PLoS ONE最新文献

Long-term disposal and management of nuclear waste is one of the major hurdles for nuclear energy. Deep geological disposal, an idea originating in the 1970s, is currently the preferred path being followed in many countries. However, acceptance of this approach is hindered by societal concerns around the safety of the "one-million years" geological disposal and passing the waste burden to future generations. iMAGINE, an integrated nuclear system based on molten salt fast reactor technology with self-sustained iso-breeding, online clean-up and reverse reprocessing, has been proposed as an innovative way to eliminate the demand for a long-term high-level waste disposal. In this work, we investigate the use of iMAGINE as a technological approach for reimagining high-level nuclear waste management by overcoming the challenges of classical partitioning and transmutation (P&T). After discussing the current status and limitations of P&T along with an overview of the nuclear waste classification and management framework existing in major nuclear power producing countries, we demonstrate the potential impact of iMAGINE in simplifying the disposal of high-level waste. The results indicate that among the key long-lived radionuclides, many lie well below the criteria for requiring deep geological disposal. Besides Finland, India and Russia where most (or all) of the important long-lived fission products exceed current high-level waste thresholds, only two to three fission products (generally with half-lives from 30 to 100 years) exceed the national limits in Canada, China, France, Germany, Japan, and South Korea, while concrete conclusions can't be drawn for the UK and US based on available information. The results presented here do not aim to make inflated claims but should be seen as the scientific basis for deeper discussions amongst all nuclear waste disposal stakeholders to explore a novel technological solution for rethinking high-level waste management and possibly eliminating the need for a "one-million years" geological disposal.

With the emergence of antiretroviral therapy (ART), changes have occurred over time in the causes of death and pathological findings among people living with HIV, including an increasing contribution of serious non-AIDS-related diseases. Assessing concordance between ante-mortem clinical and post-mortem diagnoses remains an important approach for evaluating diagnostic performance and monitoring changes in causes of death in this population. This study aimed to evaluate the concordance between ante-mortem clinical diagnoses of the underlying cause of death and autopsy diagnoses among adults living with HIV who underwent autopsy at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil, between 2014 and 2019. This cross-sectional retrospective study included 101 autopsies. Class I discordances were identified in 48 of 101 cases (47.6%), predominantly involving infectious diseases (37/48; 77.1%), followed by undiagnosed neoplasms (8/48; 16.7%) and other conditions (3/48; 6.2%). Overall concordance for the underlying cause of death was 36.7%, and most deaths were attributable to AIDS-defining diseases. The absence of ART was associated with a higher frequency of class I discordances. The high frequency of major missed diagnoses may also reflect advanced disease at presentation, overlapping clinical manifestations of opportunistic infections, and limitations in the availability of specific diagnostic methods during the study period. Overall clinicopathological discordance was 63.3%, underscoring the continued value of autopsy for identifying missed diagnoses and highlighting the importance of timely clinical assessment and improved access to sensitive and specific diagnostic methods for adults living with HIV.

[This corrects the article DOI: 10.1371/journal.pone.0281739.].

Animal movement data often contain multiple behavioural states that vary across space and time, but identifying these states in a biologically interpretable way remains challenging. We propose an ecologically guided framework for inferring individual behavioural states from movement trajectories using hidden Markov models with step selection functions (HMM-SSFs). The method combines a small set of a priori, biologically motivated state hypotheses with explicit ordering and distinctness criteria on movement signatures, together with model-adequacy diagnostics and a stable fitting strategy. Unlike fully unsupervised approaches, our framework is designed to select among a limited number of ecologically meaningful behavioural states rather than exhaustively search a large latent state space. Simulations show that the method can recover the intended state structure under different behavioural scenarios, and that inference is sensitive to the specification of control locations in the SSF component. An illustrative application to a plains zebra trajectory demonstrates how the framework can be used to infer and label behavioural states from movement data. Overall, the proposed workflow provides a practical and reproducible way to infer individual-level behavioural states while maintaining ecological interpretability.

Background: Evidence-informed health policymaking (EIPM) is essential for strengthening health systems and achieving equitable health outcomes. Despite policy commitments in Nepal, the translation of research evidence into policy and practice remains limited. This scoping review synthesizes the barriers and facilitators influencing EIPM across health policy domains in Nepal.

Methods: We conducted a scoping review following the Arksey and O'Malley framework and PRISMA-ScR guidelines. Peer-reviewed studies published between 2015 and 2025 that examined barriers and facilitators of EIPM in Nepal were identified through searches of PubMed, Scopus, Embase, and Global Health. Two reviewers independently screened studies, extracted data, and conducted descriptive and thematic analyses.

Results: Of 2,139 records identified, 26 studies met the inclusion criteria. The studies covered maternal and neonatal health, non-communicable diseases (NCDs), nutrition, emergency care, health systems governance, climate-health, public health regulation, and COVID-19 ethics. Barriers were grouped into five themes: systemic and governance challenges; capacity and resource constraints; evidence-related issues; contextual and cultural factors; and operational gaps. Common barriers included political interference, fragmented coordination, workforce shortages, inadequate funding, donor-driven agendas, poor dissemination of research, and limited implementation guidance. Facilitators clustered into four themes: institutional and structural enablers, political and leadership commitment, capacity building and stakeholder engagement, and global and donor support. Sector-specific differences were observed, with socio-cultural barriers more prominent in maternal and neonatal health, governance and coordination challenges particularly evident in NCD policies, and technical capacity and data limitations more pronounced in climate-health policy.

Conclusions: Nepal's EIPM landscape reflects strong commitment but uneven institutionalization. Strengthening governance, institutional capacity, evidence systems, and coordination across federal, provincial, and local institutions is essential to improve the translation of research into policy and practice. Institutionalizing EIPM requires not only producing evidence but also creating systems that routinely generate, translate, and use evidence for decision-making.

Currently, there are still no reliable pre-treatment biomarkers for vedolizumab in ulcerative colitis. To investigate baseline mucosal signals, we reconstructed the discovery cohort from GSE73661 and evaluated the derived panel in the blood samples from GSE191328 and the independent mucosal RNA-seq cohorts from E-MTAB-7845. The reconstructed cohort comprised 24 baseline samples, including 14 composite responders and 10 non-responders. Through repeated LASSO variable selection, the study identified an exploratory gene set consisting of ZNF689, TPRXL, ZC3H10, and MRPL55. The selection procedure yielded a mean held-out AUC of 0.611 across 18 complete nested-validation repetitions; this does not independently validate the final gene set. When the fixed gene set was projected exploratorily, the AUC for 17 blood samples was 0.458 (95% CI 0.162-0.755), and the AUC for 27 independent UC mucosal samples was 0.534 (95% CI 0.293-0.775). The apparent AUC of this gene set on the discovery set was 1.000, and 500 full-process bootstrap analyses indicated that gene selection was unstable. Among the three targeted inflammatory panels, interferon-γ showed a directional difference that was not statistically significant (mean GSVA score difference -0.425; nominal P = 0.066; adjusted P = 0.197). Expression scales and clinical endpoints differed across cohorts. The above results describe post-selection separation within the discovery cohort and do not establish reproducible predictive performance, tissue specificity, or a definitive four-gene signature.

Objective: To determine the prevalence of sarcopenia and identify clinical and functional factors independently associated with confirmed sarcopenia in individuals with stroke undergoing rehabilitation.

Methods: This cross-sectional study enrolled 209 adults with stroke admitted for neurological rehabilitation. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) algorithm, using SARC-CalF, handgrip strength, five-times sit-to-stand test, physical performance measures and appendicular skeletal muscle mass by dual-energy X-ray absorptiometry (DXA). Bivariate analyses and multivariable logistic regression were performed to identify factors independently associated with confirmed sarcopenia.

Results: Confirmed sarcopenia was identified in 55 of 209 participants (26.3%; 95% CI: 20.6% to 32.8%). Participants with sarcopenia were older and had lower body mass index (BMI), poorer physical performance, and greater motor impairment than those without sarcopenia. In the multivariable model, lower BMI (OR = 0.70; 95% CI: 0.59 to 0.83), positive SARC-CalF screening (OR = 6.37; 95% CI: 2.03 to 20.05), and lower Short Physical Performance Battery (SPPB) scores (OR = 0.83; 95% CI: 0.69 to 0.99) remained independently associated with sarcopenia. Motor impairment severity, assessed using Fugl-Meyer motor categories, was also independently associated with sarcopenia.

Conclusion: DXA-confirmed post-stroke sarcopenia affected approximately one in four individuals undergoing rehabilitation and was independently associated with lower BMI, poorer physical performance, and greater motor impairment. These findings indicate that sarcopenia is closely linked to functional impairment after stroke and reinforce the importance of integrating muscle health and functional assessment during rehabilitation. Early identification of individuals at risk may support more individualized rehabilitation strategies and improve clinical decision-making.

Background: Inflammation is a common pathological feature underlying type 2 diabetes (T2D) risk and progression. Determining the roles of fatty acids and bioactive lipid oxylipin inflammatory mediators could inform T2D preventative efforts and therapeutic targets.

Methods: Leveraging the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we evaluated cross-sectional and prospective associations of 81 oxylipins and polyunsaturated, monounsaturated, and saturated fatty acids with T2D. We assessed whether fatty acid levels differed at visit 2 by visit 1-prevalent T2D status and prioritized likely causal metabolites using Bayesian model averaging Mendelian randomization (MR-BMA).

Results: Fifty-four fatty acids and oxylipins were associated with prevalent T2D at visit 1 (15,138 participants; 2,962 T2D cases), four of which (adrenic, dihomo-gamma-linolenic, tricosanoic, and lignoceric acids) were also associated with incident T2D by visit 2 (8,548 participants; 1,376 T2D events), though effects were attenuated for adrenic and dihomo-gamma-linolenic acids upon further adjustment for impaired glucose tolerance. Sixteen out of 28 fatty acids were significantly different at visit 2 between those with and without prevalent T2D at visit 1 (9,115 participants; 2,151 T2D cases), holding visit 1-measured fatty acid levels constant. MR-BMA prioritized one diHETrE oxylipin as a likely causal risk factor for T2D.

Conclusions: Fatty acids and oxylipins showed complex patterns of association with T2D, including more associations likely reflecting overt disease processes in prevalent T2D, than incident risk-enhancing associations.

This retrospective study examined the historical progression of Olympic swimming performance across 24 Olympic Games from Paris 1924 to Paris 2024. Finalist race data for 1553 women and 1641 men were extracted from the official World Aquatics database, including final times, reaction times, and calculated swimming speeds across all strokes (freestyle, backstroke, breaststroke, butterfly) and Olympic distances (50-1500 m). Across all strokes and distances, final times demonstrated substantial reductions over the century, with the most pronounced improvements observed in freestyle and long-distance events. The largest percentage improvements in performance were observed during specific Olympic cycles, including 1956, 1972, and 2008, which coincided with major developments in pool engineering, competition regulations, training methodologies, and swimsuit technology. Swimming speeds increased consistently in all events, while reaction-time analyses revealed significant improvements across Olympic Games during the period in which reaction-time data were recorded. Overall, these findings demonstrate substantial long-term improvements in Olympic swimming performance and provide a comprehensive historical overview of performance changes across strokes, distances, and sexes. The periods associated with the largest performance improvements coincided with major technological, biomechanical, and regulatory developments in the sport. The results may serve as valuable benchmarks for coaches, athletes, and sports scientists to evaluate long-term performance trends and prepare for future international competitions.

Background: Osteosarcopenia - the concurrent presence of sarcopenia and low bone mass, including osteopenia or osteoporosis - is emerging as a significant health issue in aging populations. This study aimed to estimate the prevalence of osteosarcopenia and identify factors associated with prevalent osteosarcopenia among older Vietnamese outpatients.

Materials and methods: A cross-sectional study was conducted on 389 outpatients aged ≥60 years at Can Tho University of Medicine and Pharmacy Hospital from 01/202511/2025. Osteosarcopenia was defined by coexistent low bone mass (osteopenia/osteoporosis via DXA) and sarcopenia defined according to AWGS 2019 as low muscle mass accompanied by low muscle strength, low physical performance or both. Logistic regression analyses were used to assess factors associated with osteosarcopenia. All data were analysed using R version 4.5.5.

Results: The overall prevalence of osteosarcopenia was 26.7% (95% CI 22.6-31.3%). Prevalence was similar in women and men (26.3% vs 28.6%, p = 0.68). On multivariable analysis, older age (per 1-year increase; OR 1.06, 95% CI 1.02-1.10), lower BMI (per 1 kg/m2 increase; OR 0.57, 95% CI 0.50-0.65), coronary artery disease (OR 2.07, 95% CI 1.09-3.95), and diabetes (OR 2.48, 95% CI 1.35-4.56) were independently associated with osteosarcopenia.

Conclusion: Osteosarcopenia affected about one in four older outpatients in this Vietnamese cohort. Older age, lower body mass index, coronary artery disease, and diabetes were independently associated with osteosarcopenia. These findings highlight the importance of early screening and integrated management of bone and muscle health in older adults.