PLoS ONE最新文献

Objectives: The study aimed to evaluate medication knowledge and adherence among patients with type 2 diabetes mellitus (T2DM) in northwestern China, identify factors influencing adherence, and examine the role of medication knowledge in adherence behavior.

Methods: This hospital-based,cross-sectional study was conducted at Xi'an People's Hospital (Xi'an Fourth Hospital) from February to May 2025. A total of 510 adult patients with T2DM were enrolled. Medication knowledge and adherence were assessed using "diabetes medication knowledge questionnaire (DMKQ)" and "general medication adherence scale (GMAS)", respectively. Multiple linear regression analysis was employed to identify independent risk factors associated with adherence.

Results: The study revealed that 53.93% of patients achieved satisfactory medication adherence, while 58.04% possessed adequate medication knowledge. Forgetfulness or difficulty remembering medication schedules was the most frequently reported barrier to adherence. Notably, a substantial proportion of patients were unaware of potential medication side effects, and nearly half lacked sufficient knowledge on managing adverse effects. Multiple linear regression analysis identified gender (B = 0.564, P = 0.039), education level (B = 0.565, P = 0.032), living conditions (B = 0.776, P = 0.004), duration of antidiabetic drugs used (B = -0.046, P = 0.009) and medication knowledge (B = 1.318, P < 0.001) as independent factors of medication adherence, with medication knowledge exhibiting the strongest association (Beta = 0.533). Furthermore, a significant positive correlation was observed between medication knowledge and adherence.

Conclusion: Patients with diabetes in northwestern China often demonstrate suboptimal levels of both medication knowledge and adherence. As medication knowledge positively affects medication adherence, healthcare providers should assume a more proactive role in delivering comprehensive medication education to this patient population.

Cochlear implantation has emerged as a transformative intervention for children with severe-to-profound hearing loss, improving not only auditory and linguistic abilities but also broader aspects of quality of life. This study examined school readiness in toddlers and preschool-aged children with cochlear implants in Saudi Arabia and explored the role of psychosocial factors-self-reliance, well-being and happiness, and social relationships-in predicting readiness outcomes. Using a cross-sectional correlational survey design, data were collected from 155 parents via an online questionnaire distributed in social media groups for families of children with hearing loss. Data were collected using an online parent-reported questionnaire disseminated through established WhatsApp and Telegram groups for families of children with hearing loss in Saudi Arabia. A non-probability convenience sampling technique was employed to recruit participants. Descriptive statistics indicated that most children were perceived as keeping pace with peers in educational settings, although parental concerns about future school placement were common. Pearson correlations revealed moderate positive associations between each psychosocial factor and school readiness, while multiple regression analysis identified social relationships as the only significant predictor when all factors were considered together. The findings underscore the importance of fostering strong peer and teacher relationships in early intervention programs, alongside promoting self-reliance and emotional well-being. These results have implications for educators, policymakers, and rehabilitation specialists seeking to enhance the educational readiness and quality-of-life outcomes of children with cochlear implants in Saudi Arabia.

Agriculture requires sustainable approaches for effective weed management reducing the negative consequences of synthetic herbicides. In this context, some agricultural by-products such as pistachio hulls could be considered as source of biopesticide compounds due to their allelopathic effect. The application of pistachio hull extract and powder produced an allelopathic effect against the weeds Solanum nigrum, Lactuca serriola and Lolium rigidum in in vitro and in vivo assays. In the in vitro assay, the germination and radicle and epicotyl growth of Lactuca serriola and Solanum nigrum was significantly reduced under both 2.5% and 10% extract concentrations, while in Lolium rigidum the germination was not affected by the 2.5% extract. In pot assay, the effect of the extract (10%) was more noticeable in the broad-leaf weeds Solanum nigrum and Lactuca serriola, while the powder (1 g per pot) seemed to be a more efficient strategy in Lolium rigidum according to the reduction in weeds' fresh and dry weights and plant number. The allelopathic effects were mainly produced by the high concentration of phenolic compounds such as gallic and protocatequic acids, since the pure compounds application at the concentration found in the extract inhibited seed germination and radicle and epicotyl development. Moreover, hull extract had no biofungicide effect against Alternaria alternata, Botryosphaeria dothidea, Aspergillus niger and Rhizoctonia solani pathogens. Altogether led to conclude that pistachio hull extract and powder could be a good approach to control weeds in sustainable agriculture. Further studies are required to elucidate the mode of action of these phenolic compounds.

Malaria is prevalent in Mali and children under 5 are more vulnerable. Temperature and precipitation can affect vector density and parasite development, impacting malaria transmission. This exploratory study aimed to investigate potential associations between changes in precipitation and temperature and prevalence of malaria infection in children under 5 in Mali. A cross-sectional study was conducted using data from the Mali Demographic and Health Surveys and Malaria Indicators Surveys conducted in 2012/13, 2015, 2018, and 2021. We examined malaria prevalence diagnosed by rapid diagnostic tests (RDT) in children ages 6-59 months. Exposures included precipitation and temperature (minimum, maximum, average). Three monthly lags were created for each exposure. Multilevel modelling was conducted to assess the relationships between exposures and malaria for each lag in a pooled analysis of the survey years. With a three month lag, precipitation was statistically significantly positively associated with the odds of RDT-diagnosed malaria in children ages 6-59 months (Odds ratio (OR) [95% CI], 1.005 [1.002, 1.009]) and minimum, maximum, and average temperature were statistically significantly negatively associated with the odds of malaria (Minimum temperature = 0.761 [0.621, 0.931], maximum temperature = 0.871 [0.791, 0.958], average temperature = 0.822 [0.718, 0.942]). With a two month lag, maximum temperature was statistically significantly negatively associated with the odds of malaria (0.863 [0.750, 0.992]). At a one month lag, minimum temperature was statistically significantly positively associated with the odds of malaria (1.110 [1.014, 1.216]). All other results were not statistically significant. Precipitation may be a risk factor for malaria infection in children under 5 in Mali. Temperature alone is likely not contributing to changes in the odds of malaria infection, particularly when considering precipitation. Future studies focusing on regional-specific differences are needed to fully understand the relationships.

Background: In 2024, the World Health Organization (WHO) introduced new hemoglobin cutoffs for diagnosing anemia. The WHO also incorporated revised altitude adjustments and lowered thresholds to diagnose anemia for children aged 6-23 months. Puno, Peru has historically reported the highest prevalence of anemia in the country, exceeding 70% in infants and young children.

Objective: To assess the impact of the new WHO cutoffs on anemia prevalence and evaluate whether they affected the proportion of anemia attributable to iron deficiency (ID), inflammation, and other causes.

Methods: A cross-sectional study was conducted among 310 children aged 6-59 months in Puno, Peru. Participants were recruited via convenience sampling during routine medical check-ups. Venous blood samples were analyzed using an automated hemoglobin analyzer and serum biomarker evaluations. Anemia prevalence was determined based on WHO guidelines for children aged 6-59 months (and 6-23 months and 24-59 months as subgroups). The ratio of anemia due to ID (Ferritin <12 ng/mL) or inflammation (IL-6 > 60 pg/mL) was estimated using adjusted Poisson regression models, reporting prevalence ratios (PR).

Results: Applying the new WHO guidelines, anemia prevalence changed from 50% to 42.2% in children aged 6-59 months (62% to 47% in children aged 6-23 months and from 45.9% to 40.6% in children aged 24-59 months). The proportion of anemia due to ID was 27.5%, due to inflammation was 45.9%, and due to other causes was 26.6%. ID was significantly associated with anemia in both unadjusted and adjusted analyses (PR: 1.4, 95% CI: 1.1-1.8; PR: 1.32, 95% CI: 1.0-1.7). The 2024 WHO guidelines did not substantially alter the estimated proportion of anemia associated with ID or inflammation.

Conclusions: Application of the new WHO cutoffs resulted in a lower estimated prevalence of anemia among young children. ID accounted for only a small proportion of cases of anemia, emphasizing the need for further research into other causes of childhood anemia in Peru.

This paper examines the nonlinear effects of Digital Inclusive Finance (DIF) on urban-rural integration (URI) using a provincial panel for mainland China (31 provinces, 2011-2023). We construct a multidimensional URI index and decompose DIF into coverage breadth (D1), usage depth (D2) and digitalization level (D3). Estimation proceeds with two-way fixed-effects models and Hansen-style panel threshold regressions with bootstrap inference; robustness checks include placebo tests and instrumental-variable specifications. The evidence shows that DIF's impact on URI is regime-dependent: marginal returns are limited at low development levels but increase sharply once DIF and complementary institutional conditions cross empirically identified thresholds. Disaggregation reveals that usage depth (D2) consistently promotes integration, whereas the benefits of coverage (D1) and digitalization (D3) materialize mainly in digitally mature regimes. Traditional finance exhibits declining marginal contribution beyond its effective range, underlining the catalytic role of digital systems. We document heterogeneity across regions and show that negative baseline coefficients on openness and education reflect spatial concentration rather than intrinsic harms. The findings reconcile mixed results in prior work and imply that policy should be threshold-aware: prioritize foundational access where coverage is low, while in advanced contexts emphasize usage, platform interoperability, and regulatory safeguards to manage platform concentration and distributional risks.

[This corrects the article DOI: 10.1371/journal.pone.0339909.].

Background: Health and Wellbeing Queensland (Australia) is leading Queensland Government efforts to enhance food environments, ensuring that Queenslanders have access to healthy food and drinks options in places outside their homes. In healthcare settings, the A Better Choice (ABC): Food and Drink Supply Strategy for Queensland Healthcare Facilities is a policy that sets targets for the availability and promotion of food and drinks in retail outlets and vending machines with the aim of providing and promoting healthier options for staff and visitors. To strengthen policy action, a mandatory Health Service Directive: Healthier food and drinks at healthcare facilities (Directive) requires Hospital and Health Services (HHS) to meet ABC targets. Compliance with the Directive is assessed through annual audits.

Objective: The objective of this study was to establish an enduring data and analytics solution to assist in the implementation of ABC and monitoring of compliance with the Directive.

Methods: The Queensland Digital Health Centre, in collaboration with Health and Wellbeing Queensland developed a digital dashboard to report and manage audit data on food and drinks supplied in retail outlets and vending machines across Queensland public HHSs. Annual survey data was completed by 16 HHSs and Mater Health. These data were checked, aggregated and loaded into the digital analytics dashboard.

Results: The development process resulted in a replicable digital dashboard for reporting and decision-making. The ABC dashboard provides previous and current compliance data for all HHSs, featuring visualisations that illustrate changes in compliance over time to help identify emerging trends. Users can interact with the dashboard to filter data by HHS, year and by outlet and food or drink type. This digital innovation has facilitated faster delivery of food and drink supply trend analysis and compliance reporting for HHSs and statewide policy makers.

Conclusions: Digital dashboards for public health policy compliance enable greater interrogation of data and provide visualisation tools to track trends in compliance over time. This allows more responsive and effective action to increase the impact of public health policies.

An experiment is conducted in which investment advice is passed from one cohort to the next. Participants make asset allocation decisions for thirty years to a safe and risky asset and provide annual forecasts (beliefs) on the return on the risky asset. Risky asset returns are drawn from the price returns on the S&P 500 from 1921-2010; Cohorts 1/2/3 received the actual returns in the time period from 1921-1950/1951-1980/1981-2010 respectively. Results show that negative investment advice passed from Cohort 1 to Cohort 2 leads to: 1) significantly lower allocations to the risky asset in Cohort 2 compared to Cohort 1; and 2) a 19% difference in allocations between cohorts who received either positive advice or negative advice in Cohort 2. A second experiment examines the effect on Cohort 3 from receiving consistent and mixed advice from Cohorts 1 and 2. The results from the first experiment are replicated showing that positive (negative) advice received from prior cohorts leads to higher (lower) investment beliefs and portfolio allocations to a riskier asset. Statistical analyses are conducted to determine if the large differences in allocations are driven by changes in beliefs about future returns or changes in risk attitude. The primary takeaway is that experiential cohort advice has a significant impact on subsequent cohorts even when it has little informational value.

Objectives: Sedentary lifestyles often develop during adolescence and may be deleterious to physical and mental health. Sedentarism is known to be common in high-income countries; this study examines its prevalence in a remote city in India, including the amount of time school-going adolescents spend being sedentary and the activities that make up this time.

Methods: We developed a 24-hour time-use survey and collected data with a sample of school-going adolescents ages 12-17 years in a mid-sized South Indian city (n = 395). We built measures of daily sedentary minutes and frequency (bouts) of sedentary activities and calculated population-based prevalence of sedentary activities across gender and school type. We used survey-weighted distributions and linear regression models to estimate sedentary time after accounting for socio-demographic characteristics.

Results: On average, adolescents had 7.3 sedentary bouts/day, amounting to 527.7 minutes/day. Compared to private-school students, those in government schools spent 2 fewer hours (-134.5 minutes;-174.4, -194.6) sedentary, including 82 (-122, -42.0) fewer minutes in classroom and tutoring time and an hour (-57.82; -69.4,46.2) less in vehicle-based commuting. Girls spent 44 minutes less time in class and in tutoring (-75.88, -12.11)and more time watching television than boys. Adolescents spent comparable time doing homework and reading for leisure.

Conclusion: Sedentary lifestyles are reaching children even in remote communities in India. A large component of this time is dedicated to learning. Private school students spent the most time sedentary, making them an especially vulnerable group for cardiometabolic disease, in spite of socioeconomic advantages.