific divergence.</p> Methods <p>We utilized public transcriptomic data from normal liver and MASLD samples to identify differential transcriptomic signals. We employed Spearman correlation analysis and generalized additive models (GAM) for nonlinear age-related trajectory modeling, and functional enrichment analysis for signaling pathway characterization.</p> Results <p>We integrated 1,354 public liver transcriptome samples from GEO and GTEx databases to construct a cross-age cohort. Differential expression and age-correlation analyses showed minimal overlap (only 22 genes) between age-associated genes in MASLD and controls, with some genes displaying opposite age-related trends. GAM identified four major expression patterns in MASLD—stable, early-life change, late-life acceleration, and mid-life fluctuation—with trajectory inflection time points around ages ~35 and ~75. Functional enrichment indicated that control age-associated genes mainly involved classical cell cycle processes, whereas MASLD changes were enriched for protein deubiquitination, proteostasis imbalance, and p53-related stress and apoptotic signaling. Many MASLD age-associated genes were also associated with fibrosis stage or NAS, largely in concordant directions.</p> Conclusion <p>MASLD exhibits disease-specific age-related transcriptional remodeling characterized by dysregulation of proteostasis and deubiquitination pathways, activation of cellular stress-response programs, and enrichment of p53-associated apoptotic signaling, rather than a simple acceleration of physiological aging.</p> Maria Hjorth Anna Forsberg 10.1371/journal.pone.0356782 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Maria Hjorth, Anna Forsberg</p> Aim <p>To explore aspects of implementing a nurse-based outpatient follow-up intervention for patients with liver cirrhosis by means of experiences reported by registered nurses, physicians and managers employed at six study clinics.</p> Methods <p>This explorative, qualitative and deductive study involved interviews with 29 healthcare professionals and managers about the implementation of the intervention. Repeated interviews were performed from 2018 to 2022. Directed content analysis was performed, based on a coding scheme from the PARiHS conceptual framework. Reporting followed the COREQ guidelines.</p> Results <p>The analysis revealed 23 different factors that influenced implementation of the nurse-based intervention, which covered all PARiHS elements. Eleven factors reduced the likelihood of successful implementation, e.g., the randomised study design became a moral dilemma, lack of clarity, resources and supportive leaders in the organisation, unclear roles, and a fragile mandate for nurses to implement the intervention. Twelve factors improved the probability for implementation success. The intervention was deemed safe, relevant and in line with clinical goals. Managers could facilitate the nurses’ role in the team, which supported the nurses’ mandate and professional growth.</p> Conclusions <p>In conclusion, implementation of nurse-based interventions is facilitated by simple procedures that can be performed independently by RNs but also by the fact that the interventions are considered valuable for the clinic concerned. Staff shortage is a barrier to clinical research, and a moral dilemma might be experienced when not all patients in need of extensive care can be randomized to the intervention. An adequate number of benefits are needed to drive the success of an implementation. The PARiHS conceptual framework includes relevant perspectives required to implement evidence-based nursing practice.</p> Marcel Rainer Adrian Martinez De la Torre Romuald Bellmann Andrea Michelle Burden Stefan Weiler 10.1371/journal.pone.0356774 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Marcel Rainer, Adrian Martinez De la Torre, Romuald Bellmann, Andrea Michelle Burden, Stefan Weiler</p> Drug–drug interactions (DDIs) are a significant contributor to adverse drug reactions (ADRs) in clinical practice. Despite established pharmacovigilance systems, underreporting and inconsistent causality assessment remain challenges. Switzerland and Austria offer a unique comparative setting due to similar healthcare infrastructures but different pharmacovigilance system designs. This study aims to compare pharmacovigilance system outcomes of Switzerland and Austria by examining how system designs may influence DDI reporting patterns and report quality. We retrospectively analysed 1,499 individual case safety reports involving DDIs submitted between January 2008 and April 2024 to the national pharmacovigilance systems of Switzerland (n = 1,159) and Austria (n = 340). As indicators of system performance, reports were assessed for demographics, reporter categories, seriousness of outcomes in relation to polypharmacy (expressed as reporting odds ratios [RORs] and confidence intervals [CIs]), ADR types, and pharmacological plausibility. Cross-national disparities were evident: Switzerland reported 3.4 times more DDI cases than Austria (mean 5.8 vs. 1.7 cases/month), with comparable patient demographics and differing reporter proportions. Most reports were classified as serious (80% Switzerland, 84% Austria), with polypharmacy strongly associated with serious outcomes in both countries (Switzerland: ROR 3.71, 95% CI 3.26–4.23, p < 0.0001; Austria: ROR 1.98, 95% CI 1.60–2.44, p < 0.0001). Reported ADRs differed qualitatively, with Switzerland predominantly reporting mechanisms whereas Austria reported more frequently symptoms. Differences were also found in the pharmacological consistency between ADR and associated drugs. These cross-national disparities in DDI reporting volume, content, and quality suggest that pharmacovigilance system design and specialist involvement influence reporting. The integration of clinical pharmacologists and pharmacists in ADR processing warrants further investigation, given its potential to strengthen DDI-related pharmacovigilance practices. These findings provide actionable insights for policymakers and regulatory agencies seeking to strengthen their pharmacovigilance systems through strategic specialist integration. Un-Kon Lee 10.1371/journal.pone.0356766 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Un-Kon Lee</p> Concerns regarding the potential for artificial intelligence to cause harm to humans have intensified. Since approximately 2020, various organizations—including governments, think tanks, and big tech companies—have sequentially enacted artificial intelligence ethical principles. However, prior studies on these principles exhibit several limitations: First, previous studies failed to provide an integrated framework of artificial intelligence ethical principles; second, they lack a consensus on the prioritization of these principles; third, five years have passed since 2020 when the artificial intelligence ethical principles were enacted, but they have not been updated; and fourth, there has been a lack of strategic consideration regarding the relative importance and performance of these principles. To address this gap, this study extracted 17 artificial intelligence ethical principles by synthesizing 37 representative previous studies. Universal priorities were determined based on a comparative analysis of these principles’ reference rankings. By evaluating the shifts in these ranking before and after 2020, this study identifies three principles—transparency, robustness, prohibition of infringement—that should be continuously adopted in artificial intelligence system development, and ive principles— responsibility, wellbeing, human rights, controllability, and sustainability—require greater emphasis and implementary development. the existing 10 Korean AI ethical principles are proposed to be expanded to 14. The results of the Importance-Performance Analysis (IPA) indicate that social value principles, such as respect of diversity, human rights, transparency, common good, and solidity, which demonstrated high performance levels, should be continuously integrated into development of artificial intelligence systems. Moreover, it is urgent to establish a governance framework to ensure accountability for responsible artificial intelligence and to develop systems for safe artificial intelligence usage, focusing on privacy, safety, prohibition of infringement, and data management. This study contributes to the foundation for building responsible, trustworthy, and safe AI systems. Xin Cao Aqilah Yaacob Kim Mee Chong 10.1371/journal.pone.0356763 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Xin Cao, Aqilah Yaacob, Kim Mee Chong</p> This study examines how photo source configurations are associated with perceived information usefulness in second-hand e-commerce and whether these relationships vary across displayed-price conditions. Drawing on the Information Adoption Model (IAM) and Signaling Theory, the study conceptualizes product photos as both visual evidence about product condition and seller-related market signals. A 3 × 2 between-subjects experiment was conducted using simulated iPhone product pages on Xianyu (n = 660). The experiment compared User-Generated Photos (UGPs), Firm-Generated Photos (FGPs), and Mixed Photos across higher and lower displayed-price conditions. Data were analyzed using partial least squares structural equation modeling, multi-group analysis, and supplementary interaction tests. The results show that both information quality and source credibility were positively associated with information usefulness. At the overall photo-source level, the information quality–information usefulness relationship was stronger for Mixed Photos and FGPs than for UGPs, whereas the source credibility–information usefulness relationship was strongest for FGPs. Differences across displayed-price conditions were limited and configuration-specific. The information quality relationship was stronger under the higher displayed-price condition, with the clearest difference observed for Mixed Photos, whereas no consistent price-related difference emerged for the source credibility relationship. These findings extend the application of IAM to visual information evaluation in second-hand markets by showing that photo source configurations correspond to distinct evaluative routes and that these relationships can vary across displayed-price contexts. Huahan Zhan Linghong Zhang Lu Ge Yanli Chen Peiyi Zhang Yumeng Jiao Xiaocheng Luo Hui Xia Qiang Fang Zhiyong Tao 10.1371/journal.pone.0356742 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Huahan Zhan, Linghong Zhang, Lu Ge, Yanli Chen, Peiyi Zhang, Yumeng Jiao, Xiaocheng Luo, Hui Xia, Qiang Fang, Zhiyong Tao</p> Objective <p><i>Clogmia albipunctata</i> (<i>C. albipunctata</i>) is a synanthropic moth fly frequently found in humid human environments. Larvae of this species have been reported in suspected cases of intestinal myiasis, but whether they can establish true gastrointestinal infestation remains uncertain. This study evaluated the survival, development, and colonization potential of <i>C. albipunctata</i> using <i>in vitro</i> digestive models and murine oral gavage models.</p> Methods <p>Wild-caught moth flies were reared in artificial climate chambers to establish laboratory colonies. Species identification was subsequently performed through morphological characterization and molecular analysis. The <i>in vitro</i> digestion model exposed <i>C. albipunctata</i> eggs and larvae to simulated gastrointestinal fluids, and their survival was monitored. For <i>in vivo</i> assessment, BALB/c mice were orally gavaged with viable eggs. Feces were examined for seven consecutive days, and gastrointestinal tissues were evaluated by time-point necropsy and histological examination.</p> Results <p>Laboratory colonization of <i>C. albipunctata</i> was successfully achieved, and the species identity was confirmed. The <i>in vitro</i> digestion model demonstrated that standard simulated gastric fluid acts as a lethal barrier. Specifically, egg hatchability decreased from 76.80% ± 3.57% in controls to 0% after digestion, and larval mortality increased from 19.17% ± 3.01% to 99.17% ± 0.83% after simulated gastric exposure. While simulated postprandial weakly acidic conditions (pH 2.0–5.0) partially attenuated this lethality, sequential intestinal fluid exposure induced further mortality. <i>In vivo</i>, the oral gavage of viable eggs and live first-instar larvae in mice resulted in no fecal shedding, tissue injury, or pathological colonization in the gastrointestinal tract.</p> Conclusions <p>These findings indicate that healthy murine gastrointestinal conditions and simulated human digestive fluids are highly unfavorable for the survival and colonization of <i>C. albipunctata</i> eggs and larvae. The results support the interpretation that many suspected clinical cases may represent sample contamination or pseudomyiasis rather than true intestinal myiasis.</p> Saima Mushtaq Sehrish Saeed Amjad Khan Tayyab Saeed Akhtar Sameen Abbas Bilal Ashraf Yalin Dong Weiyi Feng Yu Fang 10.1371/journal.pone.0356531 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Saima Mushtaq, Sehrish Saeed, Amjad Khan, Tayyab Saeed Akhtar, Sameen Abbas, Bilal Ashraf, Yalin Dong, Weiyi Feng, Yu Fang</p> Background <p>Ulcerative colitis (UC) is chronic inflammatory bowel disease that significantly impairs both physical and psychological well-being. This study explores the prevalence of depression and its impact on quality-of-life (QoL) among UC patients in Pakistan, aiming to inform integrated care approaches in a setting where mental health often remains under-addressed.</p> Methodology <p>A cross-sectional study was conducted at outpatient IBD clinics of Gastroenterology department of Holy Family Hospital, Rawalpindi, from February 2024 to May 2025. Data were collected using structured forms covering demographics, clinical history, and disease severity (assessed via Mayo Score and Montreal classification). Psychological status was evaluated using HADS and BDI-II, while QoL was assessed using the IBDQ-32.</p> Result <p>Among 101 UC patients, anxiety was present in 21.8% and depression in 17.8% patients. The mean IBDQ score was 150 ± 32.9, with 12.9% reporting poor QoL, 60.4% good QoL, and 1% excellent QoL. Disease severity showed significant positive correlations with anxiety (ρ = 0.42,p = 0.001) and depression (ρ = 0.38,p = 0.002), and strong negative correlation with QoL (ρ = −0.51,p < 0.001). Kruskal–Wallis tests confirmed significant differences in psychological distress and QoL across severity groups (p < 0.05). Multivariable regression identified Mayo score, HADS-A, HADS-D, and disease extent as significant negative predictors of IBDQ score (p < 0.05).</p> Conclusion <p>This study underscores strong correlation between higher Mayo scores, together with elevated levels of anxiety and depression, and poorer QoL as measured by IBDQ among patients with UC in Pakistan. Therefore, there is an important consideration to explore the psychological burden and QoL impairments faced by UC patients in Pakistan to inform holistic management strategies.</p> Kinza Shahid Mirza Imran Shahzad Muhammad Ehsan Rui-Si Hu Areeba Yousaf Gildardo Rivera Muhammad Safdar Muhammad Rashid Muhammad Irfan Malik Muhammad Mudasser Nazir 10.1371/journal.pone.0356497 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Kinza Shahid, Mirza Imran Shahzad, Muhammad Ehsan, Rui-Si Hu, Areeba Yousaf, Gildardo Rivera, Muhammad Safdar, Muhammad Rashid, Muhammad Irfan Malik, Muhammad Mudasser Nazir</p> Background <p><i>Fasciola gigantica (F. gigantica</i>) is a widespread zoonotic trematode that poses a substantial burden on livestock and public health in endemic regions. Elucidating host–parasite interactions relies largely on proteomic data. Excretory-Secretory proteins (ESPs) can play central roles in the host-parasite interactions, immune evasion, and parasite pathogenicity; however, proteomic information on <i>F. gigantica</i> infecting buffalo remains scarce, particularly from Pakistan.</p> Objectives <p>In this study, we present the first comprehensive proteomic characterization of adult <i>F. gigantica</i> recovered from naturally infected buffaloes in Punjab, Pakistan, with a specific focus on putative excretory–secretory proteins.</p> Methodology <p>Somatic protein extracts from adult flukes were initially assessed using sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS–PAGE) and Western blotting, confirming a high abundance and broad molecular weight distribution of parasite proteins. Subsequent liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis generated the largest proteomic dataset for <i>F. gigantica</i> to date, a total of 4,777 proteins. <i>In‒silico</i> prediction using DeepLoc 2.0, SignalP, and transmembrane helices (TMHMM), enabled the identification of a substantial repertoire of putative ESPs, including both classical secretory proteins possessing N-terminal signal peptides and non-classical secreted proteins lacking transmembrane helices. Functional annotation and Gene Ontology (GO) enrichment analysis revealed that these proteins were predominantly associated with catalytic, hydrolase, and oxidoreductase activities, highlighting their roles in tissue invasion and nutrient acquisition.</p> Conclusions <p>Among 4,777 proteins, 95 proteins associated with molecular functions, 77 in biological processes, and 65 in cellular components were linked to immune regulation, stress response, metabolic adaptation, and parasite survival. Pathway enrichment further highlighted their involvement in protein processing, signal transduction, and mechanisms facilitating host invasion and chronic infection. Collectively, these findings emphasize the vital role of proteins (somatic/putative secreted) in orchestrating host–parasite interactions and sustaining chronic infection.</p> Ronald Kibirige Marianna Agaba Nyangire Mark Kaddumukasa Christine Muhumuza Christopher Burant Shirley Moore Elly T. Katabira Martha Sajatovic Jane Tugume John Nsubuga Nazarius Mbonna Tumwesigye Aggrey David Mukose 10.1371/journal.pone.0356494 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Ronald Kibirige, Marianna Agaba Nyangire, Mark Kaddumukasa, Christine Muhumuza, Christopher Burant, Shirley Moore, Elly T. Katabira, Martha Sajatovic, Jane Tugume, John Nsubuga, Nazarius Mbonna Tumwesigye, Aggrey David Mukose</p> Background <p>Epilepsy is a common neurological disease especially in Sub-Saharan Africa. Medication adherence is essential in seizure control; however, majority of patients living with epilepsy have poor adherence to anti- seizure medications. The purpose of this study was to determine the prevalence, the factors associated with, and the experiences with adherence to anti-seizure medications among people living with epilepsy attending a community- based epilepsy clinic in Buikwe District and Mukono General Hospital in Mukono District, central-Uganda.</p> Methods and material <p>In this cross-sectional mixed methods study, 277 participants were enrolled and 20 in-depth interviews were conducted from April to July 2024. Socio-demographics and treatment related information were collected using structured questionnaires. Medication adherence was measured using the standardized 8- item Morisky Medication Adherence Scale. Modified Poisson regression was done to determine factors associated with adherence to anti-seizure medications. Thematic analysis was conducted to explore participant’s experiences with adherence to anti-seizure medications.</p> Results <p>The overall prevalence of adherence to anti-seizure medications was 66.5%. Factors significantly associated with adherence to Anti-seizure medications were earning a modest monthly income, adjusted prevalence ratios [aPR], (aPR 1.29; CI 1.13-1.53), receiving an inadequate treatment dosage (aPR 0.80; 95% CI 0.64-0.92), waiting for three or more hours at the facility (aPR 0.79: 95% CI 0.61-0.91), and being aged 30 to 34 years (aPR 0.71: CI 0.53-0.95). Key themes describing experiences with adherence to anti-seizure medications included fear of stigmatization, fear of injury and loss of life, social support, financial burden, individual motivation, misconceptions about anti-seizure medications, and limited awareness about their effectiveness.</p> Conclusion <p>This study revealed that about two- thirds of people living with epilepsy were adherent to anti-seizure medications. There is a need to implement strategies such as incorporating a medication adherence tool into routine patient care to improve adherence in our settings.</p> Brandon Mossop Salimur Choudhury 10.1371/journal.pone.0356474 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Brandon Mossop, Salimur Choudhury</p> Non-stationary time series are common in many real-world domains, including infectious disease spread, where the underlying relationships between variables evolve over time. However, most existing forecasting methods assume stationarity and fail to capture changing causal dynamics. To address this challenge, we propose the Causal Regime Bayesian (CaReBayes) forecasting framework, which integrates regime detection, causal discovery, and Bayesian forecasting within a unified approach. CaReBayes segments time series into regimes using temporal causal discovery, fits a Bayesian structural autoregressive model for each regime, classifies the current regime, then performs regime-specific forecasting with uncertainty quantification. The framework introduces methodological advances: a grid-search procedure for automated regime-dependent causal discovery, a classification method that assigns future observations to regimes based on learned Bayesian structures, and regime-conditioned Bayesian structural forecasting. Across both synthetic and Ontario COVID-19 time series data, CaReBayes outperforms benchmark models for time series forecasting. In addition to improved forecasting performance, it produces regime-dependent causal graphs that summarize candidate structural relationships in the system, enhancing interpretability. Barbara Metzler Martin Fleischmann Daniel Arribas-Bel 10.1371/journal.pone.0356472 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Barbara Metzler, Martin Fleischmann, Daniel Arribas-Bel</p> Accurately mapping environmental and social inequalities at fine spatial scales is critical for urban policy, yet the data required are often costly and infrequently updated. Vision foundation models can extract information directly from satellite imagery, offering a rapid and scalable alternative. We compare three modelling pipelines for predicting two contrasting indicators of urban inequality – air pollution and house prices – across England on a fine hexagonal grid: regression models trained on structured <i>features of form and function</i> (census, land cover and urban morphology), models trained on 128-dimensional image embeddings from a geospatial foundation model and a hybrid of the two, each evaluated with and without coarse regional context. Structured features achieve the best overall accuracy, but image embeddings become competitive once regional context is added – most clearly for air pollution, where image-only models reach a median R² of 0.78 (0.85 with regional context), indicating that the embeddings capture genuine image signal. For house prices the picture is more cautious: image-only models achieve a median R² of around 0.58; however, much of the embeddings’ apparent gain reflects coarse spatial location rather than image content. Off-the-shelf satellite embeddings, while not yet surpassing data-intensive approaches, are a promising low-cost complement, particularly for rapid, large-scale, or repeated analyses and in settings where traditional data are limited. Kelly D. Carrasco Andre M. Escarzaga Melanie Gonzalez Andrew Rosenfelder Nicolas Beltran Cory Ford Kai Miguel Leah C. A. Scott Andres Carrasco 10.1371/journal.pone.0356395 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Kelly D. Carrasco, Andre M. Escarzaga, Melanie Gonzalez, Andrew Rosenfelder, Nicolas Beltran, Cory Ford, Kai Miguel, Leah C. A. Scott, Andres Carrasco</p> As the field of virtual reality continues to advance, approaches that integrate naturalistic immersive content with artificial simulations have gained increasing scholarly attention in educational psychology, offering novel opportunities to assess learning within realistic yet experimentally controlled environments. The present pilot study evaluated the feasibility of a chroma-key augmented-virtuality (AV) system as a research and teaching tool, examining short-term factual recall, presence, and visio-vestibular discomfort among university students (n = 104) attending a prerecorded 360° AV lecture. In this system, participants were incorporated via chroma-key passthrough into a recorded classroom scene, thereby situating them physically within the virtual environment. Pre- and post-tests assessed immediate recall of lecture content alongside self-report measures of presence and comfort. Analyses revealed statistically significant improvements in immediate recall following the lecture (64.58% relative increase, <i>p</i> < 0.001, Cohen’s <i>d</i> = 0.88), although absolute post-test performance remained modest (M = 4.29 of 10 items). Participants reported moderate levels of presence (M = 3.50, SD = 0.72, on the 0–6 IPQ scoring) and minimal cybersickness symptoms (M = 2.12, SD = 0.92, on the 7-point CSQ-VR scale), and presence was not significantly associated with recall. Collectively, these findings indicate that short, passive 360° AV lecture formats constitute feasible tools for investigating short-term factual recall and user experience within controlled classroom contexts. Qingshan Luo Jiahao Ji Tao Yang Yurui Xu Yunsheng Yao 10.1371/journal.pone.0356376 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Qingshan Luo, Jiahao Ji, Tao Yang, Yurui Xu, Yunsheng Yao</p> To address the strong dependence of space object orbit prediction on physical models and initial conditions, as well as the difficulty of completely eliminating prediction errors, this study proposes a satellite orbit prediction correction method that integrates an attention mechanism with a long short-term memory (LSTM) network. Taking the LAGEOS satellite as the research object, the proposed method uses position error, velocity, and acceleration features extracted from historical orbital data to train a deep learning model for predicting one-day-ahead orbital errors and correcting the SGP4 orbit prediction results. The experimental results show that the ATLSTM model outperforms the LSTM, support vector machine (SVM), back propagation neural network (BP), and bidirectional long short-term memory (BiLSTM) models in both orbital error prediction and correction. The residual ratios of ATLSTM in the X, Y, and Z axes are reduced to 3.68%, 4.77%, and 2.37%, respectively, effectively improving the accuracy of satellite orbital error prediction. Further analysis indicates that a reasonable setting of the number of neurons helps improve model performance, while the prediction difficulty increases with the extension of the prediction duration, suggesting that the ATLSTM model is more suitable for short-term orbital error prediction and correction. In addition, validation results for satellites at different orbital altitudes demonstrate that the proposed model has certain generalization capability. In summary, combining deep learning methods with physical orbital models can effectively improve the accuracy of space object orbit prediction and provides an effective approach for orbital error prediction, space situational awareness, and collision warning. Dina Lelic Frederic Marmel 10.1371/journal.pone.0356295 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Dina Lelic, Frederic Marmel</p> Purpose <p>This study aimed to provide normative affective ratings for middle-aged to older adults with normal hearing using the Marcell database. The database includes 120 diverse environmental sounds representing various real-world acoustic events, such as those produced by animals, humans, musical instruments, tools, signals, and liquids. Secondary aims were to examine the relationship between valence and arousal, and whether factors such as age, gender, hearing-related lifestyle, hearing demands, and self-reported hearing difficulties influence these affective evaluations.</p> Study sample <p>Ninety participants (mean age: 54 ± 9 years) with self-reported normal hearing.</p> Data collection and analysis <p>The study was conducted online. Participants rated each sound token in the Marcell database in terms of valence (pleasantness) and arousal (intensity). They also completed a hearing-related lifestyle questionnaire assessing the frequency, importance, and difficulty of hearing in everyday situations. Normative data for valence and arousal were calculated as means and standard deviations across participants for each individual sound token. To explore the relationship between valence and arousal, correlation analyses were performed. Furthermore, mixed-effects linear regression was used to examine whether any of the measured variables could predict participants’ affective responses to the sounds.</p> Results <p>Normative data for each individual sound token were obtained and reported. A moderately strong negative correlation was found between valence and arousal ratings, indicating that pleasant sounds were generally perceived as calming, while unpleasant sounds were seen as more arousing. Regression analyses revealed that age, gender, hearing-related lifestyle, hearing demands, and self-reported hearing difficulties did not significantly predict valence or arousal ratings in the current dataset of middle-aged to older adults.</p> Conclusions <p>The normative data presented in this study offer a benchmark for the hearing research community when examining emotional responses across middle-aged to older adult populations.</p> Mingze Sun Maohuan Peng Jiahui Gu Huiqing Liu Xinru Wang Chenyang Li Liyue Xu Long Zhao Bing Zhou Lanbo Wu Xiaosong Dong Fang Han 10.1371/journal.pone.0356270 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Mingze Sun, Maohuan Peng, Jiahui Gu, Huiqing Liu, Xinru Wang, Chenyang Li, Liyue Xu, Long Zhao, Bing Zhou, Lanbo Wu, Xiaosong Dong, Fang Han</p> Objective <p>This study aimed to translate Global Sleep Assessment Questionnaire (GSAQ) in Chinese and to validate it in adult patients with sleep disorders.</p> Methods <p>GSAQ was translated following the steps of scale translation. Two hundred and one adult patients (aged over 18 years old) with sleep disorders were recruited. All filled out the 11-item Chinese version of GSAQ. The translated version was tested by exploratory factor analysis (EFA), confirmatory factor analysis (CFA), criterion validity, Cronbach’s α and spilt-half reliability. To evaluate the predictive ability of the questionnaire and elicit cutoff values, receiver operating characteristic (ROC) curves were generated.</p> Results <p>Out of the 11 questions in the questionnaire, each item was significantly correlated with the total score by a correlation coefficient (r) ranging from 0.24 to 0.73. Four factors were extracted explained 68.89% of the total variance. Cronbach’s α coefficient for the total scale of 11 items was 0.72 and for four factors was 0.81, 0.64, 0.76 and 0.72 respectively, with a split-half reliability of 0.75. ROC analysis yielded an AUC > 0.8. The “obstructive sleep apnea related”, “insomnia related”, “restless legs syndrome related”, and “parasomnias related” scores showed cutoff values of 3,3,1,1, respectively. The GSAQ had positive correlation with AHI (r = 0.248 p = 0.0025), insomnia severity index (r = 0.322, p = 0.017) and the rapid eye movement sleep behavior disorder screening questionnaire (r = 0.721, p < 0.0001). There was no correlation between the total GSAQ score and iRLS (r = 0.140, p = 0.309).</p> Conclusion <p>The Chinese version of the GSAQ is available and can be used to evaluate the sleep disorders of adult patients.</p> Bo Hu Wei Li 10.1371/journal.pone.0356261 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Bo Hu, Wei Li</p> Forest restoration reshapes nutrient cycling and soil stoichiometric regulation in fragile plateau ecosystems. To clarify variations in soil C:N:P stoichiometry and its environmental controls during ecosystem recovery on the southwestern China plateau, this study investigated three representative forest types along a restoration gradient, including Pinus yunnanensis forest, mixed conifer broadleaf forest, and secondary evergreen broadleaved forest. Soil samples were collected from three depths of 0–20 cm, 20–50 cm, and 50–80 cm, together with dominant tree leaf samples, and a total of 27 composite soil samples and 81 undisturbed soil cores were analyzed. Heatmap analysis, Mantel tests, redundancy analysis, and random forest modeling were used to evaluate stoichiometric characteristics and regulatory mechanisms. The results showed that soil organic carbon or total organic carbon and total nitrogen were the dominant factors controlling soil stoichiometry across forest types, whereas the effects of soil layer, iron and aluminum oxides, pH, and nutrient fractions varied with restoration stage. In the Pinus yunnanensis forest, available K and available Al were the primary predictors of C:P, and total nitrogen was the primary predictor of N:P. In the mixed conifer broadleaf forest, total organic carbon became the primary predictor of C:P and C:N ratios, while nitrogen fractions strongly regulated N:P variation. In the evergreen broadleaved forest, C:P was co-regulated by total P, available Al, TOC, and nitrate nitrogen, while N:P was predominantly governed by total P and total N. The explanatory power of environmental variables increased markedly along the restoration gradient, and nutrient heterogeneity in the 0–20 cm soil layer intensified during later restoration stages.Mixed‑effects models confirmed that forest type × depth interactions significantly modulated Al, Fe, and P stoichiometry, corroborating the successional shift from physical to biogeochemical controls. These results indicate that forest restoration progressively strengthens plant-soil nutrient associations and corresponds to a transition from available K/Al and bulk density constraints in the early-stage plantation toward absolute nutrient pools and organo-mineral interactions in the mature forest. Nardos Gelana Finina Abebe Menen Tsegaw Yordanos Tadesse Melkamu Ayalew Kokebie Tseganesh Gedlu Hanna Alemayehu Tesfaye Bikes Yeshiwork Eshetu Mesfin Kassaye Adugna Endale Rachana Sharma Hiwot Getachew Hnin Su Mon Tolasa Yadate 10.1371/journal.pone.0356253 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Nardos Gelana, Finina Abebe, Menen Tsegaw, Yordanos Tadesse, Melkamu Ayalew Kokebie, Tseganesh Gedlu, Hanna Alemayehu, Tesfaye Bikes, Yeshiwork Eshetu, Mesfin Kassaye, Adugna Endale, Rachana Sharma, Hiwot Getachew, Hnin Su Mon, Tolasa Yadate</p> Background <p>Despite global progress, significant disparities persist in routine childhood vaccination coverage, commonly in low- and middle-income countries, including Ethiopia. Ethiopia has made considerable progress in extending immunization services through the national Expanded Program on Immunization. However, still significant coverage gaps remain, particularly among the vulnerable population such as urban slums and pastoralist areas. This study seeks to capture the perspectives of healthcare professionals and program managers to understand the challenges, best practices, and opportunities for strengthening immunization service delivery in these marginalized settings.</p> Methods <p>An exploratory qualitative study was conducted in urban slum and pastoralist areas of Ethiopian regions from November to December, 2023. Purposive sampling technique was used to select 39 key informants, including healthcare providers, health extension workers, maternal and child health directors, Woreda Immunization officers, and focal persons. The interview guides were developed with Human-Centered Designand the World Health Organization’s behavioral and social drivers frameworks. Open Code software version 4.03 was used to perform thematic analysis, employing both deductive and inductive coding approaches. Inter-coder reliability and daily debriefing were used to ensure the trustworthiness of the study.</p> Results <p>Key barriers affecting the routine childhood immunization service included inconsistent vaccine supply, limited cold-chain capacity, low financing, high workloads, and challenges in reaching these populations. However, best practices such as community engagement, involvement of local community structures, mobile teams and the inclusion of the private sector demonstrated notable successes. Healthcare professionals recommended improving supply chains, enhancing healthcare providers training and supervision, and increasing community awareness as crucial strategies to reach under-immunized groups.</p> Conclusion <p>This study identified that persistent health system challenges remain in delivery of routine childhood vaccination, while there is best practices in some areas. Strengthening health system capacity in terms of human power and necessary, combined with active community engagement, is essential to achieving equitable vaccine coverage among under-immunized populations.</p> Juan Ge Peifang Lu Shuzhi Peng Haiyun Huang 10.1371/journal.pone.0356250 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Juan Ge, Peifang Lu, Shuzhi Peng, Haiyun Huang</p> Objective <p>To delve into the intricate relationship between sleep quality and prevalence of type 2 diabetes (T2D) among community-dwelling chronic disease patients, and to provide insights that can inform clinical practice.</p> Methods <p>Data on basic information and sleep quality of patients with chronic diseases were collected via questionnaire surveys. Following descriptive and logistic regression analyses, restricted cubic spline regression was further applied to explore a possible nonlinear dose-response relationship between sleep quality and prevalence of T2D among these patients.</p> Results <p>A total of 902 valid samples were included in this study, among which 565 were cases of T2D, accounting for 62.64%. The average score of the Pittsburgh Sleep Quality Index (PSQI) was 11.11. In all three models, a positive association was observed between higher PSQI scores and prevalence of T2D. Subsequent analysis employing RCS regression substantiates this nonlinear association and discerns two inflection points at 12 and 13 When the PSQI score was greater than 12, the odds ratio (OR) increased with higher PSQI scores, suggesting a significant increase in the association with the prevalence of T2D. When the PSQI score reaches 13, the OR stabilises, indicating that the rate of increase in risk has slowed.</p> Conclusion <p>Sleep quality is an important factor for the prevalence of T2D, exhibiting a threshold range effect. Community health practitioners may consider sleep quality assessment as a supplementary tool, particularly in patients with existing chronic conditions. Implementing targeted sleep improvement interventions in this high-risk subgroup (PSQI≥12) may holds substantial potential to be associated with reduced T2D prevalence.</p> Xiangjun Li Ruitao Li Zhui Tu Qingting Wei 10.1371/journal.pone.0356238 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Xiangjun Li, Ruitao Li, Zhui Tu, Qingting Wei</p> Phage therapy has become an important strategy against the crisis of antibiotic resistance for its potential to specifically target pathogenic bacteria. However, the narrow host range of phage makes the screening of precise matches of clinical strains inefficient, while existing computational tools are difficult to capture the dynamics of phage-host interactions due to their reliance on single modal features (genome or proteins). In this paper, we propose FusionPHI, a phage-host interaction prediction model that adopts a fully connected neural network architecture and takes multi-modal features as input, including the k-mer statistics of genome sequences, the physicochemical properties of proteins, and the embedded representations of evolutionarily conserved gene motifs for a comprehensive understanding of phage-host interactions. Moreover, FusionPHI contains a dual-stage attention-drive feature fusion module that integrates a self-attention mechanism to optimize the correlation among the features within a single modality followed by a cross-attention mechanism to dynamically fuse genetic distribution patterns with the protein function information in global or local regions of sequences. The experiments of phage-host interaction prediction show that FusionPHI achieves 91% ROC AUC in cross-validation, demonstrating competitive performance compared to the evaluated baseline methods on our dataset, and ablation experiments further validate the necessity of multi-modal features and attention mechanism. The case study of <i>E. coli</i> infected by the <i>M13K07</i> phage further validate the prediction ability of the proposed FusionPHI model. Ali Sait Özer Fehmi Sevilmiş Hulusi Karaca Hafiz Ahmed 10.1371/journal.pone.0355943 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Ali Sait Özer, Fehmi Sevilmiş, Hulusi Karaca, Hafiz Ahmed</p> The distribution static compensator (DSTATCOM) is widely employed to regulate the voltage of self-excited induction generators (SEIGs) in wind energy systems. It supplies the reactive power demanded by both the SEIG and the connected load, drawing on the DC bus voltage for this purpose. Effective operation requires maintaining the DC bus voltage at a constant reference value and accurately determining the reactive power demand. This, in turn, depends on precise estimation of the reference source currents. Under nonlinear and unbalanced loading conditions, inadequate filtering of load currents can lead to errors in separating their active and reactive components, thereby degrading system performance. To address this challenge, this paper proposes an extended enhanced phase-locked loop (E²PLL)-based control algorithm for DSTATCOM-supported SEIGs operating with nonlinear and unbalanced loads. The proposed E²PLL achieves an effective balance between structural complexity and filtering capability, enabling accurate estimation of load current magnitude and frequency. This allows the DSTATCOM to maintain balanced and sinusoidal source currents even under nonlinear and unbalanced loading conditions. The proposed approach is comprehensively validated through real-time hardware-in-the-loop system (OPAL-RT) under these adverse conditions. In addition, robustness evaluations under practical operating disturbances, including wind-speed variations, measurement noise, and DC-link voltage ripple, further demonstrate the reliability of the proposed controller. The results demonstrate its effectiveness in ensuring accurate current estimation and stable system operation. Miaomiao Li Deyu Miao Qingcong Mo Qinghua Chen Liming Lu 10.1371/journal.pone.0355941 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Miaomiao Li, Deyu Miao, Qingcong Mo, Qinghua Chen, Liming Lu</p> Background <p>Cannabis use disorder (CUD) imposes a significant global health burden, yet comparative evidence for the diverse range of non-pharmacological interventions (NPIs) remains fragmented. Existing reviews often combine diverse NPIs into broad categories, overlooking the specific contributions of neurobiological modalities. This study aims to establish a comprehensive comparative efficacy hierarchy for non-pharmacological CUD interventions by integrating psychosocial therapies and neurotherapy into a unified analytical framework.</p> Methods <p>We will conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials comparing NPIs against control group(including waitlist, no-intervention, or non-specific control) or another NPIs for individuals with CUD. Systematic searches will be performed across PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Primary benefit outcomes will include biochemically verified cannabis abstinenc and self-reported days of cannabis use over the past 30 days. Primary acceptability will be evaluated by treatment retention, defined using an intention-to-treat approach as the proportion of randomized participants completing at least one session during the final treatment week, alongside follow-up retention rates. Primary safety will be assessed by the overall incidence of intervention-related adverse and serious adverse events. Pairs of reviewers will independently perform study selection, data extraction, and risk of bias. A frequentist NMA will be conducted to synthesize evidence. We will employ the Grading of Recommendations Assessment, Development and Evaluations(GRADE) approach to assess the certainty of evidence and categorize interventions using a minimally contextualized framework based on predefined decision thresholds.</p> Results <p>Comprehensive search strategies have been validated across target databases. Formal study screening, data extraction, quantitative network meta-analyses, and GRADE evidence assessments are scheduled for completion by September 2026, followed by final manuscript preparation.</p> Conclusion <p>This NMA will establish a comprehensive comparative evidence hierarchy for non-pharmacological CUD interventions by bridging psychosocial and neurobiological modalities. By pairing network estimates with GRADE certainty assessments, our findings will offer a standardized, actionable foundation for tailored clinical care and future trial methodology.</p> Trial registration <p>PROSPERO CRD420251173215.</p> Aki Ohdera Matthew Wang Maille Mansbridge Changhua Yu Ryan Ginn Hannah DeMerit Isabella Guillen Christy Lam Andrew Hyunsoo Kim Gianni Notaro Jonathan Ong David Herman Lea Goentoro 10.1371/journal.pone.0355863 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Aki Ohdera, Matthew Wang, Maille Mansbridge, Changhua Yu, Ryan Ginn, Hannah DeMerit, Isabella Guillen, Christy Lam, Andrew Hyunsoo Kim, Gianni Notaro, Jonathan Ong, David Herman, Lea Goentoro</p> The moon jelly <i>Aurelia coerulea</i> does not typically regenerate appendages. A previous study found that increasing nutrient availability promotes the activation of appendage regeneration. In this study, we found that changes in nutrient availability alter microbiome composition. Genome-scale metabolic modeling of the microbial symbionts suggests that the microbiome modulation reduces the abundance of a symbiont that competes with the host for metabolic resources. Antibiotic treatment that recapitulates the microbiome shift significantly promotes regeneration. Transcriptomic analysis of the host shows an upregulation of genes involved in the arginine biosynthetic pathway, including <i>argininosuccinate synthase</i> and <i>carbamoyl phosphate synthase</i>. Exogenous arginine supplementation promotes appendage regeneration. These findings suggest that microbiome composition, influenced by nutrient availability, contributes to the activation of host regeneration, and identify a role for arginine in promoting regeneration. Hao Liu Yiming Ren Lin Jia Lijing Wang Rugang Wang Tongtong Yang Yingquan Zhou Hongxin Zhao Lili Dai 10.1371/journal.pone.0355744 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Hao Liu, Yiming Ren, Lin Jia, Lijing Wang, Rugang Wang, Tongtong Yang, Yingquan Zhou, Hongxin Zhao, Lili Dai</p> Background <p>Persistent low-level viremia (pLLV) remains clinically challenging among people living with HIV (PWH) receiving antiretroviral therapy (ART), and whether ART regimen switching improves virologic outcomes remains controversial.</p> Methods <p>We conducted a multicenter retrospective real-world cohort study across seven Chinese medical institutions. Adults with pLLV (50 copies/mL ≤ plasma viral load [VL] < 1000 copies/mL) were included and classified into a non-switch (control) group or a switch group based on the management decision of treating physicians at pLLV. The primary outcome was viral suppression at week 48; week 24 and week 96 suppression were secondary. Adjusted odds ratios (aOR) and risk differences (aRD) were estimated using logistic regression. Longitudinal viral load and CD4 trends were assessed using rank-based nonparametric longitudinal models.</p> Results <p>162 participants were included (97 control; 65 switch). Viral suppression at week 48 was 64.37% in the control group and 68.52% in the switch group (aOR 1.40, P = 0.427; aRD 0.07, P = 0.423). At week 24, suppression occurred in 40.98% and 50.00%, respectively (aOR 1.34, P = 0.521; aRD 0.07, P = 0.518). HIV RNA levels decreased and CD4 increased modestly over time in both groups without between-group differences.</p> Conclusions <p>In this retrospective cohort, regimen switching after pLLV was not associated with improved virologic suppression.</p> Weilue He Julie Osborne Megan C. Frost 10.1371/journal.pone.0355735 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Weilue He, Julie Osborne, Megan C. Frost</p> The success of terminal sterilization is a critical step for medical device manufacturing to guarantee device functionality and limit infections. The Food and Drug Administration (FDA) Established Category A approved sterilization methods include heat (steam or dry), radiation (gamma, X-ray, electron beam), ethylene oxide (EtO) gas, and vaporized hydrogen peroxide (VH₂O₂). Although EtO is the most commonly used method in the industry, its high toxicity has always been a major concern for human health, environmental impact, and medical device integrity. The developement of novel alternative technologies are actively encouraged by the FDA, aiming to provide similar scalable sterility assurance level (SAL) as EtO gas while reducing health and environmental issues. Nitric oxide (NO) gas was evaluated as the novel sterilant provided by Sterile State Inc. (Grand Rapids, MI) to achieve SAL of 10⁻⁶ at room temperature (RT) and regular atmospheric conditions (21% oxygen and ambient pressure). Commercially available biological indicators (BIs) designed for heat, EtO, and VH₂O₂, and widely used spore species, including <i>B. atrophaeus, B. subtilis</i> and <i>G. stearothermophilus</i>, were used to validate the NO sterilization system. All the species showed a Log-linear reduction pattern under NO sterilization according to ISO 11138−1 guidelines, and the <i>D</i>-values of these microorganisms were determined. NO’s ability to inactivate clinically relevant bacteria, <i>E. coli</i> and <i>S. aureus</i>, was also evaluated through <i>D</i>-values. The sterilization cycle was performed at RT, specifically at 21−23 °C, regular atmospheric pressure, and the NO dose potentially exposed to end-users was significantly less than National Institute for Occupational Safety and Health (NIOSH) defined human Immediately Dangerous to Life or Health (IDLH) level. For the first time, we proved the utility and effectiveness of NO as an agent to achieve sterilization at mild conditions using BI and the SAL of 10⁻⁶ standard. NO sterilization holds great potential to be used as a green alternative to traditional gaseous sterilant sterilization for medical device manufacturing and infection control. Matt Vogel Heeyoung Lee Taylor Kaser Yoobin Kim 10.1371/journal.pone.0355673 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Matt Vogel, Heeyoung Lee, Taylor Kaser, Yoobin Kim</p> The Social Vulnerability Index (SVI), a measure designed to gauge a community’s resilience to natural disasters, such as hurricanes or wildfires, has been increasingly adopted in community violence research to identify places at risk of firearm-related harms. We take stock of recent research on social vulnerability and critically assess the conceptual and empirical validity of the SVI in the context of community firearm violence. We first compare the measurement properties of the SVI with a conventional index of concentrated disadvantage (CDI) commonplace in social science research on community violence. We then compare the empirical associations between firearm violence and the SVI and CDI in a series of tract-level, cross-sectional models in 84 American cities. Our results demonstrate that the SVI consistently underperforms relative to the traditional measure of CDI and that the SVI’s explanatory power derives almost entirely from its socioeconomic status subtheme. Conceptually, the SVI measures a community’s capacity to absorb exogenous shocks, not the structural determinants of violence. Methodologically, its rank-based equal-weighting scheme weakens construct validity. We argue that the reliance on SVI in the realm of firearm research represents a form of conceptual drift that risks misdirecting prevention resources and mischaracterizing the community-level origins of firearm harms in the United States. Didrik Ulleberg Gema Raspati Tara Baele Mari Birkeland Jon Brage Svenning 10.1371/journal.pone.0355602 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Didrik Ulleberg, Gema Raspati, Tara Baele, Mari Birkeland, Jon Brage Svenning</p> The shift to a circular bioeconomy is dependent on green-tech innovations that upcycle waste streams into reusable components. The current study explores the chemical and microbiological stability of a fertilizer concentrate produced from effluent water of recirculating aquaculture systems (RAS) using reverse osmosis. The objective was to assess the shelf life of the concentrate and determine whether pasteurization is required to prevent spoilage during storage in light-proof containers at room temperature for six months. The chemical and microbiological storage stability of the pasteurized concentrate was monitored by periodic sampling and compared to an untreated control. Pasteurization decreased the initial concentration of elements dissolved in the concentrate, the viable cell load and the percentage of intact bacterial cells. However, both the pasteurized and the untreated control maintained chemical and microbiological stability during storage, indicating that the concentrate has a shelf life of at least 6 months independent of pasteurization. The concentrate is therefore suitable for long-term storage, without the increased production costs and energy use required for pasteurization, thereby providing a reliable and circular source of plant nutrients that have the potential to support sustainable farming practices. This study will contribute to the continued transition towards sustainable aquaculture by repurposing RAS effluent as a valuable by-product for crop cultivation. Nina Wanča Jakub Jehlička Anna Hála 10.1371/journal.pone.0355543 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Nina Wanča, Jakub Jehlička, Anna Hála</p> In 2023, the Children’s Museum, a new permanent exhibition for children, opened at the National Museum in Prague. Primarily designed for children aged 5–10, the exhibition aims to provide an educational alternative to traditional (pre-)school education and classical museums. Through a combination of interactive and traditional presentation methods, the exhibition offers imaginative and interdisciplinary perspectives on various phenomena. It encourages visitors to explore and learn in their own ways. This approach requires a significant interpretative effort from both children and their accompanying adults. To evaluate how the exhibition’s concept resonates with visitors, we observed visitor interactions over a period of 2.5 months, analysing 720 interactions involving more than 2000 visitors. Our analysis revealed that older children (aged 6–10, the primary target group) showed higher levels of interaction and engagement compared to younger children. However, the primary target group constituted only 23% of the child visitors, with 72% being younger children. This indicates that the exhibition is not attracting its intended audience effectively, and the majority of the young visitors may face challenges due to the complexity of the exhibition’s concept. We discuss the implications of these findings and suggest strategies to align the exhibition’s content better with its target audience. Eugênio Simão 10.1371/journal.pone.0355540 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Eugênio Simão</p> Cellular commitment thresholds—such as metabolite concentrations triggering irreversible developmental transitions—cannot be derived as structural properties of network topology in classical computational formalisms. Existing numerical approaches (e.g., ODE bifurcation analysis) predict thresholds only after full parameterization; the threshold is an output of fitting, not of topology. The fundamental reason: classical models treat metabolites either as passive substrates (metabolic networks) or as Boolean switches (gene networks), lacking unified semantics for molecules functioning simultaneously as metabolic currencies and regulatory signals. We present signal hierarchy theory establishing formal foundations for hierarchical biological control. The theory proves two structural theorems: signal flow graphs must be acyclic, and lower-layer signal depletion structurally preempts higher-layer transitions—formalizing that resource exhaustion overrides regulatory programs regardless of controller abundance. We implement this theory as signal hierarchical Petri nets (SHPN), extending classical Bio-PN from 5-tuple to 13-tuple formalism with signal flow arcs enabling consumptive information propagation. Modelers designate any metabolite as signal place (ATP, GTP, NADH, cAMP, Ca²⁺) when biological evidence supports regulatory gating. Unlike test arcs (non-consuming catalysis), signal flow arcs create basin boundaries with commitment threshold Mcommit=θ+Ws computable directly from arc parameters—no simulation, no fitting. The formalism unifies metabolic-regulatory modeling: normal arcs for horizontal mass transfer, signal flow arcs for vertical information propagation. Applied to <i>Bacillus subtilis</i> sporulation, the formalism captures the Fujita and Losick (2005) observation: abrupt induction of Spo0A* yields only ≈5% sporulation while gradual KinA phosphorelay accumulation yields ≈52%. The asymmetry emerges structurally from the σH commitment separatrix (≈1.60μM): gradual accumulation allows the σH positive-feedback loop to cross threshold stochastically; an abrupt pulse fires before [σH] builds. Stochastic sweep simulation (25 conditions, 50 replicates) reproduces the 52% vs. ≈5% contrast; all arc parameters (Γ, phosphorelay rates, σH feedback) derive from published biological measurements—none was optimized to match this ratio. Fayssal Mekaret Abdelaziz Rabehi Baya Zebentout Shahrazade Tizi Abdelmalek Douara Mawloud Guermoui Imad Eddine Tibermacine Amal H. Alharbi El-Sayed M. El-kenawy Mustapha Habib Zineb Benamara 10.1371/journal.pone.0355480 2026-08-21T14:00:00Z 2026-08-21T14:00:00Z <p>by Fayssal Mekaret, Abdelaziz Rabehi, Baya Zebentout, Shahrazade Tizi, Abdelmalek Douara, Mawloud Guermoui, Imad Eddine Tibermacine, Amal H. Alharbi, El-Sayed M. El-kenawy, Mustapha Habib, Zineb Benamara</p> This work presents a comprehensive comparative analysis of Schottky barrier (SB) inhomogeneities in three SiC polytypes (3C, 4H, and 6H) using three established theoretical approaches: the Cowley and Sze interface state model, the Werner Gaussian distribution model, and the Tung localized patch model. Through analytical simulations performed in MATLAB, we examined how each model’s intrinsic parameters, including the interface state density (N_ss), the standard deviation (σ), and the inhomogeneity parameter (γ), influence the effective Schottky barrier height (SBH) and the corresponding I–V characteristics predicted by each model. Our results demonstrate that each model reveals a distinct physical mechanism governing charge transport at the metal/semiconductor interface. The Cowley and Sze model emphasizes Fermi-level pinning due to interface states, Werner’s model accounts for statistical fluctuations of the barrier height, and Tung’s model describes localized current flow through low-barrier patches. Even though the numerical values obtained for each case are different, Although the three SiC polytypes exhibit different quantitative responses, they all show thermally activated transport behavior. These findings provide valuable guidelines for optimizing Schottky contact performance in high- temperature SiC power devices. The proposed comparative framework serves as a predictive tool for designing, engineering, and improving metal/SiC interfaces in advanced power device technologies.