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High-performance supercapacitor based on tungsten oxide iodide/polymer nanocomposite for advanced energy storage

Scientific Reports Ahmed H. AbdEl-Salam, Hassan A. Ewais, Mohamed Rabia et al. Dec 04, 2025 DOI: 10.1038/s41598-025-29780-y

Abstract A novel pseudosupercapacitor has been successfully developed based on a nanocomposite of tungsten oxide iodide integrated with poly(1H-pyrrole) (WO 3-X I X /P1HP). This hybrid material synergistically combines the redox activity of transition metal oxides with the conductivity and flexibility of a polymer matrix, enabling high-performance energy storage. The incorporation of iodide within the crystalline tungsten oxide framework enhanced electrochemical functionality, while scanning electron microscopy reveals cauliflower-like nanostructures (~ 30 nm) with hierarchical roughness, offering increased surface area for charge storage. As a result, the composite exhibited an outstanding capacitances of 775 F/g at 1.0 A/g and 425 F/g at 2.0 A/g, respectively. Corresponding energy densities reached 100 Wh/kg and 52 Wh/kg, respectively. These impressive values are attributed to the synergistic effect of efficient redox activity of the tungsten oxide iodide component, as well as the enhanced electron transport via P1HP matrix. The integrated hybrid architecture also ensures structural integrity and cycling stability. Overall, the WO 3-X I X /P1HP nanocomposite represents a promising candidate for next-generation supercapacitors. Its superior electrochemical performance, structural robustness, and scalable synthesis suggest significant potential for practical applications in portable electronics and advanced industrial energy storage systems.

Evolutionary dynamics of value co-creation within the industry-university-research network: A multi-agent game perspective

PLoS ONE Xuemin Zhang, Haijun Wang, Sardar M. N. Islam et al. Dec 04, 2025 DOI: 10.1371/journal.pone.0338379

This paper investigates the evolutionary dynamics of value co-creation and defines the roles of multiple agents within the industry-university-research (IUR) network. A distinctive evolutionary game model from a multi-agent perspective is proposed to capture the previously under-explored dynamics of value co-creation within the IUR network. Furthermore, China’s high-end manufacturing industry was selected to establish the IUR network for simulation analysis because of its rapid transition toward innovation-driven value co-creation and the availability of granular data on IUR partnerships. The evolutionary game analysis yields three key findings with specific implications: Firstly, it reveals that the network’s average positive co-creation probability is inversely correlated with the enterprise investment difference and the academic knowledge input disparity between positive and negative value co-creation. This inverse relationship, identified by the game model, underscores the critical need for an effective supervision and management mechanism to optimize the utilization of enterprise investment and academic knowledge input during the value co-creation process within the IUR network. Secondly, the evolutionary game analysis demonstrates that specific parameters within the model – namely, the enterprise’s knowledge absorption capacity, the academic institution’s R&D capability, the government’s subsidy and penalty, and the intermediary’s transformation coefficient – play crucial roles in enhancing value co-creation probability. Based on these model-driven insights, we conclude that a combination of government guidance and market mechanisms serves as a sustainable driver for promoting value co-creation within the network. Thirdly, the model establishes an inverted U-shape relationship between the enterprise’s benefit distribution coefficient and the average positive co-creation probability. This critical finding from the evolutionary game simulation highlights the advantage of establishing an impartial interest distribution mechanism between industry and academia to foster synergy and stability in value co-creation within the IUR network.

Advanced blade profiles for improved efficiency in Savonius wind turbines: the aeroleaf case study

Scientific Reports Seyed Mohammadali Hosseinian, Mohsen Mohseni, Mohamad Sadeq Karimi Dec 04, 2025 DOI: 10.1038/s41598-025-30636-8

Non-muscle myosin IIC predominantly expressed in the slow-twitch skeletal muscles impedes age-related muscle weakness

PLoS ONE Hiroki Hamaguchi, Shino Hiraoka, Kun Tang et al. Dec 04, 2025 DOI: 10.1371/journal.pone.0337708

Skeletal muscle expresses three types of non-muscle myosin (NM) II in addition to skeletal type myosin. While immature myoblasts have been reported to express NMIIA and NMIIB, playing roles in cell morphology, the specific localization and function of NMIIC in skeletal muscle cells remain unclear. In this study, we aimed to investigate the expression pattern and the physiological role of NMIIC in skeletal muscle. NMIIC was specifically expressed in the slow-twitch muscles such as soleus, which primarily consists of type I and type IIa fibers, and its expression increased as muscle differentiation progressed. To explore the function of NMIIC in skeletal muscle, we used whole-body NMIIC knockout (KO) mice. Myofiber size was slightly but significantly decreased in the soleus of young (18–20-week-old) NMIIC KO mice. However, contractile force of the isolated soleus muscle in the NMIIC KO mice did not differ from that of wild-type mice, suggesting that the slight reduction in fiber size has limited physiological significance at this age. Interestingly, in 81-week-old NMIIC KO mice, soleus contractile force was significantly reduced despite no difference in fiber size between aged wild-type and NMIIC KO mice. Notably, NMIIC expression levels were higher in aged than young mice. These findings suggest that while NMIIC has minimal impact on skeletal muscle function under young and healthy conditions, it may play a crucial role in maintaining muscle function when muscle is compromised at age.

Alfalfa MsSOS2 confers salinity tolerance by promoting lateral root growth and regulating Na+/K+ homeostasis

Scientific Reports Biswa R. Acharya, Lorenso A. R. Reyes, Lipsa Mishra et al. Dec 04, 2025 DOI: 10.1038/s41598-025-21355-1

Abstract Salinity is a major abiotic stress limiting plant productivity. The Salt Overly Sensitive (SOS) pathway, comprising SOS1, SOS2, and SOS3, is central to ion homeostasis under salt stress. While the pathway has been extensively studied in model plants, its components remain uncharacterized in Medicago sativa (alfalfa), a moderately salt-tolerant forage crop of global economic importance. Here, we report the functional characterization of MsSOS2 , a CIPK family gene and putative ortholog of AtSOS2 . Sequence analysis revealed that MsSOS2 possesses conserved domains essential for kinase activity, including a kinase domain, activation loop, the phosphatidic acid (PA)-binding site, and NAF motif. Phylogenetic analysis placed MsSOS2 with AtSOS2 and OsSOS2. Yeast-two-hybrid assays confirmed the interaction between MsSOS2 and MsSOS3, mimicking the AtSOS2 – AtSOS3 complex. Transgenic expression of MsSOS2 in the Arabidopsis sos2 mutant restored salinity tolerance during seed germination, seedling development, and late vegetative growth. Ion profiling showed reduced Na accumulation and enhanced K retention in MsSOS2 -expressing lines under salinity. We propose that MsSOS2 activates AtSOS1 to facilitate Na⁺ efflux and disrupts AtCBL10-mediated inhibition of AKT1 to promote K⁺ uptake. This study provides the first functional validation of an SOS pathway component in alfalfa and highlights MsSOS2 as a promising candidate for improving salinity tolerance in legumes.

Comprehensive analysis platform to understand, remedy, and eliminate amyotrophic lateral sclerosis (CAPTURE ALS): Study protocol for a Canadian multicenter, multimodal, longitudinal observational study

PLoS ONE Natalie Saunders, Claire Magnussen, HyungMo Kang et al. Dec 04, 2025 DOI: 10.1371/journal.pone.0332430

Background The marked heterogeneity of Amyotrophic Lateral Sclerosis (ALS) combined with a lack of biomarkers are key contributing factors to the lack of disease-modifying treatments. The Comprehensive Analysis Platform to Understand Remedy and Eliminate ALS (CAPTURE ALS) is a Canadian platform designed to create the most comprehensive picture of people living with ALS with the objective of facilitating ALS research initiatives worldwide. Objectives The main aims of CAPTURE ALS include: (1) to characterize ALS and healthy controls with biosamples and data in order to provide the most comprehensive picture of individuals living with ALS to date; (2) to create a de-identified database and biosample repository linked to detailed clinical information; and (3) to develop and implement an inclusive and transparent participant engagement strategy to be active throughout all stages of CAPTURE ALS. Methods/Results CAPTURE ALS is a prospective, multicenter, observational, longitudinal study. People living with ALS, or a related disease and healthy controls undergo a harmonized protocol including the collection of detailed clinical information, neurological and cognitive examination, speech recording, advanced magnetic resonance imaging, and biosampling. Data and samples are stored in a biobank operating under an open science governance framework. An inclusive and transparent participant engagement strategy was designed and implemented throughout all stages of CAPTURE ALS. Four sites are operating in the consortium with a fifth being onboarded. The target enrollment is 120 affected participants and 50 controls, with the first participant visit having occurred in March 2022. Recruitment is ongoing. Discussion CAPTURE ALS is a scalable clinical research platform that connects scientists and patients to facilitate efficient translational research. The unique and deeply phenotyped data and biosamples are a global resource towards the development of biomarkers and understanding ALS biology. This study is registered at clinicaltrials.gov (NCT: NCT05204017).

Remote ischemic preconditioning improves ileal microvascular oxygenation during rodent hemorrhagic shock without improving variables of microcirculation and mitochondrial respiration

Scientific Reports Stefan Hof, Leandra Krüll, Liana Stepanyan et al. Dec 04, 2025 DOI: 10.1038/s41598-025-29245-2

Abstract Hemorrhagic shock is characterized by decreased microvascular blood flow, leading to a critical depletion of tissue oxygenation, particularly within the gastrointestinal tract. The integrity of the intestinal barrier, however, plays a crucial role in maintaining systemic homeostasis. Remote ischemic preconditioning (RIPC), achieved through transient, repeated occlusion of blood flow to a limb, has been shown to exert beneficial effects on various tissues under hypoxic conditions. These effects are at least in part attributed to circulating humoral mediators with vasoactive properties. This study aimed to investigate the effect of RIPC - implemented via intermittent bilateral hind limb perfusion occlusion - on intestinal microvascular oxygenation, regional microcirculation, and mitochondrial function in a fixed-pressure model of hemorrhagic shock in rats with subsequent autologous blood transfusion. RIPC ameliorated the decrease of microvascular oxygenation in the ileum (shock: 34 ± 4% vs. shock + RIPC: 48 ± 4%), but not in the colon (shock: 51 ± 2% vs. shock + RIPC: 50 ± 4%). RIPC had neither an effect on regional microcirculation nor on mitochondrial respiration assessed ex vivo post hemorrhage and transfusion. These findings suggest that RIPC may improve intestinal tissue oxygenation in hemorrhagic shock independently of regional microcirculation and mitochondrial respiration and that this protective effect of RIPC might vary between different sections of the gastrointestinal tract. The mechanism by which RIPC improves ileal tissue oxygenation has to be clarified in future studies.

The role of active inference in conscious awareness

PLoS ONE Jonathan Edward Robinson, Andrew W. Corcoran, Christopher J. Whyte et al. Dec 04, 2025 DOI: 10.1371/journal.pone.0328836

Active inference, a first-principles framework for modelling the behaviour of sentient agents, is beginning to be applied in consciousness research. One hypothesis arising from the framework is that active inference is necessary for changes in conscious content. As one component of an extensive adversarial collaboration among competing theories of consciousness, active inference will be contrasted with two other theories of consciousness, neither of which posit that active inference is necessary for consciousness. Here, we thus present a Study Protocol designed to test the active inference hypothesis using a carefully controlled adaptation of the motion-induced blindness paradigm, where an ‘active’ condition with richer active inference is contrasted with a ‘passive’ condition. In the active condition, participants direct their gaze towards a target stimulus following its disappearance from consciousness, and report on its subsequent reappearance. In the passive condition, participants maintain central fixation, while the stimulus array is moved across the visual field (in a replay of the active condition based on eye-tracking data acquired during active trials). In two experiments, we plan to investigate target reappearance across active and passive conditions to evaluate the contribution of active inference to conscious awareness. Results will eventually be considered in the context of all the experiments conducted as part of the overall adversarial collaboration.

Optimizing urban last mile delivery efficiency through dynamic vehicle routing heuristics and traffic flow analysis

Scientific Reports Lu Liu, Tianxia Wang Dec 04, 2025 DOI: 10.1038/s41598-025-29861-y

Impact of anodal tDCS and virtual reality on cognitive dysfunction in patients with Multiple Sclerosis: Protocol of a double blind, randomized, prospective, controlled study

PLoS ONE Lucilla Vestito, Cristina Schenone, Francesca Casazza et al. Dec 04, 2025 DOI: 10.1371/journal.pone.0337405

Background Cognitive impairment (CI) affects a significant proportion of people with Multiple Sclerosis (PwMS), even in the early stages of the disease, increasing fatigue perception and reducing quality of life. Various restorative interventions have been tested to mitigate CI, but their efficacy remains limited. Transcranial direct current stimulation (tDCS) has emerged as a promising add-on to conventional rehabilitation in several neurological conditions, including MS. Similarly, novel technologies such as exergames are gaining attention as supportive tools in the rehabilitation of PwMS. These approaches can be combined within integrated protocols to maximize therapeutic benefits on CI. However, robust evidence of efficacy is still lacking, and only one case report has been published to date. Aims The primary aim is to investigate the potential benefits of combining anodal tDCS (A-tDCS) with exergame-based training in the rehabilitation of CI in PwMS. The secondary aim is to assess whether the proposed protocol can provide sustained benefits over time. Methods 80 PwMS with CI will be consecutively enrolled and evaluated through a comprehensive neuropsychological battery. 40 participants will be randomized to the experimental group (EG) and 40 to the control group (CG). All participants will undergo 10 sessions of exergame-based rehabilitation. In addition, the EG will receive concurrent A-tDCS over the left dorsolateral prefrontal cortex, whereas the CG will receive sham stimulation. Assessments will be conducted at baseline, post-treatment, and at one and six months follow-up. Discussion We hypothesize cognitive improvements in both groups due to exergame training. However, we expect greater improvements in the EG compared with the CG. Furthermore, we hypothesize that the beneficial effects in the EG will be sustained over time. Clinical trials registration ClinicalTrials.gov, Identifier: NCT07114809 (Date: August 8th, 2025)

A multi module a.i. system for intelligent health insurance support using retrieval augmented generation

Scientific Reports Sejal Hanmante, Shivani Patil, Aniket K. Shahade Dec 04, 2025 DOI: 10.1038/s41598-025-31038-6

Bone Health Index (BoneXpert) and parameters of peripheral quantitative computed tomography indicate overall adequate bone health in adolescents with chronic endocrine diseases at time of transition

PLoS ONE Sebastian Gippert, Markus Bettendorf, Johannes Hoos et al. Dec 04, 2025 DOI: 10.1371/journal.pone.0337842

Background/Aim Low bone mass is common in children and adolescents with chronic endocrine disorders. Peripheral quantitative computed tomography (pQCT) is used to quantify bone health. A new automated Bone Health Index (BHI) determination (BoneXpert TM ) is available using digitized X-rays of the left hand taken for bone age (Greulich&Pyle, BA) determination. In this study, we determine the BHI in adolescents with various endocrine disorders and compare it to conventional pQCT indices to evaluate the BHI as a potential surrogate parameter for bone health and muscle strength in adolescents. Methods 134 adolescents (70 females) with chronic endocrine diseases and a median age of 17.6 years (IQR: 16.4,19.4) were included at the time of transition. Diagnoses were growth hormone deficiencies (GHD, n = 37), Turner syndrome (TS, n = 27), congenital adrenal hyperplasia (CAH, n = 22), small for gestational age (SGA, n = 20), multiple pituitary hormone deficiency (MPHD, n = 17) and Klinefelter syndrome (KS, n = 11). BA and BHI were assessed by BoneXpert™ (available for 104 patients) and were compared to a random subgroup with available pQCT parameters (n = 38: 13 CAH, 12 GHD, 7 TS and 6 SGA) assessed by XCT-2000 scanner. Further, grip strength was assessed by hand dynamometer (n = 134). Results Median BHI-SDS for all patients available was −0.66 (IQR: −1.50,0.18, n = 104), lowest in patients with CAH (−1.04, IQR: −2.34,0.22, n = 22). The majority of patients (58.6%) had a BHI-SDS greater than −1, indicating adequate bone health. Median pQCT parameters and median grip strength showed a z-score greater than −1, suggesting an appropriate muscle strength for most patients. Patients with both available BHI-SDS and pQCT parameters (n = 32) showed significant positive correlations with several measurements: bone mineral content (65%) SDS (ρ = 0.576, p < 0.001); metaphyseal (4%) site total BMD SDS (ρ = 0.492, p = 0.005); total cross-sectional area SDS (ρ = 0.379, p < 0.032) and SSI SDS (ρ = 0.417, p = 0.018). In addition, BHI-SDS correlated positively with muscle cross-sectional area SDS (ρ = 0.352, p = 0.066, n = 32) and grip strength SDS (ρ = 0.205, p = 0.050, n = 104). Conclusions At the time of transition, the bone health of adolescents with chronic endocrine diseases is mostly appropriate, as estimated by BoneXpert TM and pQCT. Grip strength was also adequate in the majority of patients. In addition, this study is the first to demonstrate a significant correlation between these methods in adolescents. Consequently, the BHI has the potential to be an effective screening tool for assessing bone health, characterized by wide availability and low radiation exposure, though additional analyses are needed.

Sleep-wakeup based secure multipath routing in wsn using fennec fox optimized deep learning framework

Scientific Reports Mohammad Bilal J, D. Suresh, R. Karthikeyan Dec 04, 2025 DOI: 10.1038/s41598-025-30622-0

Cross-shelf and vertical structure of pelagic amphipods (Crustacea) related to hydro-meteorological conditions in the neritic zone, southern Gulf of Mexico

PLoS ONE Marco Violante-Huerta, Laura Sanvicente-Añorve, Miguel Alatorre-Mendieta et al. Dec 04, 2025 DOI: 10.1371/journal.pone.0336930

The environmental drivers that effect the pelagic amphipod communities in the neritic province have received little attention worldwide. This study analyzed the influence of fluvial discharges and wind regime on the pelagic amphipods in neritic waters of the southern Gulf of Mexico during two contrasting seasons: May ( dry , lower discharges and wind speeds) and November ( nortes , higher discharges and wind speeds). Zooplankton samples were collected at five depth levels of the water column (0–6, 6–12, 12–18, 45–55, and 95–105 m) using a stratified opening-closing net system. Environmental gradients were assessed by defining three horizontal assemblages (‘coastal’, ‘neritic’, ‘slope’) and two vertical assemblages (‘surface’: 0–18 m; ‘deep’: 45–105 m). Seasonally, the greater volume of nutrient-rich discharges during nortes resulted in a higher amphipod density. Spatially, low salinity waters off river mouths corresponded to the lowest amphipod density and diversity. The horizontal and vertical assemblages showed significant differences during the dry (ANOSIM test, p  < 0.05); during nortes , the structure of horizontal and vertical assemblages showed a lower heterogeneity, probably due to wind strength. Differences within the assemblages defined in the horizontal and vertical planes were only evident when Lestrigonus bengalensis was considered in the analysis; however, without this species, the amphipod community showed more homogeneity across the two seasons. Anchylomera blossevillei, Tetrathyrus forcipatus, and the juveniles of Eupronoidae were ecologically relevant in the characterization of the assemblages due to their specific environmental requirements. Diversity, evaluated using the completeness method, increased from the coast to the ocean in both seasons; vertically, diversity was highest in the ‘deep’ assemblage during the dry , but no differences were observed between assemblages in nortes . The greater similarity of the assemblages during nortes was associated with a higher homogeneity in hydrological conditions due to the strong winds that dominate this season. These findings contribute to a deeper ecological understanding of the effects of hydro-meteorological conditions on the structure of pelagic amphipod communities.

Spatiotemporal characteristics and multiple driving paths of the low-carbon transition in household consumption: a configurational analysis using dynamic QCA

Scientific Reports Shunyi Li, Langchao Zhang Dec 04, 2025 DOI: 10.1038/s41598-025-27223-2

Association of non-nutritive sweetener consumption with food craving and body image among university students: A cross-sectional study

PLoS ONE Anfal AL-Dalaeen, Hebah Hamid, Tasneem Abu Hasan Dec 04, 2025 DOI: 10.1371/journal.pone.0335838

Non-nutritive sweeteners (NNS) are widely used for weight control and dietary regulation by university students, however, their psychological associations remain unclear. The aim of this study to investigate the associations between NNS consumption and food craving, and body dissatisfaction. A cross-sectional analysis was conducted among 300 students from Applied Science Private University (ASU) in Amman, Jordan. Participants completed a validated online questionnaire including demographic data, NNS consumption, food craving using Food Craving Questionnaire-Trait Rediced (FCQ-Tr), and perceptions of Sihhouette Ratine Scale Dissatisfcation index (SRS-D) body image using. To evaluate the associations between NNS exposure and psychological outcomes, age, sex, body mass index (BMI), dieting status, smoking behavior, were adjusted using multivariable linear and ordinal regression models. The NNS consumption was 83.3% among university students, with 30.0% indicating daily use of NNS. Increased frequency of NNS intake was significantly associated with higher FCQ-T-r scores (β = 0.21, 95% CI [0.08–0.34], p = 0.002) and elevated SRS-D scores (β = 0.17, 95% CI [0.05–0.29], p = 0.006). Also (74.3%) reported no mood change after NNS intake, and 21.0% reported mood enhancement. These findings found that frequent NNS = intake is associated with heightened food craving and body dissatisfaction among students, independent of body weight, age, smoking or academic faculty.

A three day coaching protocol for deep inspiration breath hold in left breast radiotherapy using active breathing control

Scientific Reports Siqi Jiang, Haokun Shi, Xi Ye et al. Dec 04, 2025 DOI: 10.1038/s41598-025-30484-6

Abstract The deep inspiration breath-hold (DIBH) technique is recommended for left-sided breast radiotherapy to reduce heart dose exposure. However, this technique introduces uncertainties due to possible anatomical variations across successive breath-holds, requiring patient coaching to ensure reproducibility. This study aims to establish an objective coaching framework to optimize DIBH effectiveness and achieve the reproducibility of chest anatomy in left-sided breast radiotherapy. This study implemented a three-day DIBH coaching protocol using the Active Breathing Coordinator (ABC) system (Elekta AB, Sweden), with particular emphasis on the breath-hold threshold and the lung volume difference from CT images. The former was a manually configured parameter in the ABC system that reflected the stability of patient’s respiratory maneuvers during coaching. The latter was used to quantify the DIBH reproducibility. Quantitative analysis demonstrated that for the 9 patients who exhibited fluctuations in their breath-hold threshold, continued coaching successfully enabled them to achieve stability. Another 14 patients maintained a consistent breath-hold threshold throughout the entire coaching process. Only one patient showed deterioration in this parameter. Additionally, the breath-hold threshold showed significant positive correlations with DIBH lung volumes: left lung ( r  = 0.638, p  = 8.028 × 10 −4 ), right lung ( r  = 0.647, p  = 6.284 × 10 −4 ). Regarding reproducibility of DIBH, 78.3% (18/23) and 73.9% (17/23) of patients maintained ≤ 0.1 L difference between two DIBH scans for left and right lung volumes, respectively, with no patient exceeding a relative lung volume difference of 0.2. Ultimately, 96% (24/25) of the patients achieved highly reproducible DIBH after coaching. In this study, the individualized determination of breath-hold thresholds was critical in ABC-assisted DIBH left breast radiotherapy. Through a standardized process, it objectively identified which patients required additional assistance and which were prepared to proceed. After coaching, the observed differences in lung volume between successive breath-holds were minimal, indicating excellent reproducibility of the chest anatomy positioning and enabling more precise left-sided breast radiotherapy.

Whether groups value agreement or dissent depends on the strength of consensus

PLoS ONE James C. Mellody Dec 04, 2025 DOI: 10.1371/journal.pone.0334850

I investigate the conditions under which groups value agreement versus dissent in collective decision-making processes. I argue that which kind of contribution a group values more will depend on the strength of the consensus. As a consensus evolves from weak to moderate to strong, I predict that groups will prefer agreement, dissent, and then agreement again. These predictions are in line with a multi-phase decision-making process in which groups pursue sequential goals reflected in the evolving consensus: establishing an initial consensus, exploring alternative perspectives, and settling on a final decision. I test these predictions with data from the Reddit community r/AmItheAsshole, in which people make normative judgments of social situations. I find support for the predicted pattern, with one caveat: when the consensus is strong, groups exhibit no preference for agreement or dissent.

Texture-based image analysis and explainable machine learning for polished asphalt identification in pavement condition monitoring

Scientific Reports Mansour Fakhri, Seyed Vahid Pourjafar, Mohammad Hassan Daneshvari Dec 04, 2025 DOI: 10.1038/s41598-025-27203-6

Lactate-to-albumin ratio and albumin-corrected anion gap as predictors of outcome in methanol poisoning: A retrospective observational study

PLoS ONE İlter Ağaçkıran, Merve Ağaçkıran Dec 04, 2025 DOI: 10.1371/journal.pone.0336382

Background Methanol poisoning is a serious condition with high morbidity and mortality, mainly due to its metabolism to toxic formic acid. Laboratory findings, particularly albumin-corrected anion gap (ACAG) and lactate-to-albumin ratio (LAR), can lead critical in assessing the severity of toxicity. This study aims to evaluate the prognostic significance of ACAG, lactate-to-albumin ratio and other laboratory markers in methanol poisoning and to assess the impact of admission time on patient outcome. Methods A retrospective observational study was conducted in a tertiary emergency department. Patients aged ≥18 years presenting with suspected methanol poisoning between January 2020 and December 2023 were included. Diagnosis was based on the American Academy of Clinical Toxicology (AACT) treatment criteria combined with metabolic acidosis and a suggestive history. Clinical and laboratory parameters were compared between good outcome (CPC = 1) and poor outcome (CPC ≥ 2, including deaths) groups. Results Forty-two patients were included. The mean age was 43.45 years and 95.2% were male. The mortality rate was 35.7%. Among patients with poor outcome (n = 17), 15 died and 2 survived with severe neurological sequelae. Patients with poor outcomes had significantly lower pH and bicarbonate levels and higher AG, ACAG, lactate, and creatinine levels (p < 0.001). ACAG ≥25.6 and LAR ≥ 1.24 were the strongest prognostic markers for poor prognosis. Hypotension and osmolar gap differences were noted but were evaluated only as supportive indicators of severity. Conclusion ACAG and LAR can lead useful prognostic markers in methanol poisoning. Patients with ACAG ≥25.6 or LAR ≥ 1.24 should be closely monitored and considered for early intensive management.