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Correction: The relationship between N-terminal pro-brain natriuretic and coronary artery lesions in Kawasaki disease: A meta-analysis

PLoS ONE Yanyan Li, Chaolong Zheng, Sisi Cheng et al. Jul 28, 2026 DOI: 10.1371/journal.pone.0354951

Quantitative metrics to characterize radiologists’ search patterns during multiparametric MRI assessment for prostate cancer

Scientific Reports Ryan C. Au, Derek W. Cool, Harry R. Marshall et al. Jul 28, 2026 DOI: 10.1038/s41598-026-56901-y

TBC1D9 and TBC1D9B are ARL8 effectors that modulate exosome secretion through a RAB11A–exocyst pathway

Proceedings of the National Academy of Sciences Ganesh Vilas Shelke, Chad D. Williamson, Tal Keren-Kaplan et al. Jul 28, 2026 DOI: 10.1073/pnas.2527864123

Multivesicular endosomes (MVEs) are endolysosomal compartments containing intraluminal vesicles (ILVs) that follow two alternative pathways: fusion with lysosomes, leading to ILV degradation, or fusion with the plasma membrane, resulting in ILV secretion as exosomes. The mechanisms governing this fate decision have only recently begun to be elucidated. Previous work showed that the Biogenesis of lysosome related organelles complex-one-related complex (BORC) and the small guanosine triphosphatase (GTPase) ARL8 promote MVE–lysosome fusion through the ARL8 effector homotypic fusion and protein sorting complex (HOPS), thereby diverting MVEs from exosome secretion. Here, we identify TBC1D9 and TBC1D9B as ARL8 effectors that further suppress exosome release. Acting as GTPase-activating proteins, these proteins drive RAB11A inactivation and dissociation from endolysosomes. This reduces recruitment of the RAB11A effector exocyst complex, preventing MVE fusion with the plasma membrane. These findings thus define a BORC–ARL8–TBC1D9/TBC1D9B axis that further attenuates exosome secretion by blocking MVE–plasma membrane fusion.

Correction: Burnout among anesthesia personnel in Thailand: A national survey of workload, personality traits, and resilience

PLoS ONE Napasorn Sakulteera, Pongtong Puranitee, Atipong Pathanasethpong et al. Jul 28, 2026 DOI: 10.1371/journal.pone.0354956

Cooking and sensory properties of different varieties of rice from various agro-climatic areas of Nigeria

Scientific Reports Chukwunwike Uchenna Enyi, Chinasa Okorie-Humphrey, Blessing Chibuzo Nwokeke et al. Jul 28, 2026 DOI: 10.1038/s41598-026-64636-z

Analysis of physical and physiological training demands in women’s basketball

PLoS ONE Pau Pons-Gomila, Julen Castellano, Julio Calleja-González et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354357

Purpose The primary aim of the present study was to analyze the physical and physiological demands associated with different training tasks in women’s basketball. Methods Fourteen basketball players were continuously monitored for 22 weeks using WIMU PRO ® ™ local positioning system and GARMIN ® heart rate monitors. The variables examined included: distance (DIST in m), number of accelerations (>2 m·s -2 , HACC) and decelerations (<−2 m·s -2 , HDEC); high speed running (>18 km·h -1 , HSR in m), number of jumps (JUMPS), player load (PL in arbitrary units) and heart rate zones (>80% of maximum heart rate, HRZ in seconds). Training tasks were classified into three orientations: directed-oriented (DIR, drills without opposition), special-oriented (SPE, small-sided games), and competitive-oriented (COM, 4-on-4 and 5-on-5 formats); and further grouped by three levels of court space. The Shapiro–Wilk test was used to verify data normality. Linear mixed-effects models were used to analyze all variables. Skewed variables were log-transformed to meet model assumptions. Significance was set at p < 0.05. Results The SPE tasks showed higher values than COM tasks (p < 0.001) in all variables except for HRZ. Also, SPE tasks reported greater values than DIR in the following variables: HRZ and HSR (both p < 0.001) and PL (p = 0.008). Finally, DIR tasks showed higher values than COM tasks in DIST, HACC, HDEC and JUMPS (all p < 0.001), whereas COM tasks exhibited higher values than DIR tasks in HRZ (p < 0.001). Considering the court space in which the tasks were performed, differences were found in all the variables analyzed, with larger spaces generally resulting in greater demands in most variables. Conclusions The results describe that task orientation and court space influence the load demands in women’s basketball. DIR and SPE tasks elicited greater intensities than COM tasks, suggesting that training design should be strategically adapted according to the desired physical and physiological stimuli.

Artificial intelligence for early detection of diabetic retinopathy: A vision transformer-based approach

PLoS ONE Asma ElAdel, Imen Filali, Mourad Zaied Jul 27, 2026 DOI: 10.1371/journal.pone.0350854

Background Early identification of diabetic retinopathy (DR), which is a primary cause of vision impairment globally, is a crucial phasis for effective intervention and treatment. Traditional screening workflows rely on manual diagnosis by ophthalmologists, which remains the gold standard but can be time-consuming and subject to variability due to human factors. To support and enhance the screening process, artificial intelligence (AI)-based tools have shown promise in automating DR detection, particularly with recent advances in deep learning. However, medical images with long-range dependencies and spatial linkages can be challenging for CNN-based algorithms to handle. Methods This paper proposes a Vision Transformer (ViT)-based model, specifically using a Compact Convolutional Transformer (CCT), for early automated detection of DR. The model uses self-attention techniques to improve feature extraction and classification performance; combining three main stages: the CCT tokenizer, transformer encoder, and sequence pooling. The proposed approach was trained on public datasets (EyePACS and APTOS 2019) and evaluated against state-of-the-art deep learning architectures. Results Our experimental findings demonstrate that ViT performs among the best in the current state of the art with an overall accuracy of 97% and F1-scores above 0.95 across all DR severity levels. Our system is primarily designed for the pre-screening stage of diabetic retinopathy workflows, enabling rapid and reliable identification of potential DR cases for further clinical evaluation. Conclusion These results highlight the potential of transformer-based designs in medical picture analysis, as well as the implications for telemedicine and e-health solutions in real-time, especially in cases of low-resource settings.

Persistence of viable opportunistic pathogens in a multi-stage natural wastewater treatment system

PLoS ONE Hazem Aqel, Husni Farah, Ramy Fodah et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354338

Nature-based wastewater treatment systems are increasingly implemented to support water reuse in arid regions, yet their effectiveness in removing viable culturable opportunistic pathogens remains insufficiently characterized. In this exploratory, culture-based study, we assessed bacterial population dynamics across a five-stage natural wastewater treatment system (Wadi Hanifa, Riyadh, Saudi Arabia), tracking culturable bacteria from secondary-treated influent to sand-filtered effluent. Water samples were collected at five sequential treatment stages and analyzed for physicochemical parameters, total culturable bacterial abundance, bacterial diversity, taxonomic composition, and antimicrobial susceptibility of persistent isolates. Total culturable bacterial counts decreased by approximately 1.1 log 10 CFU mL ‒1 across the system, accompanied by an approximately 50% reduction in observed isolate richness. The fecal indicator Escherichia coli was detected only in upstream and intermediate stages (sampling locations L3.1-L3.3) and was absent from downstream samples. In contrast, the opportunistic pathogen Klebsiella pneumoniae was recovered across all five treatment stages and accounted for 44.4% (8/18) of all morphologically distinct isolates grown on the selected culture media. Turbidity declined by 71% along the treatment train and showed a strong positive correlation with bacterial richness (Kendall’s τ = 0.84, p = 0.038), although this exploratory correlation should be interpreted with caution given the small sample size (n = 5 stages). Phenotypic antimicrobial susceptibility testing revealed multidrug resistance (MDR) in 62.5% (5/8) of K. pneumoniae isolates, although all remained susceptible to amikacin and meropenem. Under the conditions examined, multi-stage natural wastewater treatment substantially reduced overall bacterial abundance and diversity but did not eliminate viable, multidrug-resistant Klebsiella pneumoniae . The discordance between fecal-indicator removal and opportunistic pathogen recovery highlights system-specific limitations of indicator-based monitoring for assessing microbial safety in wastewater reuse systems. Given the limited isolate number (n = 8 K. pneumoniae ) and the absence of molecular resistance-gene characterization, broader claims about wastewater as a dissemination pathway for antimicrobial resistance cannot be drawn from these data. These findings are based on a single cross-sectional sampling event and should be considered hypothesis-generating rather than confirmatory.

Dual regulatory effects of medical bovine collagen sponge on macrophages in vitro

PLoS ONE Rui Wang, Yu Liu, Jingjing Chen et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354588

Medical bovine collagen sponges (MBCS) are extensively utilized in clinical settings for hemostasis and tissue augmentation owing to their superior biocompatibility, biodegradability and hemostatic properties. Nevertheless, their immunomodulatory influence on macrophage function remains largely unexplored. In this study, we systematically evaluated the effects of MBCS on RAW264.7 macrophages through comprehensive in vitro assays, including proliferation analysis, phagocytosis assessment, cytokine expression and angiogenesis evaluation. Our results demonstrate that MBCS significantly enhances macrophage proliferation and phagocytic capacity while potently stimulating VEGF secretion. Furthermore, MBCS-conditioned macrophage supernatants markedly promote endothelial tubule formation in vitro. Notably, MBCS moderately promotes inflammatory responses in resting macrophages, whereas pretreatment with MBCS effectively inhibits lipopolysaccharide (LPS)-induced pro-inflammatory reactions, as reflected by reduced production of TNF‑α, nitric oxide and CD86. These findings reveal the effects of MBCS on macrophages at the cellular level, providing experimental evidence and mechanistic support for its tissue-repairing functions.

The effect of squat training with different eccentric contraction tempos on lower limb muscle strength

PLoS ONE Mushuai Hao, Haonan Qi, Liang Zhao et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354725

Objective This study aims to investigate the impact of 8-week squat training with different eccentric contraction tempos on maximal squat strength, jump height, and sprint performance among university students majoring in sports training. Methods Thirty participants were randomly assigned to either the 4/0/X/0 group, the 2/0/X/0, or the self-selected eccentric, isometric and inter-repetition tempo group (V/V/X/V), performing tempo-specific loaded squat training twice weekly for 8 weeks. Maximal squat strength, 30-meter sprint performance, countermovement jump (CMJ), and squat jump (SJ) heights were assessed before and after the intervention. A two-way repeated-measures ANOVA and effect size analysis were used to evaluate the training outcomes. Results 1) For maximal squat strength, no statistically significant inter-group difference was detected (P > 0.05). All three groups exhibited significant within-group improvements relative to baseline (P < 0.05 to P < 0.01). Descriptive effect size analysis showed the magnitude of improvement ranked as follows: 2/0/X/0 group (ES = 1.45)> V/V/X/V group (ES = 0.85)> 4/0/X/0 group (ES = 0.64). 2) For CMJ height, both the 2/0/X/0 and V/V/X/V groups showed significant improvement compared to pre-intervention (P < 0.05), while the 4/0/X/0 group exhibited a significant decrease (P < 0.01). ES magnitudes followed the order: 2/0/X/0 group (ES = 1.07) > V/V/X/V group (ES = 0.30) > 4/0/X/0 group (ES = −0.90). 3) SJ height results mirrored CMJ trends, with ES values ranking:2/0/X/0 group (ES = 1.09) > V/V/X/V group (ES = 0.34) > 4/0/X/0 group (ES = −0.83). 4) In 30-meter sprint performance, the 2/0/X/0 group demonstrated significant improvement (P < 0.05), the 4/0/X/0 group showed significant decline (P < 0.01), and the V/V/X/V group exhibited no significant change. Effect sizes indicated significant improvement in the 2/0/X/0 group (ES = −0.76), no meaningful change in the V/V/X/V group (ES = −0.10), and a significant decline in the 4/0/X/0 group (ES = 0.63). Notably, despite significant gains in maximal strength, the 4/0/X/0 group displayed concurrent decrements in stretch-shortening cycle-based explosive performances. Conclusion Compared with the 4/0/X/0 and V/V/X/V tempos, the 2/0/X/0 tempo showed the most favorable improvement trend in lower-limb maximal strength, and induced significantly greater enhancements in explosive power performance.

Public parks utilization and citizen satisfaction in Bangkok Metropolitan: An integrated theoretical model for tropical urban health

PLoS ONE Wichian Chanthanet Jul 27, 2026 DOI: 10.1371/journal.pone.0354172

Background Tropical megacities face escalating non-communicable disease burdens requiring innovative urban health solutions. Despite public parks’ critical role as health infrastructure, limited research exists on utilization patterns and satisfaction in tropical urban contexts, where extreme heat and humidity create unique challenges. The equitable distribution of park benefits across socioeconomic groups remains underexplored in Southeast Asian contexts, a gap this study directly addresses. Objective This study developed and validated an integrated theoretical model of public park utilization and citizen satisfaction in tropical environments, identifying key determinants and providing evidence-based recommendations for health-promoting urban design, with attention to socioeconomic and gender equity dimensions. Methods We conducted a sequential explanatory mixed-methods study combining the Social Ecological Model, Expectation-Disconfirmation Theory, and Place Attachment Theory. Data were collected from 1,200 park users across 30 Bangkok parks using four-stage stratified random sampling, supplemented by 30 in-depth interviews. Analysis included hierarchical regression, thematic analysis, and comprehensive validity assessment. Results Participants (58.3% female, mean age 35.9 years) visited parks 3.3 times weekly for 1.8 hours per session. Park quality emerged as the strongest satisfaction predictor (β  =  0.401–0.607, all p  <  0.001), followed by usage patterns and accessibility. The integrated model explained 61.7–68.5% of satisfaction variance, a relatively high figure that partly reflects the common-method effects inherent in self-report designs (see Limitations). All nine hypotheses were confirmed with strong correlations (r  =  0.554–0.796). Climate-specific challenges included inadequate shade coverage (M  =  2.96/5.0) and insufficient evening lighting (M  =  2.98/5.0). Qualitative analysis revealed parks function as urban oases, social ‘third places,’ and community-building spaces, with heat protection identified as the primary accessibility barrier. Significant socioeconomic gradients were observed, with lower-income users reporting systematically lower satisfaction across all domains. Conclusions This study provides a comprehensive integrated theoretical model for tropical urban park utilization, indicating that strategic quality improvements are more strongly associated with satisfaction than quantity expansion. Climate-adaptive features—particularly heat protection and extended evening access—represent essential design requirements differing fundamentally from temperate guidelines. The findings indicate that park benefits are not equitably distributed, with implications for Bangkok Metropolitan Administration (BMA) policies including the 15-minute city park initiative.

A simulation model to predict the most efficient way to utilise operational resources when vaccinating badgers against bTB

PLoS ONE Richard Budgey, Megan Bird Jul 27, 2026 DOI: 10.1371/journal.pone.0354329

Bovine tuberculosis (bTB) is a disease carried by badgers that seriously impacts the health and productivity of cattle in the United Kingdom (UK). The UK government’s aim is to be officially TB-free in cattle by 2038 in England and badger vaccination is one approach that can be used to achieve this. We use a simulation model to compare the relative performance of different vaccination strategies (treatment every year, every second year and every third year) under different field conditions and assumptions about vaccine efficacy. Population density, disease prevalence and duration of vaccine-induced immunity substantially affected the outcome of vaccination. A vaccine strategy with lower frequency treatment was effective and offers operational efficiency as multiple areas can be treated near concurrently by a single vaccination team, potentially halving the cost per unit area. The information presented here may be used to guide operational managers and decision makers towards a more efficient strategy in a particular area and may provide an estimation of the likely success of the chosen strategy.

Dietitian-led intervention to manage constipation in Parkinson’s disease: Study protocol for a parallel-group randomized controlled trial (NUTRI-GUT-PD)

PLoS ONE Juliana Heitich Brendler, Khadija Younes da Silva, Valesca Dall’Alba et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354608

Background Constipation is a frequent non-motor symptom in Parkinson’s Disease (PD). Standard care includes dietary and lifestyle guidance or the use of laxatives. Diet represents a promising non-pharmacological approach, but its management in PD is complex and goes beyond simple dietary recommendations. This study protocol aims to examine whether nutritional counseling delivered by a dietitian is more effective than usual care in reducing constipation symptoms in PD patients. Methods This 90-day randomized controlled superiority trial uses a parallel-group design. A total of 54 outpatients with PD without dementia and fulfilling the Rome IV criteria for functional constipation will be included. Baseline assessments comprise demographics, nutritional evaluation (anthropometric measurements and sarcopenia indicators), neurological assessment, and the Constipation Scoring System (CSS) scores. Participants will perform stool sample collection for microbiota analysis and will be requested to complete three 24-hour dietary recalls over the subsequent week. After baseline, participants will be randomly allocated to either the control group (usual care) or the intervention group (nutritional counseling delivered by a dietitian). At the first study visit, participants will deliver the stool sample and dietary recalls. The intervention will last for 90 days and will include one in person consultations and bi-weekly follow-up phone calls. Nutritional counseling will address four main topics: healthy eating, food processing, fiber and fluid intake, and levodopa interactions with diet. In addition, participants in the intervention group will receive an individualized diet plan. All baseline assessments will be repeated at the 90-day endpoint. The primary outcome is the change in weekly bowel movement frequency from baseline to day 90, measured through the stool diary. Secondary outcomes include CSS, changes in fecal gut microbiota, macronutrient distribution, diet quality, body composition and sarcopenia indicators. Trial registration number: NCT07213856.

A systems biology approach to find representative genes in Acute Myeloid Leukemia

PLoS ONE Behnam Aghajan, Mohammad Reza Ghaemi, Ali M. Mosammam et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0352167

In this study, we modeled gene expression profile data from Acute Myeloid Leukemia (AML) and healthy cases. At first, the GEO-GSE9476 dataset was processed, and a total of 341 genes were identified as differentially expressed genes (DEGs) in patients, and 599 DEGs in healthy individuals. Gene Ontology and pathway analysis on DEGs led to the identification of 5 Transcription Factors for patients and 3 for healthy cases. Analysis of the respective metabolic pathways revealed a common region in the metabolic pathway between AML and Tuberculosis (TB) that confirmed the validity of our procedure due to the consistency with similar reports. Upon PPI network analysis, Hub genes and three modules containing 41 up-regulated and down-regulated genes in AML patients were identified. Survival analysis on these genes results in reducing the number of identified effective genes into 3 upregulated ( ITGAM , ITGAL and CD163 ) and 5 downregulated genes ( MCM2 , MCM3 , RFC4 , RFC5 and FEN1 ). Finally, drug sensitivity analysis was performed on these genes demonstrating complexity in drug-resistance due to the pattern of gene expression. This knowledge could potentially enable personalized treatment approaches based on individual patient responses due to the epigenetics and life style which affect gene expression pattern.

Choroidal metastasis: Impact of primary tumors and age on survival - a single center analysis

PLoS ONE Philipp Fuchs, Adrian Reumueller, Judith Kreminger et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354598

Purpose The purpose of this study was to determine whether patient’s age and their primary tumor type act as independent predictors of their survival after a diagnosis of choroidal metastasis. Methods This retrospective single-center study (August 2013 – August 2025) included 70 patients with choroidal metastases. Clinical data and multimodal imaging were extracted from medical records. Tumor volume was calculated from ultrasound measurements. Patients were grouped according to primary tumor origin (lung, breast, or other primaries). Survival was compared between these three primary tumor groups and according to age. Group differences in continuous variables were assessed using ANOVA/Kruskal-Wallis testing, and survival distributions were analyzed with Kaplan-Meier curves. Patients were categorized into younger (<59.6 years) and older (≥59.6 years) groups for Kaplan-Meier survival analysis. Univariate and multivariate Cox regression models were performed to identify independent predictors of overall survival. Results Median overall survival was 71.6 weeks. Statistically significantly longer survival was found in patients <59.6 years (median 88.3 weeks; estimated 3-year survival 33.2%) compared with those ≥59.6 years (median 41.9 weeks; 3-year survival 16.8%; p = 0.037. Primary tumor group analysis showed a median survival of 94.4 weeks for breast cancer (estimated 3-year survival 38.3%), 52.7 weeks for lung cancer (9,5%), and 40.6 weeks for other primaries (19.7%). However, this difference was not statistically significant (p = 0.269). In multivariate Cox regression analysis, age ≥ 59.6 years (HR 2.10; p = 0.016) and >1 extraocular metastases elsewhere in the body (HR 2.53; p = 0.029) were independent predictors of mortality. Conclusion Survival in choroidal metastases is strongly driven by age and the number of extraocular metastatic sites at presentation. Our findings suggest that younger age and a lower metastatic burden are most reliable indicators for a more favorable prognosis.

The economic burden of Type 2 Diabetes by social determinants of health: A systematic review

PLoS ONE Dulce E. Alarcón-Yaquetto, Robert Stewart, Khalida Ismail et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354198

Background The unequal distribution of resources in society generates social gradients that translate into health inequalities and differential use of health care resources and their costs. Non-medical factors such as employment, income, ethnicity and education impact the prevalence and treatment outcomes of patients with type 2 diabetes mellitus (T2DM); however, there is a scarcity of articles assessing the relationship between health inequalities and the economic costs of treatment. Therefore, we conducted a systematic review of published studies examining the cost differences of treating T2DM across social determinants of health (SDH). Methods We systematically searched MEDLINE, Embase, PsycINFO, EconLit, and NHS EED for original peer-reviewed articles that provided cost differences of treating T2DM by SDH: education, income, employment, residency and ethnicity. We grouped the studies by each SDH and calculated the percentage differences where possible between the lowest and highest ends of the gradient (education, income and employment). Residency was categorised as rural vs. urban and ethnicity as white or general population vs other ethnic minorities. Results We included 19 articles retrieved internationally from varying healthcare systems. Results were contextualised given the healthcare financing model. In countries with high out-of-pocket expenses, Black and Hispanic ethnic backgrounds and rural residence were associated with lower direct health care and costs likely to be determined by ability to pay rather than clinical need. Indirect costs such as lost productivity due to absenteeism were also lower in unemployed, and lower income groups. Conclusions There are evident health disparities in the direct and indirect economic consequences of T2DM. The effect of decreased healthcare use and costs on treatment outcomes needs to be further explored to inform policies to ensure healthcare delivery is based on clinical need rather than socio-economic factors.

Prevalence, risk factors, and management practices of premenstrual syndrome among female university students in Lebanon: An observational cross-sectional study

PLoS ONE Rania Itani, Reem Al Rawass, Diala Tlayss et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354807

Background Premenstrual syndrome (PMS) is common among women of reproductive age and may impair quality of life, academic performance, and social functioning. In Lebanon, data on PMS and its management among female university students remain limited. This study aimed to estimate the prevalence of PMS among female university students in Lebanon, identify risk factors, and recognize adopted management practices and their perceived effectiveness. Methods An observational cross-sectional study was conducted among female students at Beirut Arab University, Lebanon, between April 20 and May 8, 2026. Data were collected using a self-administered questionnaire assessing sociodemographic, menstrual, lifestyle, behavioral, psychosocial, and management-related factors. Premenstrual symptoms, social media addiction, and perceived stress were assessed using the Premenstrual Symptoms Screening Tool, Bergen Social Media Addiction Scale, and Perceived Stress Scale-4, respectively. Binary logistic regression was used to identify factors associated with moderate-to-severe PMS and premenstrual dysphoric disorder (PMDD). Results Among 1,062 participants, 497 participants screened positive for moderate-to-severe PMS (46.8%), and 175 had symptoms consistent with PMDD based on the PSST (16.5%). The most frequently reported moderate-to-severe symptoms were physical symptoms (69.7%), fatigue or lack of energy (68.8%), depressed mood or hopelessness (67.8%), and overeating or food cravings (66.2%). Academic absenteeism was reported by 37.2%. More than one-third of the participants with moderate-to-severe PMS and PMDD (39%) reported using pharmacological management practices, mainly non-steroidal anti-inflammatory drugs. However, less than half of medication users perceived these treatments as being very effective (45.8%). Higher odds of moderate-to-severe PMS were observed among current smokers (AOR = 1.61, P = 0.003), those with heavy menstrual bleeding (AOR = 1.58, P = 0.03), high meal skipping (AOR = 1.38, P = 0.03), high fast-food consumption (AOR = 1.34, P = 0.04), higher social media addiction scores (AOR = 1.31, P < 0.001), and higher perceived stress scores (AOR = 1.48, P < 0.001). Conclusion PMS was common among female university students in Lebanon and a considerable proportion experienced PMDD. In fact, lifestyle, behavioral, and psychosocial factors were associated with moderate-to-severe symptoms, highlighting the need for university-based awareness, screening, and counseling strategies that address modifiable risk factors and support appropriate management of premenstrual symptoms.

Vehicle routing optimization and algorithms for instant delivery under customer loss mechanism

PLoS ONE Gaoming Cao, Weixiong Zha Jul 27, 2026 DOI: 10.1371/journal.pone.0345043

In the field of instant delivery, the mismatch between delivery resources and customer demands has led to increasingly significant customer losses. To address this issue, this study introduces the customer loss mechanism and constructs an evaluation function to screen out resource-intensive customers, thereby clarifying the scope of delivery services. Based on this, this study establishes the vehicle routing optimization model under the customer loss mechanism with the objective of minimizing the sum of vehicle fixed costs, variable routing costs, and time window penalty costs. An improved genetic algorithm is employed to solve this model. Case study results demonstrate that the improved genetic algorithm outperforms traditional genetic algorithms and tabu search algorithms in convergence speed, optimization capabilities, and stability, reducing total delivery cost by 36.25% and 4.18%, respectively, with zero delivery violations. Regarding model performance, when proactively excluding 8.33% of customers, the total delivery cost is reduced by 17.18%, primarily driven by the reduction in fleet size. Furthermore, large-scale experiments reveal a pronounced leverage effect: excluding a mere 5% of marginal customers counter-intuitively reduces both fleet size and travel distance, while a 10% loss yields an 18.39% total delivery cost reduction with zero violations, proving that the mechanism precisely screens out inefficient nodes rather than arbitrarily rejecting them. Sensitivity analysis further confirms the model’s robustness across varying resource tightness, demonstrating that proactive customer loss is a feasible and effective strategy for improving resource utilization through precise resource focusing.

Exploring the mechanism of Shuangyu Granule in regulating immune-inflammatory responses in influenza through UPLC-Orbitrap-MS/MS, GC-MS, and network target analysis

PLoS ONE Ling Sun, ZhiTao Jiang, Ying Chen et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0353259

Influenza, an acute respiratory infectious disease caused by the influenza virus, remains a significant challenge for prevention and treatment due to rapid viral mutation and high pathogenicity. Traditional Chinese Medicine (TCM), including Shuangyu Granule (SYKL), has demonstrated efficacy in managing influenza. This study aimed to systematically identify the chemical components of SYKL in vitro and its absorbed constituents in vivo, and to preliminarily explore its potential mechanism in regulating influenza-related immune inflammation. UPLC-Orbitrap-MS/MS and GC-MS were used to characterize SYKL’s chemical profile, identifying 148 in vitro components and 21 prototype absorbed blood components. Network target analysis, integrated with single-cell RNA sequencing (scRNA-seq) data from influenza patients, predicted that the absorbed components may target multiple immune-inflammatory regulatory genes across various immune cell types. Molecular docking suggested favorable predicted binding potential between these components and target proteins. Experimental validation using poly(I:C)-induced inflammatory models in both RAW264.7 macrophages and mouse bone marrow-derived macrophages (BMDMs) showed that the absorbed components—loganic acid, 8-epiloganic acid, calycosin, atractylodin, eucalyptol, secoxyloganin, and paeoniflorin—significantly reduced mRNA expression of immune-inflammatory genes (DUSP6, MAPKAPK2, NOD2) and inhibited secretion of TNF-α, IL-6, IL-8, and NO. These findings suggest that SYKL may alleviate influenza-associated inflammation through multi-component, multi-cell, and multi-target pathways, highlighting its potential in modulating excessive immune responses in influenza.

A standardized imaging and analysis workflow for quantitative evaluation of cutaneous neurofibromas in Nf1-KO mice

PLoS ONE Laura Fertitta, Fanny Coulpier, Layna Oubrou et al. Jul 27, 2026 DOI: 10.1371/journal.pone.0354818

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder in which cutaneous neurofibromas (cNFs) represent one of the most common and burdensome manifestations. No approved pharmacological treatment exists. Preclinical studies are essential to evaluate candidate therapies, but reliable outcome and endpoint measures for cNFs in animal models remain limited. We developed and validated a standardized methodology to assess drug efficacy in the Prss56Cre Nf1-KO mouse model which recapitulates key features of cNFs. In this model, Nf1 inactivation and tdTomato (Tom) reporter expression were specifically targeted to Schwann cells (SCs) responsible for cNF development. This approach enables real-time monitoring, isolation, and manipulation of tumor SCs at any time. We defined macroscopic (tumor count, total Tom + fluorescent surface area, fluorescence intensity) and microscopic (cell-type composition defined by immunolabeling with a panel of specific markers, area quantification) endpoints, developed dedicated ImageJ scripts for automated image analysis, and compared the results with those obtained using the conventional manual method. Both automated measurements showed excellent reproducibility (ICC = 1) and strong correlation with manual analysis (Spearman’s coefficient > 0.90), while significantly reducing analysis time (up to 100-fold faster). Bland–Altman analyses confirmed the absence of systematic bias compared with manual scoring. The standardized image naming and metadata integration further facilitated data consolidation and statistical analysis. This validated approach provides a reliable, reproducible, and time-efficient framework for evaluating drug effects on cNFs in preclinical studies. It establishes a foundation for robust efficacy testing of candidate therapies, facilitates cross-study comparability, and accelerates therapeutic development and clinical translation.