PLoS ONE最新文献

Academic buoyancy, recognized as a key component of positive personality traits in learning, has garnered significant attention. However, most research on buoyancy is limited to general educational contexts, lacking a comprehensive theoretical framework that poses challenges in evaluating buoyancy's impact on learners within the domain of second language acquisition (SLA). This study seeks to bridge this gap by investigating academic buoyancy within the realm of foreign language learning, specifically among university students in mainland China studying English as a foreign language (EFL). The study comprises two phases, with a total of 632 EFL participants. In the initial phase, a 32-item scale was tailored to the present study, drawing on scales from previous buoyancy-related research. Item analysis and exploratory factor analysis were subsequently conducted with a sample of 209 students. The phase retained 21 measurements and identified three main components of buoyancy: sustainability (the ability to persist despite difficulties), goal-orientedness (the focus on achieving specific learning objectives), and controllability (the perception of managing learning challenges). In the second phase, the refined questionnaire was administered to an additional 423 students, and the data underwent confirmatory factor analysis. A reliable 12-item scale was obtained that accurately reflects the identified components of academic buoyancy. By elucidating the structure of buoyancy, this study offers valuable empirical insights that can guide pedagogical strategies and strengthen learner buoyancy in language learning contexts. The findings contribute to the broader discourse on positive personality traits in education, highlighting the importance of fostering buoyancy in language learners to support their academic success.

Background: Stroke is one of the leading disabling conditions in the United Kingdom. While an increasing focus on the rehabilitation care for stroke survivors has been noted, practice guidelines, targets and services tend to be tailored for the elderly population rather than young adults.

Objectives: This scoping review aimed to map the existing literature on the rehabilitation care experiences and outcomes of young adults post-stroke aged between 18 and 45 years within acute and social care settings.

Methods and analysis: A scoping review was conducted to identify existing practice and published academic and evidence-based literature related to the topic. Arksey and O'Malley's framework guided the review and reporting followed the PRISMA-ScR checklist. Electronic databases and grey literature were searched to capture the potentially recent and relevant literature available in English from year 2000-2022. The databases included CINAHL, MEDLINE, EMBASE, PsycINFO, ASSIA, AMED, PEDro, Cochrane Library and Web of Science. Grey literature was searched from the following sources: Google Scholar, websites of networks, organisations and charities related to stroke. Hand searches were performed on the reference lists of the included articles and grey literature to find relevant references. Data were extracted on young adults' experiences of stroke and rehabilitation care and their outcomes and experiences of a particular stroke rehabilitation programme in acute and social care settings.

Results: Eighty-five articles were included in this review. In most instances, stroke was reported to negatively impact young adults, although positive consequences were also documented. The focus and the outcomes of stroke rehabilitation were predominantly physical especially in the areas of movement, communication and memory. Young adults experienced a lack of age-adapted stroke rehabilitation in acute and social care settings.

Conclusion: Our results highlight the unmet needs of young adults in their stroke recovery journey. Effective rehabilitation programmes and interventions should be developed to support young adults following stroke and meet their age-specific needs.

Sleep problems are commonly related to stress and mental health problems. However, social media use has become widespread in the general population during recent years, and their addictive potential may influence people's sleep routine. In addition, the COVID-19 pandemic gave rise to substantial mental health problems in the population, and restrictions in social life gave social media a unique position as means for both entertainment and interpersonal contact. The aim of the study was to examine sleep problems in relationship to social media use in a cross-national sample two years after the COVID-19 outbreak. Participants were 1405 adults from four countries who completed a cross-sectional online survey. The data were analyzed with independent samples t-tests, Chi Squared tests of independence, and single and multivariable logistic regression analyses. Of the 858 (61.1%) participants who reported sleep problems during the past weeks, a substantial proportion (n = 353, 41.1%) related their sleep problems to their experience with COVID-19. With adjustments for age, gender, employment, and psychological distress, more hours of daily social media use was not significantly associated with sleep problems. However, higher age (OR: 1.13, p = 0.01), female gender (OR: 1.69, p<0.001), having employment (OR: 1.34, p = 0.04), and higher levels of psychological distress (OR: 1.20, p<0.001) were independently associated with sleep problems. While the debate about the pros and cons of social media use continue, this study suggests that higher levels of social media use was not of great concern for people's sleep quality in the late COVID-19 pandemic phase. However, other aspects of social media use (eg, time of the day, content of interactions, associated stress experience) may be more relevant for understanding sleep problems and may be taken into consideration for people who experience such problems.

In recent years, coupled double-layer networks have played an increasingly critical role in evolutionary game theory. Research indicates that these networks more accurately reflect real-world relationships between individuals. However, current studies mainly focus on unidirectional influence within double-layer networks. Based on this, we propose a strongly coupled double-layer network cooperation evolution model. Strength individuals are located in the upper network layer, influencing the strategy choices of ordinary individuals in the lower layer, and vice versa. Monte Carlo simulations show that strength individuals can effectively enhance overall group cooperation. Under low temptation to defect, the group maintains a high cooperation rate; under high temptation, the presence of strength individuals prevents the group from falling into total defection, helping ordinary individuals escape the defection dilemma and improve cooperation levels.

The continuous development of the field of artificial intelligence, not only makes people's lives more convenient but also plays a role in the supervision and protection of people's lives and property safety. News of the fire is not uncommon, and fire has become the biggest hidden danger threatening the safety of public life and property. In this paper, a deep learning-based flame recognition method for complex scenes, GGSYOLOv5, is proposed. Firstly, a global attention mechanism (GAM) was added to the CSP1 module in the backbone part of the YOLOv5 network, and then a parameterless attention mechanism was added to the feature fusion part. Finally, packet random convolution (GSConv) was used to replace the original convolution at the output end. A large number of experiments show that the detection accuracy rate is 4.46% higher than the original algorithm, and the FPS is as high as 64.3, which can meet the real-time requirements. Moreover, the algorithm is deployed in the Jetson Nano embedded development board to build the flame detection system.

Cardiac rehabilitation effectively reduces mortality and enhances the quality of life for individuals with cardiovascular disease. Despite that, individuals' engagement in cardiac rehabilitation remains low. Considering the significant contributions of individuals' self-management of cardiovascular disease to their progress, it is essential to understand the personal factors that influence engagement in cardiac rehabilitation. This scoping review aims to identify and map personal factors that influence cardiac rehabilitation engagement with a specific focus on the subjective experiential dimensions of personal factors (cognitive, emotional, and behavioural). It also aims to explore interventions targeting personal factors to increase cardiac rehabilitation engagement. This review will be reported using the PRISMA-ScR checklist following the Joanna Briggs Institute (JBI) methodology. It will include peer-reviewed articles published in English from January 2004, excluding grey literature. Studies reporting adult populations aged 18 and over with cardiovascular disease and addressing personal factors or interventions to increase cardiac rehabilitation engagement, will be included. Databases for the searches will include PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus, and Web of Science. The data extraction is developed by the reviewers based on JBI guidelines and relevant literature, the form will detail the characteristics of included publications, personal factors influencing cardiac rehabilitation engagement, and intervention characteristics. The data analysis will summarise descriptively the key features of the included studies and interventions, the Patient Health Engagement Model will guide the categorisation of personal factors into cognitive, emotional, and behavioural aspects, with other personal factors organised as emerging other relevant factors themes. The findings of this review will provide important evidence support for researchers, clinicians and policy makers to promote participation in cardiac rehabilitation. Within the constraints of medical and human resources, attention to personal factors can maximise the individual's role in cardiac rehabilitation and self-management, contributing to the efficient allocation and use of resources.

Background: There is still a significant gap in understanding the impact of concomitant or previous cancer diagnoses on clinical outcomes of acute myocardial infarction (AMI).

Objective: To provide updated evidence on the effect of concomitant or previous cancer diagnoses on mortality and risk of complications, specifically major bleeding, myocardial reinfarction, and stroke, of patients with AMI.

Methods: A literature search was conducted across PubMed, EMBASE, and Scopus databases. English-language cohort studies published in peer-reviewed journals were included. Pooled effect estimates were calculated using random-effects models and reported as odds ratio (OR) or hazards ratio (HR) with 95% confidence intervals (CI). The certainty of the evidence was assessed using the standard GRADE approach.

Results: A total of 22 studies were included. AMI patients with previous or concurrent cancer had increased risk of in-hospital mortality (OR 1.44, 95% CI: 1.20, 1.73), in-hospital mortality related to cardiovascular complications (OR 2.06, 95% CI: 1.17, 3.65), mortality at 30-days follow up (OR 1.47, 95% CI: 1.24, 1.74) and mortality at 1 year follow up (HR 2.67, 95% CI: 1.73, 4.11), compared to patients without cancer. The risk of major bleeding (OR 1.74, 95% CI: 1.40, 2.16), reinfarction (OR 1.20, 95% CI: 1.05, 1.37), and stroke (OR 1.16, 95% CI: 0.99, 1.37) was also higher in patients with previous or concurrent cancer. The certainty of evidence was rated as "low" for all outcomes, except for the risk of major bleeding, which was rated as "very low."

Conclusion: Based on the low to very low certainty of evidence, we conclude that the presence of previous cancer diagnosis or concurrent cancer may increase the risk of adverse outcomes in patients with AMI. Early interventions, such as close monitoring of cardiac function, lifestyle modifications, and targeted pharmacological therapies, might help mitigate the risk of AMI and improve overall clinical outcomes. However, further methodologically rigorous studies are needed to validate the findings of this review.

Background: Malnutrition presents a significant challenge in managing patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), yet its impact on AF recurrence after catheter ablation in this population remains unclear.

Methods: We conducted a retrospective analysis of 204 patients with paroxysmal non-valvular AF and HFpEF who underwent radiofrequency or cryoballoon ablation. Risk of malnutrition as assessed using three screening tools: the Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index (PNI), and Nutritional Risk Index (NRI)]. We examined the relationship between risk of malnutrition and AF recurrence post-ablation.

Results: After a mean follow-up period of 11.2 ±  1.8 months, 43 patients (21.1%) experienced AF recurrence. Despite being classified as overweight or obese based on body mass index, many patients were at risk of malnutrition according to the CONUT score, NRI, and PNI. Adjusted analyses showed that higher CONUT scores (HR: 10.132; 95% CI: 2.545-40.336; P =  0.001), lower NRI (HR: 22.734; 95% CI: 6.399-80.776; P <  0.001), or lower PNI (HR: 9.469; 95% CI: 3.232-27.739; P <  0.001) were significantly associated with increased risk of AF recurrence. Restricted cubic spline regression revealed an inverted U-shaped relationship between the CONUT score and AF recurrence, and L-shaped relationships for both NRI and PNI with AF recurrence.

Conclusions: Systematic nutritional assessment is crucial in patients with paroxysmal non-valvular AF and HFpEF. High CONUT scores, low NRI, or low PNI serve as independent predictors for AF recurrence. Further large-scale randomized controlled trials are required to validate these findings.

Background: COVID-19 caused a profound global impact, resulting in significant cases and deaths. The progression of COVID-19 clinical manifestations is influenced by a dysregulated inflammatory response. Early identification of the subclinical progression is crucial for timely intervention and improved patient outcomes. While there are various biomarkers to predict disease severity and outcomes, their accessibility and affordability pose challenges in resource-limited settings. We explored the potentiality of the neutrophil-to-lymphocyte ratio (NLR) as a cost-effective inflammatory marker to predict disease severity, clinical deterioration, and mortality in affected patients.

Methodology: A hospital-based retrospective cohort study was conducted at KCMC Hospital among COVID-19 patients followed from admission to discharge between 1st March 2020 and 31st March 2022. NLR was calculated as the absolute neutrophil count in μL divided by the absolute lymphocyte count in μL. The NLR cut-off value was determined using Receiver Operating Characteristic (ROC) analysis and assessed its predictive ability at admission for in-hospital mortality. The Chi-square test compared the proportion of NLR by patient characteristics. The association of NLR with disease severity and mortality was analyzed using the modified Poisson and Cox regression models, respectively.

Results: The study included 504 patients, with a median age of 64 years, 57.1% were males, and 68.3% had severe COVID-19. The in-hospital COVID-19 mortality rate was 37.7%. An NLR cutoff value of 6.1 or higher had a sensitivity of 92.1% (95% CI 89.2%-94.0%) and a specificity of 92.0% (95% CI 89.7%-94.4%). Additionally, 39.5% of patients with an NLR value of 6.1 or higher had increased risk of severe disease, subsequent clinical deterioration, and mortality.

Conclusion and recommendation: An NLR value of 6.1 or higher at the time of hospital admission associated with severe disease, clinical deterioration, and mortality in patients with COVID-19. Integration of NLR as a prognostic parameter in COVID-19 prognosis scales could improve risk assessment and guide appropriate management strategies for COVID-19 patients, as well as for potential future viral-related pneumonias. Further prospective studies are necessary to validate these findings and evaluate the clinical utility of NLR in larger cohorts of patients.

Introduction: Diabetes mellitus (DM) is one of the most significant public health problems. Globally, one in ten adults has diabetes, and it results in macro- or microvascular complications, such as diabetic retinopathy (DR). It is one of the most prevalent eye complications associated with DM, and it is the main cause of vision loss. Even though East African countries face a growing burden of diabetes and DR, no study depicts the regional prevalence and its associated factors. Therefore, this study aimed to estimate the pooled prevalence of DR and its associated factors among adults in East African countries.

Methods: We extensively searched PubMed, Embase, Scopus, Google Scholar, and Google for relevant studies. A forest plot was used to estimate the pooled prevalence of diabetic retinopathy using DerSimonian and Laird's random-effects model. We checked publication bias using funnel plots and Egger's regression test. Potential heterogeneity was tested using the I-squared statistic. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also performed. Furthermore, the pooled odds ratios for the associated factors were estimated. The research protocol was registered in PROSPER.

Results: Among the 29 included studies, the estimated pooled prevalence of DR in East African countries was 28% (95% CI 23.0, 33.0). Besides, age ≥60 (OR = 2.88, 95% CI: 1.55, 5.32), body mass index ≥ 25 (AOR = 2.85; 95% CI: 1.69, 4.81; I2 = 85.4%, p < 0.001), and hemoglobin A1c levels ≥7 (OR = 2.48, 95% CI: 1.46, 4.23) were significantly associated with the prevalence of DR.

Conclusions: The prevalence of DR in East Africa was high, with more than one in four individuals with diabetes developing DR. Besides, advanced age, higher body mass index, and elevated hemoglobin A1c levels were significant factors associated with increased DR prevalence. Therefore, comprehensive diabetes management focusing on optimal glycemic control and healthy weight maintenance is essential to mitigate the problems. Also, the Ministries of Health and policymakers should prioritize and implement targeted strategies to address the identified modifiable risk factors, aiming to reduce the prevalence of DR in the region.

Trial registration: Systematic review registration: PROSPERO (2024: ID = CRD42024511437). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024511437.