PLoS ONE最新文献

Background: Although cytomegalovirus (CMV) reactivation is implicated in ulcerative colitis (UC) exacerbation, the efficacy of antiviral treatment in hospitalized patients with UC with suspected CMV infection has not been thoroughly investigated. We aimed to investigate the diagnostic accuracies of typical endoscopic findings for CMV reactivation in hospitalized UC patients.

Methods: A total of 143 hospitalized cases due to the exacerbation of UC were retrospectively collected. Sensitivity, specificity and diagnostic accuracy of endoscopic findings (punched-out ulcer, round ulcer, girdle ulcer, longitudinal ulcer, and ulcer with wide mucosal defect)for prediction of CMV colitis (histological CMV positivity) and CMV viremia (antigenemia, serum DNA) was assessed. Endoscopic characteristics were compared between patients who initially received anti-viral treatment and who did not receive.

Results: The diagnostic performance of endoscopic findings for histologically confirmed CMV infection varied by lesion type. Punched-out ulcers demonstrated a sensitivity of 66.7%, specificity of 58.3%, and overall diagnostic accuracy of 59.1%. Longitudinal ulcers showed a sensitivity of 58.3%, specificity of 40.0%, and diagnostic accuracy of 41.7%. In contrast, wide mucosal defects exhibited lower sensitivity (16.6%) but higher specificity (75.0%), with an overall diagnostic accuracy of 69.7%. The same tendencies were found as diagnostic accuracies of endoscopic findings of punched-out ulcers, longitudinal ulcers, and wide mucosal defects for CMV antigenemia positivity was 55.6%, 40.0%, 60.4%, respectively. The specificity of girdle ulcers for positivity of serum DNA test was relatively high (84.8%) while sensitivity was 9.1%. In total, the diagnostic accuracies of endoscopic findings with punched-out, round, girdle, and longitudinal ulcers, and those with wide mucosal defects were 46.9%, 42.9%, 33.7%, 51.0%, and 35.7% for positivity of serum DNA test, respectively. Punched-out ulceration (57% vs.13%; p < 0.001), longitudinal ulceration (70%vs.34%; p < 0.001), and ulceration with wide mucosal defects (31%vs.9%; p < 0.001) were higher with ganciclovir treatment than without.

Conclusion: Endoscopic findings cannot predict CMV antigenemia or CMV colitis. Therefore, antiviral treatment should not be administered without evidence of CMV reactivation using only endoscopic findings.

Background: Massive intraoperative bleeding (IBL) in liver transplantation (LT) poses serious risks and strains healthcare resources necessitating better predictive models for risk stratification. As traditional models often fail to capture the complex, non-linear patterns underlying bleeding risk, this study aimed to develop data-driven machine learning models for predicting massive IBL during living donor LT (LDLT) using preoperative factors.

Methods: Two hundred ninety consecutive LDLT cases from a prospective database were analyzed. Logistic regression models were built using 73 preoperative demographic and laboratory variables to predict massive IBL (≥ 80 mL/kg). The dataset was randomly split (70% training, 30% testing). The model was trained and validated through three-fold cross-validation, with backward stepwise feature selection iterated 100 times across unique random splits. The final model, based on a high stability index, was evaluated using the area under the curve (AUC).

Results: Massive IBL was observed in 141 patients (48.6%). In standard logistic regression, significant differences were found in 42 of 73 factors between groups stratified by massive IBL, however, substantial multicollinearity limited interpretability. In the feature selection across 100 iterations, the data-driven model achieved an average AUC of 0.840 in the validation and 0.738 in the test datasets. The final model, based on 11 selected features with a high stability index, achieved an AUC of 0.844. An easy-to-use online risk calculator for massive IBL was developed and is available at: https://tai1wakiya.shinyapps.io/ldlt_bleeding_ml/.

Conclusions: Our findings highlight the potential of machine learning in capturing complex risk factor interactions for predicting massive IBL in LDLT.

Influenced by the complex geological conditions in mountainous region, micro-pile foundation for transmission line faces the risk of insufficient bearing performance. It is important to study the risk suppression measures of micro-pile foundation and its assessment method to promote the construction of transmission lines in mountainous regions. Firstly, the mechanical simulation model of pile-soil system for the micro-pile foundation is established in this paper, and the field test is carried out to verify the accuracy of the simulation model, thus the ultimate load of the micro-pile foundation is determined according to the current code requirement for maximum displacement in case of damage to the group pile foundation. Secondly, to address the subjectivity of traditional methods, an improved Likelihood-Exposure-Consequence (LEC) method is proposed. Its novelty lies in constructing a quantitative displacement-risk mathematical mapping, directly linking the physical limit state (maximum displacement) to the risk likelihood factor. Thirdly, structural risk reduction measures for the micro-pile foundation using micro-expanded pile foundation and micro-inclined pile foundation are proposed, and the ultimate load of the traditional micro straight pile foundation is used as an excitation to carry out the simulation of the bearing performance of the two improved micro-pile foundations, and the maximum displacements of the two improved micro-pile foundations are calculated. Finally, based on the proposed improved LEC method, the risk values-defined in the LEC framework as the quantitative product of Likelihood (L), Exposure (E), and Consequence (C)-and risk classes of the two improved micro-pile foundations are calculated and compared with the conventional micro straight pile. The results demonstrate that the proposed strategies significantly reduce the safety risk class, providing a robust, quantifiable basis for optimizing foundation designs in complex mountainous terrain.

The sleep state is traditionally defined as global, involving the entire body. Accordingly, a two-process mathematical model of the switch between sleep and wakefulness was proposed by Borbely more than 30 years ago and successfully used in deep modeling studies. However, in recent decades, new data have been obtained that call for a more complex understanding of sleep, both in spatial and temporal aspects. In particular, this concerns such phenomena as local sleep and short sleep episodes (naps). Here, we propose a mathematical model that gives the space for both local sleep phenomena and short sleep episodes. In doing so, we rely on the concept of a "sleep unit" and propose a phenomenological rate model of its activity. We also use a concept of a psycho-sensory drive to simulate various scenarios induced by external or internal stimuli. An essential element of our model is the representation of the background neural activity as a random signal, which reflects the real situation of overlapping multiple internal and external stimuli. The corresponding simulation runs confirm that the model reproduces both phenomena: local sleep and short nap episodes. As a particular but illustrative result, we demonstrate an example of involuntary global falling asleep under conditions of an overload of a separate sleep unit. In conclusion, we discuss the potential of our model and ways of its further quantitative parameterization.

Strontium isotope analysis is now a key method for investigating ancient human mobility, leading to a rapid expansion of available ⁸⁷Sr/⁸⁶Sr datasets. Owing to the relatively homogeneous surface geological conditions across present-day Denmark (excluding Bornholm) and the growing number of regional datasets, it is now possible to construct statistically defined ranges of bioavailable strontium directly from archaeological human data. In this study, we compile 513 published strontium isotope values from tooth enamel and pars petrosa of individuals recovered from archaeological sites across present-day Denmark and add 115 new values. Using the Median Absolute Deviation (MAD) method to identify outliers in this comprehensive and diachronic database of 628 human ⁸⁷Sr/⁸⁶Sr ratios, we define the first statistically constrained, human-based range of bioavailable strontium isotope values for Denmark to ⁸⁷Sr/⁸⁶Sr = 0.7089-0.7117. We interpret this range as representing typical bioavailable strontium signatures in prehistoric Denmark. We then apply it, for the first time, as one of the reference frameworks for investigating the mobility of non-elite individuals from the Nordic Bronze Age in present-day Denmark. In total, we conducted 34 strontium isotope analyses on individuals from two sites: fourteen analyses from six inhumations at Kalvehavegård on Funen, and twenty analyses from cremated individuals at Sølager on Zealand. We compare the individuals' strontium isotope values both to established baselines relevant for past mobility studies and to the new human-based range defined in this study. The results indicate that mobility during the Nordic Bronze Age was not restricted to elite social groups but also encompassed some non-elite individuals, offering new insights into social dynamics during this formative period of European prehistory. Moreover, the new strontium dataset presented here represents the first accessible, country-wide compilation of human-derived Sr data for Denmark, providing a robust platform for future comparative studies and mobility research in the region.

Purpose: To assess intraocular pressure (IOP) changes and pain scores during 24 hours and short-term outcomes after micropulse transscleral laser therapy (MP-TLT).

Design: Retrospective case series.

Methods: We reviewed eyes undergoing MP-TLT (2,000 mW; 31.3% duty cycle; 100-200 seconds) with serial IOP measurements during the first operative day, excluding those with prior cyclophotocoagulation or combined procedures. IOP and pain scores (numerical rating scale, NRS) were recorded at 1, 5, 9, 13 hours, and the following day post-procedure. Data from follow-up visits were obtained to evaluate success rates (≥30% IOP reduction or an IOP 6-18 mmHg). Mixed-effects regression and Kaplan-Meier method were used for analysis.

Results: This study examines 46 eyes from 40 patients, 58.7% with secondary glaucoma. The mean preoperative IOP was 40.6 mmHg. The NRS was 2.3 at the end of the procedure. The mean postoperative IOP (% reduction) and NRS values were 33.9 (16.5) mmHg and 2.4 at 1 hour, 36.1 (11.1) mmHg and 2.8 at 5 hours, 32.6 (19.7) mmHg and 1.7 at 9 hours, 29.7 mmHg (26.8) and 1.2 at 13 hours, and 24.5 (39.7) mmHg and 1.0 on the following day. The IOPs were significantly lower at all time points (p < 0.05), with the lowest mean value of 16.4 mmHg at week 1. The success rate was 80.6% at 12 months. One patient developed transient hypotony maculopathy.

Conclusions: MP-TLT resulted in a significant IOP reduction within 24 hours, with maximal effect at 1 week, and demonstrated favorable short-term outcomes.

Due to the challenging nature of surveying exploited workers, scholars are often limited in their ability to standardize data collection efforts. Using two samples of survey data from workers in the Costa Rican fishing industry, we compare latent classes of exploitative labor between a subset of individuals surveyed through a proportional probability sample (PPS) and Vincent-link-tracing sampling (VLTS). Results suggest there are some differences between latent classes across the differently sampled groups, with those in the PPS sample being more defined by severe forms of exploitation. Despite these differences, latent classes largely looked similar, with each group having a more highly exploited class and a more minimally exploited class. This study suggests that sampling techniques may affect the broader understanding of the issue, but most of the variation of exploitative experiences may lie in the characteristics of specific contexts or occupations.

Background: Myocardial ischemia-reperfusion injury (I/R) significantly exacerbates cardiomyocyte damage post-recanalization therapy in acute myocardial infarction. Pyroptosis and the NLRP3 inflammasome are crucial in I/R, yet the precise mechanism remains unclear.

Materials and methods: Transcriptomics, proteomics, and single-cell transcriptomics were employed to examine cellular subtype changes and pyroptosis-associated gene regulation in I/R. Differential pyroptosis-related genes were identified from transcriptomics data and validated with proteomics. Single-cell RNA sequencing assessed pyroptosis levels and intercellular communication. Mouse myocardial I/R and human cardiomyocyte hypoxia/reoxygenation (H/R) models were used to explore STING overexpression/silencing effects on NLRP3 inflammasome activation, oxidative stress, and cellular injury.

Results: Pyroptosis-related genes were significantly dysregulated, implicating multiple inflammatory pathways. Single-cell analyses revealed increased granulocytes, macrophage infiltration, cardiomyocyte injury, and enhanced pyroptosis scores post-I/R. Cardiomyocytes, endothelial cells, and fibroblasts exhibited increased pyroptosis and inflammatory cell-cell interactions. Animal studies indicated significant declines in cardiac function and increased oxidative stress and inflammation post-I/R. STING activation (SR717) worsened cardiac function, enhanced ROS production, and elevated myocardial injury markers; STING inhibition (H151) markedly mitigated these effects. Correspondingly, the cGAS-STING pathway and NLRP3 inflammasome factors were significantly upregulated post-I/R, exacerbated by STING agonists and alleviated by STING inhibitors. Cellular studies confirmed that STING overexpression intensified oxidative stress and pyroptosis, effects reversed by STING knockdown and blocked by NLRP3 inhibitor MCC950.

Conclusion: STING activation contributes to oxidative stress and NLRP3 inflammasome-associated pyroptosis during I/R. Targeting the STING-NLRP3 axis may represent a potential strategy to reduce myocardial injury after ischemia-reperfusion.

Road traffic accidents (RTAs) continue to be a major global public health issue, particularly in countries with developing road safety infrastructure like Bangladesh, where the road traffic fatality rate remains alarmingly high. This study aims to examine the relationship between road traffic accident outcomes-fatalities and injuries-and multiple contributing factors, including driver behavior, vehicle characteristics, environmental conditions, and road infrastructure. Using a comprehensive dataset of 64,050 police-reported road traffic accidents in Bangladesh (2006-2015), we apply a Negative Binomial Regression (NBR) model to account for overdispersed count data. Our results highlight that driver-related factors such as seatbelt use and age, vehicle factors such as fitness certification, and environmental conditions such as weather and road geometry significantly influence both fatalities and injuries. Notably, roads without dividers and in rural areas were found to be particularly hazardous. The study underscores the need for targeted road safety interventions, such as improved enforcement of seatbelt use, infrastructure upgrades (e.g., dividers, lighting), and more transparent vehicle fitness monitoring. By integrating driver, vehicle, environmental, and infrastructural variables, this study provides a comprehensive understanding of road traffic accident severity in Bangladesh, offering data-driven insights to inform evidence-based policymaking and infrastructure planning aimed at reducing road traffic injuries and fatalities.