PLoS ONE最新文献

Background: Patients suffering from ST-segment elevation myocardial infarction (STEMI) and type 2 diabetes mellitus (T2DM) face an elevated risk of the no-reflow phenomenon even after successful primary percutaneous coronary intervention (PPCI). This study aimed to develop an integrated predictive model combining the triglyceride-glucose (TyG) index and the neutrophil-to-lymphocyte ratio (NLR) for no-reflow in this high-risk population.

Methods: A retrospective cohort of 524 patients with T2DM and STEMI undergoing PPCI was analyzed. No-reflow was defined as post-procedural TIMI flow grade ≤2. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were employed.

Results: The incidence of no-reflow was 8.97% (47/524). Both TyG index (adjusted odds ratio [aOR] 2.98) and NLR (aOR 1.23) were identified as independent predictors. Patients were stratified into four groups based on the optimal cut-offs for NLR (2.831) and TyG (9.347). The group with high levels of both markers had a substantially higher no-reflow incidence (23.21%) compared to the low-risk group (1.49%). The combined model (TyG + NLR) demonstrated superior predictive performance (AUC 0.785) over models containing either marker alone or baseline clinical factors.

Conclusion: The combination of TyG index and NLR effectively stratifies the risk of no-reflow in T2DM-STEMI patients, potentially aiding the early identification of patients in need of targeted management.

Time may be viewed as an emergent consequence of increasing information entropy. I explore a toy quantum‑information model in which DNA is treated as an open quantum system. In this framework, weak, time‑dependent perturbations (potentially arising from thermal fluctuations, ionic microfields, metabolic noise, or electromagnetic signals) bias the micro‑timing of events during replication and repair. These slight timing shifts can influence the fate of transient electronic and protonic configurations (including short‑lived tautomeric states driven by proton‑transfer tunnelling), subtly altering mutation probabilities. To test this idea, I map nucleotides in the Mycobacterium tuberculosis genome to constrained qubit states and quantify informational structure using Shannon and von Neumann entropies and coding to non‑coding correlation metrics. Simulations of Hamiltonian dynamics under physiologically plausible perturbations show that real genomic segments exhibit distinctive dynamical signatures compared with controls. I also examine a variant in which a weak, slowly varying external signal is introduced as a background "beat" against which DNA dynamics can be compared. Because a Doppler shift in electromagnetic waves encodes the flow of time through the relative motion of source and observer, a cosmic microwave background (CMB) with a tiny frequency drift provides a conceptual clock and a source of informational entropy: it feeds a time‑correlated input into the DNA quantum system, allowing the molecule to sample cosmic time and translate it into a biological scale by modulating tunnelling probabilities and thus mutation patterns. This CMB‑inspired drive is simply a convenient illustration; the model does not rely on it, and other sources of weakly structured entropy could be tested. Across simulations, sequence‑dependent responses to both intrinsic and structured perturbations generate testable predictions: changing the structure or timing of these weak perturbations should produce reproducible shifts in mutation spectra. This framework connects cellular ageing and evolution to the flow of cosmic time and suggests experiments to probe DNA's sensitivity to time‑dependent perturbations.

Background: Environmental exposure significantly influences mental well-being. Green spaces offer psychological benefits, while noise exposure is a recognized environmental stressor. However, their effects on mental health outcomes such as depression, anxiety, and stress remain underexplored in Lebanon. This study investigates the influence of green space and noise exposure on mental health in the Lebanese population.

Methods: A cross-sectional study was conducted using an online survey distributed across the Lebanese population. A total of 653 participants aged 18-65 years completed the questionnaire, which assessed socio-demographics, green space exposure, noise exposure, and mental health using the Arabic versions of the validated scales for depression (PHQ-9), anxiety (GAD-7), and stress (PSS-10). Data was analyzed using SPSS version 25.

Results: Higher green space exposure-such as proximity to greenery, views of natural environments, and more frequent visits-was significantly associated with lower levels of depression, anxiety, and stress (p < 0.05). Conversely, greater noise exposure at home or work, and symptoms such as sleep disturbance, irritability, or difficulty concentrating due to noise, were significantly associated with higher scores across all three mental health domains (p < 0.001). Multiple linear regression showed that some noise-related symptoms were consistently associated with higher depression, anxiety, and stress.

Conclusions: Environmental exposures play a critical role in shaping the mental health. Increasing access to green spaces and reducing noise pollution may serve as effective public health interventions to decrease levels of depression, anxiety, and stress among Lebanese residents. Urban planning and public policy should integrate these findings into mental health promotion strategies.

Taxanes form effective anticancer agents, which are found in the leaves and bark of the yew tree (Taxus L.). Paclitaxel (Taxol®) and related taxanes are widely used in cancer therapy. Due to the high demand of taxanes, there is strong pharmaceutical interest in evaluating unexplored population diversity as a potential genetic and biochemical resource. Three peripheral Greek Taxus baccata L. populations (Mt Cholomon, Mt Olympus and Mt Vourinos) were investigated to assess genetic (microsatellite markers), epigenetic (methylation sensitive amplified markers) and chemodiversity (targeted LC-MS/MS analysis of five major taxanes) variation. Taxane concentration varied significantly among populations and seasons. The dominant compound in needles was 10-deacetylbacatin III (DAB), ranging from 267.8 (Mt Vourinos) to 517.6 (Mt Olympus) mg kg-1 dw. Substantial genetic diversity (AR = 5.00; He = 0.537) and significant population differentiation (Fst = 0.153) were detected, while epigenetic analyses showed moderate haploid epigenetic diversity (Hepi = 0.051) and comparable levels of DNA methylation across populations. Multivariate analyses indicated clear population structuring in genetic and metabolomic profiles, whereas epigenetic variation was less strongly structured. Together, these results demonstrate pronounced spatial and seasonal variation in taxane production, alongside considerable genetic differentiation, and sufficient levels of total methylation, suggesting a potential capacity for responses to future climatic change. Our findings highlight peripheral Greek populations as valuable genetic resources for conservation and breeding aimed at sustainable taxane production.

Background: In Ghana, medical laboratories are a vital component of the health system, but there has been limited evidence on how well they meet international quality standards. This study assessed compliance with laboratory standards by medical laboratories in the Kumasi Metropolis of Ghana.

Methods: A descriptive cross-sectional survey was conducted among forty-three (43) laboratory facilities, including those operating within healthcare facilities and private standalone laboratories, in the Kumasi metropolis from 8th March to 26th November, 2021. The healthcare facilities assessed include seven (7) government, four (4) Christian Health Association of Ghana (GHAG), twenty-one (21) private hospitals, and eleven (11) standalone laboratories. The World Health Organisation Stepwise Laboratory Quality Improvement Process Towards Accreditation (WHO SLIPTA) checklist was used to assess compliance with laboratory standards. The checklist comprises 12 main sections, containing 117 questions, resulting in a total of 275 scores. Each item is awarded a point value of 2, 3, or 5 points based on relative importance and complexity. Scores and percentages of compliance are categorized as follows: 0-150 (<55%), 151-177 (55-64%), 178-205 (65-74%), 206-232 (75-84%), 233-260 (85-94%), and 261-275 (≥95%). These categories ultimately translate to a rating of 0-5 stars. Descriptive analysis and the Kruskal-Wallis test were conducted to examine the differences in overall compliance scores across the types of health facilities.

Results: The overall median compliance score was 61(interquartile range 53-66), the minimum score was 49, and the maximum score was 104. CHAG facilities had significantly higher scores than private facilities (Z = 2.53, p = 0.03) and standalone facilities (Z = 3.60, p < 0.001). Similarly, scores for government facilities were significantly higher than standalone facilities (Z = 3.30, p < 0.001).

Conclusion: All facilities had a zero (0) star rating and failed to meet the minimum compliance level of 55%.

Introduction: Acute pain is classified as pain that lasts less than three to six months. Globally, pain is the third most common health problem with more than a quarter of patients reporting to the Emergency Department (ED) with pain-related chief complaints. This study aimed to determine the prevalence of acute pain and assess the pain management practices in the Komfo Anokye Teaching Hospital Emergency Department (KATH ED).

Methods: Using the Numeric Rating Scale (NRS), the characteristics of acute pain among 378 patients presenting to KATH ED were measured. Additionally, the waiting time for the first pain treatment was calculated for each patient. Pain scores (pre- and post-treatment) were also taken to further inform patients' satisfaction.

Results: Out of 378 patients, 76% [95% CI: 71.3-80.2] reported to the ED with severe pain, 21% [95% CI: 16.9-25.4] reported with moderate pain, and 3% [95% CI: 1.5-5.1] reported with mild pain. The average waiting time for the initial assessment of pain was 83.97 minutes while the average waiting time for the administration of analgesia was 184.07 minutes. Having completed primary (AOR, 5.36; 95% CI, 1.03-27.97), JHS (AOR, 5.8; 95% CI, 1.19-28.35), SHS (AOR, 7.24; 95% CI, 1.38-38.01) and tertiary (AOR, 9.42; 95% CI, 1.60-55.62) were predictive of Door‑to‑Analgesia (DTA) time ≤ 90 minutes. Nearly three quarters of the study participants had maximum satisfaction with the pain management services in the ED.

Conclusion: The study revealed that documentation of pain severity scores of patients presenting with acute pain at KATH ED was encouraging, however, most patients did not receive timely pain relief. The average waiting time for the initial assessment of pain as well as the administration of analgesia was extremely prolonged. Despite this, three out of every four of the study participants had maximum satisfaction for the overall pain treatment services in the ED. These findings suggest that pain management practices at KATH ED need improvement.

In the real-world application scenario of China's public hospital multi-site operation model, this study systematically evaluates the feasibility, timeliness, and stability of drone-based medical logistics transportation between hospital campuses, providing high-quality empirical evidence for optimizing cross-campus medical supply transfer processes. This retrospective analysis collected complete drone medical logistics transport data between two campuses of Deyang People's Hospital from April 8 to July 30, 2024. The primary outcome measure was drone transport time per unit distance (min/km), compared with road traffic time per unit distance measured by three mainstream navigation apps (Baidu Maps, Amap, and Tencent Map) at different time points. Intergroup differences were analyzed using the Mann-Whitney U nonparametric test, with effect sizes calculated via Cliff's Delta. Statistical significance was set at P < 0.05. A total of 750 valid drone flight records were included, covering a distance of (5.95 ± 0.03) km with a unit time of (1.64 ± 0.14) min/km. The unit time for drone transportation was significantly lower than that measured by Baidu Maps (2.06 ± 0.12 min/km), Amap (2.01 ± 0.12 min/km), and Tencent Map (2.03 ± 0.09 min/km) at the 0-point road traffic unit time (all P < 0.001). At all nine time points monitored by Tencent Map, the unit time per kilometer exceeded that of the UAV. During the 10:00 peak period, Tencent Map recorded a unit time of (4.12 ± 0.09) min/km, with the UAV achieving a time savings rate of 60.2%. Mann-Whitney U tests revealed significant differences across all time points (P < 0.001), with Cliff's Delta absolute values consistently exceeding 0.75, indicating extremely large effect sizes. Drone-based medical logistics demonstrated significant advantages in timeliness and stability under the multi-campus model of urban hospitals, particularly during peak traffic congestion periods. This study provides crucial empirical support for establishing an efficient, intelligent medical logistics system, holding significant implications for enhancing healthcare service efficiency and improving public health emergency response capabilities.

Objective: The aim of this study was to investigate the impact of contralateral sensorineural hearing loss on prognosis in idiopathic sudden sensorineural hearing loss.

Methods: A retrospective analysis was conducted on 445 ISSNHL patients treated between January 2020 and January 2024. The patients were divided into two groups: recovery (234 cases, including complete and partial recovery) and no-recovery (211 cases, no recovery). Pure-tone audiometry was used for evaluation. Clinical characteristics were compared between the groups, and multivariate logistic regression was performed to identify risk factors for poor prognosis.

Results: Significant differences were observed between the two groups regarding contralateral hearing level, age, duration of illness, diabetes, hypertension, and audiometric curves. An increase in the hearing threshold of the contralateral ear was positively correlated with the risk of ineffective treatment. Patients with contralateral sensorineural hearing loss prior to the onset of ISSNHL exhibited a 2.757-fold increased risk of treatment failure compared with ISSNHL patients who had normal contralateral ear hearing. Multivariate logistic regression analysis revealed that contralateral sensorineural hearing loss exhibited a significant multiplicative interaction with age over 60 years, hypertension, and a disease duration exceeding 4 days.

Conclusion: The presence of contralateral sensorineural hearing loss before the onset of ISSNHL is an independent risk factor for poor prognosis in ISSNHL. It interacts significantly with age over 60 years, hypertension, and disease duration exceeding 4 days. A thorough assessment of contralateral hearing status, in conjunction with factors such as age, hypertension, and disease duration, is essential for developing personalized treatment plans to improve prognosis.

The southern foothills of the Greater Khingan Mountains in Inner Mongolia are one of the 14 contiguous destitute areas in China. The ecological environment in the region is harsh. The implementation of the Grain-for-Green Project is crucial to the restoration and protection of local forest ecosystems. However, the project has some deficiencies in terms of plant communities and soil stoichiometric characteristics. In this study, the southern slope of Daxing'anling Forest in Inner Mongolia was used as the research area, and 1 year, 3 years, 5 years, 10 years, 20 years, abandoned land, and farmland after the restoration were comprehensively selected. The purpose of this study was to analyze the dynamic changes in soil stoichiometric characteristics and plant diversity during ecological restoration of this area, explore the influence of soil stoichiometric characteristics on plant diversity. The following results were obtained: (1) In terms of plant communities, plant species increased first and then decreased after returning farmland. In the early stage, pioneer herbs increased, and some species were eliminated due to competition and other factors in the later stage. Shrubs and trees appeared late, and herbs had strong adaptability. (2) In terms of soil stoichiometry, the contents of soil organic carbon (SOC) and total nitrogen (TN) were low in the early stage of returning farmland. With the increase in years, SOC increased first and then decreased, and TN increased. The changes in each soil layer were affected by many factors and differed from those of the control. The total phosphorus (TP) content fluctuated, and the ratios of C/N, C/P, and N/P had different trends in varying soil layers with returning farmland and vegetation restoration. (3) In terms of the relationship between vegetation and soil nutrients, SOC was positively correlated with TN, TN was positively correlated with the evenness index, and TP was negatively correlated with some vegetation indexes. This work has important guiding significance for improving soil fertility and plant growth in returning farmland to forest. This work is helpful to realize ecological environment protection and sustainable agricultural development.

Objective: Regular physical activity (PA) is recommended for cardiometabolic prevention, yet emerging evidence suggests that meeting PA guidelines alone does not guarantee metabolic health. Pandemic-related disruptions may have intensified behavior-biology discrepancies. This study examined the prevalence and sociodemographic determinants of the physically active but metabolically unhealthy (PA-NH) group before, during, and after the COVID-19 pandemic in Korea.

Methods: We analyzed 17,719 adults aged ≥19 years using the 2019-2022 Korea National Health and Nutrition Examination Survey. Participants were classified into four groups: PA-H, NPA-H, NPA-NH, and PA-NH. Temporal patterns across the pre- (2019), during- (2020-2021), and post-pandemic period (2022) were assessed using χ² tests and ANOVA. Multinomial logistic regression identified determinants of PA-NH membership.

Results: From 2019 to 2022, PA-H declined during the pandemic and rebounded thereafter, whereas PA-NH increased from 31.2% to 34.0%. Older adults had markedly higher odds of PA-NH (OR 7.30 for ≥70 y vs 19-29 y). Women were less likely to belong to PA-NH. Higher education reduced the odds of mismatch relative to PA-H but increased them compared with NPA-NH. Metabolic risk factors such as hypertension and hypercholesterolemia rose despite recovery in PA.

Conclusions: The persistence and rise of PA-NH after the pandemic show an association suggesting that adherence to PA guidelines alone is insufficient for cardiometabolic protection. Post-pandemic public health strategies should integrate aerobic and resistance exercise with dietary modification, stress management, and routine screening, prioritizing older adults and other high-risk groups.