PLoS ONE最新文献

Background: Influenza is known to cause seasonal epidemics and recurrent pandemics and demands robust surveillance systems for strain detection and trend monitoring. There are global surveillance systems (FluNet and FluID) to monitor the trends in influenza virus strains and epidemiology. SEAR has been vulnerable to influenza outbreaks and hence, efforts to enhance surveillance have been ongoing. However, there is limited analysis of data trends from influenza surveillance systems from SEAR member states (MS).

Objectives: To describe the virological and epidemiological characteristics of influenza in WHO SEAR and MS therein for the years 2015 till 2023.

Methods: Influenza surveillance data from 2015 to 2023 was extracted for all WHO SEAR MS. This included virological surveillance data from FluNet and epidemiological data from FluID. Descriptive analysis was conducted for the proportionate distribution of Influenza A and B, their subtypes and proportion of ILI and SARI cases. The analysis elicited annual patterns and trends of influenza infections in each MS and across the SEAR region. A multivariable linear regression model was fitted with SARI cases as the outcome against ILI cases, influenza test positivity, country, seasonality and pre-and post- covid period with statistical significance set at p<0.05.

Results: During the reporting period, a total of 5,97,781 specimens were processed in 11 countries. A total of 85,105 (14.2%) specimens were laboratory confirmed influenza positive cases. Two peaks were seen in 2019 and 2021 in almost all the SEAR MS. India (37.4%) had the highest number of confirmed influenza cases followed by Nepal (15.6%) and Bangladesh (10.3%). Influenza A (75.5%) dominated in almost all years and countries. Thailand reported the highest ILI cases (n = 19.4 million; 95.4%), followed by Sri Lanka (n = 0.6 million; 2.9%) and Bhutan (0.8%). Nepal had the highest number of SARI cases (n = 1,03,010; 36.4%), followed by Bangladesh (n = 1,00,772; 35.6%) and Sri Lanka (n = 21,688; 7.7%). In the adjusted model, influenza positivity was associated with higher SARI cases (β = 17.35, p= 0.005), while ILI, seasonality and pandemic period were not.

Conclusion: Enhancing influenza surveillance data can improve epidemic readiness and seasonal vaccination planning. Improving the quality and timeliness of data submissions to FluNet and FluID is crucial, as current data gaps hinder effective decision-making at the regional and global levels. WHO has provided strategic guidance for strengthening the two databases and the Global Influenza Surveillance and Response System (GISRS), urging collaborative and regionally harmonized action including optimizing sentinel site networks and leveraging from COVID-19 for future pandemic preparedness.

Background: Healthcare settings are becoming increasingly multicultural. As a result, cultural factors play a bigger role in patient care. This raises an important question: are health professionals prepared to handle these situations and provide high-quality care?. To answer this, we need to identify the strategies professionals use when caring for culturally diverse patients. We must also determine whether these strategies work, whether they come from training or experience, and how they affect the work environment. The goal of this research protocol is to improve patient safety through culturally competent and culturally congruent care. It focuses on a multicultural hospital located on the border between Spain (Europe) and Morocco (Africa). The project will create a care protocol, a methodology, and a training program based on the organization's best practices, their experience, and the cultural knowledge of the population usually attended and their feedback.

Methods: The Participatory Action Research (PAR) methodology seems to fit well with the purpose and in the context selected. It will take place in several stages: approach and sensitization, induction, interaction, implementation, and systematization. An estimated sample of 20 healthcare professionals from the regional hospital in Melilla will be invited to participate, though the final number will depend on the saturation of the sample. The analysis will be carried out following Taylor and Bogdan's criteria. The use of this methodology is intended to have an impact on the participating professionals, since they are part of the process, with their ideas contributing to the elaboration of the results and being complemented with multicultural patients' views. The duration of the research protocol is estimated between 24-26 months. Approval has already been obtained from the ethics committee.

Discussion: After carrying out all the stages of this research protocol, the next step consists of transferring the evidence and best practices produced into a framework with manuals and protocols that will also be useful in the specific context and will illuminate the type of training recommended for the workforce in such a context.

The market has seen the emergence of various passive exoskeletons designed to assist with carrying tasks; however, evidence of their effects during stair negotiation remains limited. In this study fifteen female and fifteen male participants carried a 12-kg load with and without an upper-body passive exoskeleton (CarrySuitⓇ) while ascending and descending stairs. The impact of the CarrySuitⓇ was evaluated through measurements of heart rate, muscle activity, and joint range of motion during both stair ascent and descent. The results indicated that heart rate and muscle activity in the biceps brachii and erector spinae were reduced during both ascent and descent when wearing the exoskeleton, except in females during descent, where muscle activity remained comparable between conditions. An increase in upper-leg muscle activity was observed only in males during ascent, while lower-leg muscle activity was reduced during descent for all participants. Some side-based asymmetries in lower-limb activation were observed, but they were generally modest when using the exoskeleton. Use of the CarrySuitⓇ was associated with reduced joint range of motion, particularly in males, affecting the shoulders, elbows, pelvis, hips, and thorax. In females, reductions in range of motion were limited to the neck and thorax. In contrast, increases in range of motion were observed in the ankles, knees, hips, and shoulders in females, and in the ankles and knees in males. Lower perceived discomfort was reported by all participants when using the exoskeleton, with broader relief observed among male users. These findings suggest that the CarrySuitⓇ has a positive impact on physiological, biomechanical, and perceptual outcomes during stair-based load carrying, and may serve as a viable ergonomic solution for work environments where mechanical aids are impractical.

The scarcity mindset, where people do not have what they feel that they need, can help consumers address the area of scarcity, but on the other hand can lead to neglect and mistakes elsewhere. This study tests whether a scarcity mindset is associated with the use of alternative financial services, whether the association is stable above and beyond established predictors of the use of alternative financial services, and whether it differs by household income. Data come from the 2021 FINRA National Financial Capability Study's State-by-State survey wave, N = 24,349. Results of binary logistic regression analyses show that, controlling for established predictors of alternative financial services use and socio-demographic characteristics, a stronger scarcity mindset is significantly positively related to alternative financial services use. These findings hold for the pre-COVID-19 2018 data with regard to income groups, and although high-income respondent are lesser users of alternative financial services, the scarcity mindset transcends income status and emerges as a significant predictor of alternative financial services use for study participants regardless of household income. Study implications point to the need to assess the role of the scarcity mindset for newer alternative financial services products, including fintech applications. (192/300).

Objectives: This study identifies predictors of severe COVID-19 following completion of two-dose primary series of the AZD1222 COVID-19 vaccine, employing eXtreme Gradient Boosting (XGBoost) and Shapely additive explanations (SHAP), as an explainable artificial intelligence (AI) approach.

Method: A retrospective cohort study using linked primary care data from the Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub (ORCHID), including computerised medical records of over 19 million people in England, for the period from 8th December 2020-31st December 2021, as part of the Real-world effectiveness of the AZD1222 COVID-19 vaccine in England (RAVEN) study. We evaluated a two-dose primary series of the AZD1222 vaccine on COVID-19 related hospitalisation, ICU admission or death.

Results: A total of 4,515,280 individuals with a two-dose primary series of AZD1222 vaccine were analysed, where 7,171 individuals had a record of severe COVID-19. Variables with the greatest predictive weight for COVID-19 mortality in vaccinated individuals were age ≥ 85 years, high Cambridge Multi-Morbidity Score, and chronic heart, respiratory and kidney diseases; variables predicting COVID-19 hospitalisation following completed primary series included high CMMS, obesity, and being offered early COVID-19 vaccination in the national vaccine campaign (e.g., vaccinated during the first quarter of 2021); predictors of COVID-19 ICU admission included obesity, female sex, being offered early COVID-19 vaccination in the national vaccine campaign, chronic kidney disease and diabetes. Across models, age ≥ 85 years was highly predictive of mortality and moderately predictive of hospitalisation. However, for ICU admission it was reported as not predictive.

Conclusion: Obesity, chronic heart, respiratory and kidney diseases were the main predictors across models, which is comparable to the scientific literature, validating the explainable AI approach. XGBoost can accurately predict severe outcomes in fully vaccinated individuals. Predictive models built on real-world primary care data can help to timely identify individuals to be prioritised for vaccination booster.

The position of rear-edge vertical fissures in gently dipping bedding rock slopes is a critical factor in controlling their stability. However, the exact location of these fissures is often uncertain, which presents challenges for stability assessment and hazard prediction. Therefore, it is essential to develop a theoretical method capable of identifying the most unfavorable fissure position. Based on the geometric relationships and static equilibrium conditions of the unstable slope mass, this study systematically analyzes the water pressure distribution characteristics of rear-edge fissures under various water filling and outflow conditions. Four typical mechanical calculation models are constructed: (a) fissure filled with water and blocked outflow fissures, (b) fissure filled with water and unblocked outflow fissures, (c) considering only hydrostatic pressure, and (d) no water pressure scenario. By deriving the sliding force calculation formula and introducing an extremum criterion, the most critical fissure position and its corresponding maximum residual sliding force are determined. The results indicate that: (1) the width of the potential slip surface increases with the slope crest inclination (α) and slope height (H), but decreases as the bedding dip angle (θ) increases, (2) the geometric parameters (H, α, θ) have a significantly greater impact on the slip surface width than the shear strength parameters (c, φ) of the rock mass and (3) water pressure plays a significant role in altering the most unfavorable fissure position and serves as a critical hazard-inducing factor. Compared to traditional methods, which fix the fissure position at 1.5 times the slope height behind the slope face, the proposed method accurately identifies the most critical fissure location, effectively minimizing calculation errors. This study provides a more reliable mechanical model and computational foundation for stability analysis of gently inclined bedding rock slopes, offering direct guidance for disaster prevention design, risk management, and reinforcement strategies in similar slope engineering projects.

Objective was to investigate the health practices and knowledge among quilombola woman in the 'Baixada Maranhense' region, to understand how these practices are transmitted, transformed, and integrated into well-being and community identity. |Qualitative study was conducted using a hermeneutic-dialectical approach in the Quilombola community of Estiva dos Mafras, Mirinzal, Maranhão, Brazil. Thirteen quilombola woman selected by snowball sampling until theoretical saturation. Data were produced semi-structured interviews period September-December 2024, audio-recorded and transcribed verbatim. The textual corpus was processed in software and thematically interpreted from a hermeneutic-dialectical perspective. Ethical approval was obtained in accordance with Brazilian regulations for social and human sciences research. Five major themes emerged. (1) Health promotion: walking, Zumba, and healthy eating anchored in community life and locally grown foods, alongside spiritual practices for emotional and psychological balance. (2) Intergenerational practices: dialogue as a vehicle for transmitting ancestral knowledge, alongside concern about its erosion, especially the decline of midwifery. (3) Integrative and complementary practices: extensive use of medicinal plants, teas, and "home remedies" combined with biomedical treatments, amid limited recognition by health professionals. (4) Agriculture and healthcare: family farming and extractivism as foundations for healthy eating, income, autonomy, and the inseparability of land, culture, and health. (5) Social movements and territorial legitimation: woman's leadership in community associations as central to securing rights, infrastructure, and territorial recognition. Care practices among quilombola woman articulate body, spirituality, territory, and ancestry, constituting powerful community health technologies that coexist, often tensely, with biomedical care. Strengthening intercultural, intersectional, and territorially grounded health policies requires recognizing quilombola woman as key political and epistemic actors and integrating their knowledge into primary health care and broader health promotion strategies.

Human perception of a surrounding environment comes from our senses. Among these, vision has been considered the most important but, nowadays, the hearing perception features are attracting even more the attention of researchers. This study, based on five soundwalks conducted in the university district of Milano-Bicocca, compared subjective emotional responses evoked by the soundscape with psychoacoustic parameters determined from binaural recordings. Furthermore, a focus group discussion conducted at the end of each soundwalk made it possible to explore participants' in-depth perceptions and to collect their accounts of everyday life in the neighbourhood, their geographical backgrounds, and their habitual and preferred soundscapes. From the survey analysis, a consistent preference emerged for green areas, which were also statistically clustered based on psychoacoustic indices, as well as the squares and the two sites most exposed to traffic, indicating alignment between subjective responses and psychoacoustic structure. Moreover, sites with comparable A-weighted sound pressure levels (dBA) elicited different perceptual evaluations: environments featuring water sounds were systematically perceived as less noisy, while the sites with the highest dBA levels were perceived either as chaotic or monotonous, depending on the listener's subjective interpretation and the perceived meaning of the dominant noise source. These results reinforce the hypothesis that sound perception is shaped by contextual and semantic factors, and cannot be fully captured by conventional acoustic metrics alone.

Albumin is one of the most abundant and physiologically important blood protein in horses due to its ability to regulate vascular volume and transport blood metabolites or drugs. Despite the importance of this protein, in Colombia there is no previous reference of the use of equine albumin in horses as a pharmacological therapy and there is no available any pharmaceutical preparation of this protein to be administrated in horses. This study aims to evaluate for first time the preliminary clinical response of healthy adult Colombian Creole horses after the intravenous administration of an equine albumin preparation, manufactured in Colombia. Equine albumin was prepared from the plasma of healthy horses and obtained through the modified Salting Out technique. The Standard Quality Characterization was carried out following World Health Organization standards which included physicochemical, sterility and hemotropics tests before being administered to the horses. Albumin was administered at a concentration of 5,334 mg per animal to 3 healthy horses that were clinically evaluated before, during and after albumin administration, recording different paraclinical and clinical parameters. After manufacturing, the equine albumin obtained fulfilled the quality characteristics to be administered intravenously. After the administration, the product did not generate any adverse reactions or adverse clinical alteration at the concentration used. During the clinical evaluation we were able to observe a plasma volume expansion. Results indicates the ability to obtain a high quality product that can potentially be used as a pharmacological therapy in horses.

Purpose: To examine recent nationwide trends in cataract surgeries and laser peripheral iridotomy (LPI) in Korea, and to assess their temporal association and patient-level characteristics influencing procedure patterns.

Methods: This retrospective cohort study used data from the Korean National Health Information Database. Individuals aged 65 years and older who underwent cataract surgery or LPI between 2016 and 2021 were analyzed. Primary outcomes included the annual volumes of cataract surgeries and LPIs, their temporal association, patient demographics, the proportion of LPI patients subsequently undergoing cataract surgery, and the interval to surgery.

Results: Cataract surgeries increased annually until 2019, declined in 2020, and rose again in 2021, whereas LPI procedures steadily decreased after 2017. A negative correlation was observed between annual cataract surgeries and LPIs (r = -0.657, P = 0.156), although not statistically significant. Among patients aged 65-74 years, the correlation was significant (r = -0.943, P = 0.005). Among those who underwent LPI, 92.1% subsequently received cataract surgery, with a median interval of 121 days between procedures.

Conclusion: This nationwide study demonstrated a temporal association and demographic characteristics underlying the recent increase in cataract surgeries and the concurrent decline in LPI procedures in Korea. Notably, most patients who underwent LPI subsequently received cataract surgery within a relatively short interval, suggesting a possible clinical shift toward earlier lens extraction in the management of angle closure.