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Authors: Ruqaiya Al Ramadhani, Newshaw Arvin, Saphy Moussa, Monika Janda, Mary C. Playdon, Andreas Obermair

Composite dietary and lifestyle indices capture the combined effects of multiple health-related behaviours and may better reflect real-world cancer risk and survivorship than single exposures. This umbrella review aimed to evaluate and grade the strength of evidence for associations between adherence to composite dietary and lifestyle quality indices and endometrial cancer (EC) outcomes, including risk, EC-specific survival, overall survival, disease recurrence, quality of life, and new-onset cardiometabolic diseases. PubMed, Embase, Scopus, Web of Science, CINAHL, and Cochrane Library databases were systematically searched for relevant systematic reviews. Evidence was graded using prespecified umbrella review criteria. A total of 21 systematic reviews were included. Nine investigated diet quality (7 meta-analyses) and 12 investigated lifestyle exposure or interventions (8 meta-analyses). The outcomes assessed were EC risk (N = 14), all-cause or cancer-specific mortality (N = 5), recurrence (N = 4), overall or cancer-specific survival (N = 3), QoL (N = 5), and cardiometabolic events (N = 1). Following a Mediterranean diet was associated with 29% lower odds of EC (pooled OR = 0.71, 95% CI 0.51–0.98; class IV), whereas Western dietary patterns were associated with 20% higher odds of EC (pooled OR = 1.20, 95% CI 1.03–1.39; class IV). A combined healthy diet and lifestyle approach was associated with a 46% lower hazard of EC incidence (pooled HR = 0.54, 95% CI 0.42–0.71; class III), although heterogeneity was high. No significant associations were observed between lifestyle interventions and global or domain-specific quality of life (QoL) across follow-up durations ranging from 9 weeks to 12 months, irrespective of the validated assessment instruments used. Evidence remains limited regarding the associations between diet and lifestyle factors and EC recurrence, survival, mortality, and cardiometabolic outcomes. Our umbrella review identified suggestive (class III–IV) evidence for associations between healthy dietary patterns, particularly the Mediterranean diet, and combined healthy lifestyle approaches with lower EC incidence. Evidence remains insufficient or non‐significant for post-diagnosis outcomes, underscoring the need for further high-quality research.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360238. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Ngozi Precious Uwagboe, Adaku Israel Obia, Onyinye Lilian Nwaolai, Pemije Gadimoh, Eghosa Osahon Alari, Carolyne Naana Yanney, Nnamdi John Eseme, Uchechukwu Levi Osuagwu

Dance, as a culturally embedded and universally accessible form of art, offers a promising medium for health education in settings with diverse literacy levels. This pilot study evaluated the feasibility and immediate effects of a multimodal, dance-integrated educational video package designed to improve eye health knowledge, attitudes, and preventive intentions among Nigerian adults. Between April 11 and June 22, 2025, adults recruited through optometry clinics and community outreach programmes viewed culturally tailored educational videos addressing at least one eye condition (myopia, cataract, or glaucoma) and general eye health, including common myths and preventive practices. Pre–post changes were assessed using paired comparisons, with subgroup analyses by educational attainment. Among 438 participants, 77.7% were aged 18–44 years, 52.5% were female, 75.1% had higher education, 80.0% reported existing health-promoting behaviours, and 79.7% considered regular eye examinations important. Following the intervention, perceived eye health knowledge increased from 42.0% to 68.0% (absolute increase, 26.0 percentage points; relative increase, 61.9%; p = 0.013; Cramér’s V = 0.279), while objective eye health knowledge scores increased by 52.4 percentage points (p = 0.013; Cramér’s V = 0.069). Self-reported intentions to adopt protective practices, including wearing sunglasses, reducing screen time, and attending regular eye examinations, also increased. Overall intention to visit an eye clinic increased by 10%, although this change was not statistically significant (p = 0.443), likely reflecting high baseline health-seeking intentions. The largest improvements in willingness to attend regular check-ups occurred among participants with secondary education (27.5% to 96.3%, p < 0.001) and those with primary or no formal education (41.4% to 96.6%, p < 0.001). Dance-integrated educational videos were associated with immediate improvements in eye health knowledge and preventive intentions, particularly among participants with lower educational attainment, supporting their potential as a culturally relevant and scalable approach to eye health communication in diverse, resource-limited settings and community-based health promotion programmes.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0005585. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Agmas Wasie Abate, Assasahegn Tedla, Gashaw Mehiret Wubet, Getasew Legas, Amsalu Belete, Kirubel Shiferaw, Getnet Mihretie Beyene, Assefa Agegnehu Teshome, Wondimnew Desalegn Addis, Melaku Mekonnen Agidew, Samuel Berihun Dagnew, Belete Asnake Sitotaw, Birhanu Mengist Munie

Introduction Multidrug-Resistant Tuberculosis (MDR-TB) continues to pose a serious global health challenge, particularly in low-income and lower-middle-income countries where the disease burden, fragile health systems, and socioeconomic hardships are most pronounced. These conditions not only complicate treatment but also worsen patients’ vulnerability to depression. Although numerous primary studies have investigated the prevalence of depression among individuals with MDR-TB, their findings have been inconsistent. To address this gap, the present study seeks to estimate the pooled prevalence of depression and identify its associated factors among MDR-TB patients in low- and lower-middle-income countries. Methods Relevant studies were sourced from Google Scholar, Scopus, PubMed, and Web of Science. Additionally, the reference lists of selected articles were manually reviewed to identify further eligible publications. A random-effects model was employed to calculate the pooled prevalence of depression among MDR-TB patients in low- and lower-middle-income countries. Results The meta-analysis incorporated 23 primary studies with a combined sample of 5,734 MDR-TB patients. The pooled prevalence of depression among this population was 41.89% (95% CI: 32.63–51.15; I² = 98.51%, P < 0.001). Several factors were significantly linked to depression, including female gender (AOR = 2.00, 95% CI: 1.66–2.41), financial hardship (AOR = 2.56, 95% CI: 1.44–4.55), presence of comorbidities (AOR = 3.72, 95% CI: 2.11–5.38), greater disease severity (AOR = 2.13, 95% CI: 1.42–3.12), medication-related side effects (AOR = 2.77, 95% CI: 2.20–3.48), and perceived stigma (AOR = 3.58, 95% CI: 2.13–6.02). Conclusions The prevalence of depression among MDR-TB patients in low- and lower-middle-income countries was found to be notably high. These findings emphasize the importance of implementing routine depression screening and integrating psychosocial support into patient care.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360738. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Ga-Hyeon Jeong, Sung-Jea Park, Kyu-Sang Lim

Weaning exposes piglets to abrupt nutritional and environmental changes that induce physiological stress. Saliva, unlike serum or tissue samples, enables repeated and stress-free sampling, making it a practical biological matrix for monitoring early-life adaptation. To evaluate whether salivary microRNAs (miRNAs) can serve as non-invasive indicators of these responses, we profiled miRNA expression in saliva collected from suckling and weaning piglets. Small RNA sequencing was conducted to detect salivary miRNAs and a total of 41 differentially expressed miRNAs (DEMs) were detected between the two groups, with 20 showing highly expression and 21 showing lowly expression in weaning piglets. Several of these DEMs have been previously associated with immune activity, inflammatory regulation, oxidative stress responses, and disease processes, highlighting their biological relevance during the weaning transition. Functional annotation of predicted target genes revealed enrichment in pathways such as TGF-beta, HIF-1, and AMPK signaling, as well as autophagy-related processes. These pathways are known to play key roles in stress adaptation, cellular metabolism, and immune modulation. These findings suggest that salivary miRNA profiles may reflect molecular changes associated with the weaning transition and may serve as candidate non-invasive indicators of physiological stress and health status in piglets. This approach may provide a basis for future development of saliva-based monitoring strategies after validation in larger cohorts and cost-effective targeted assays.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360727. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Tina M. Olsson, Hanna Ginner Hau, Sabina Kapetanovic, Diana Kajic, Therése Skoog

School-level social determinants of health (SDOH) account for a large share of variation in students’ health behaviors. Because educational attainment is itself a key social determinant of health—shaping later employment, income, and health—efforts to promote equitable health must include understanding and improving school climate as a mechanism influencing academic achievement and wellbeing. This project examines how school-level SDOH develop and how they relate to later employment, income, and health outcomes in a representative sample of Swedish young people. It also investigates how school staff and students perceive the school’s ability to address school-level SDOH and develops and pilots an intervention aimed at strengthening these determinants. This multi-method, multi-informant study uses a large longitudinal dataset following a representative cohort from ages 12–20. Additional primary data will be collected from school staff and students to assess perceptions of school-level SDOH. The project will also design and test an intervention intended to improve students’ academic achievement, a central pathway influencing later employment, income, and health. Combining longitudinal data with new qualitative and quantitative materials allows the project to examine the development of school-level SDOH and the mechanisms through which they shape long-term outcomes. Education is essential for strengthening skills, economic opportunities, and health equity. Strong links exist between education level, employment, income, and health, making this project relevant for students, families, school personnel, and broader policy development. Findings may guide schools and policymakers in improving school environments to support achievement and long-term health equity. The project involves extensive data collection and collaboration across disciplines and universities. By integrating multiple methods, it aims to advance knowledge on how education influences employment, income, and health while informing school-level and policy-level strategies to support academic achievement and wellbeing.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360645. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Hanna Lu, Xi Ni, Natalie Shu Yang, Yuk Shan Yuen, Yuqi Gong, Suk Ling Ma

Background Subjective cognitive decline (SCD) is increasingly recognized as an early and potentially modifiable stage in the trajectory of neurodegenerative diseases. In older adults with SCD, untreated sleep disturbances may accelerate the neurodegenerative process, potentially via mechanisms involving amyloid-beta accumulation, and contribute to more rapid cognitive deterioration. Currently, non-pharmacological treatment options that concurrently manage SCD and sleep disturbances remain scarce. High-definition slow-oscillatory transcranial direct current stimulation (so-tDCS) is an emerging, frequency-specific neuromodulation technique designed to enhance brain health and cognition. Methods and design This is a randomized, double-blind, sham-controlled clinical trial. Right-handed Chinese older adults with SCD and sleep disturbances will be randomly assigned to receive either high-definition 0.75 Hz so-tDCS or sham stimulation over a 4-week intervention period, with 40 participants per group. Outcome measures, including galvanic skin response, subjective cognitive complaints, sleep quality, salivary amyloid-beta levels, and domain-specific cognitive performance, will be evaluated at four time points: baseline, week 4 (immediately post‑intervention), and follow‑up at weeks 8 and 12. Conclusions Personalized neurophysiological signals, namely electrode-skin impedance, will be monitored using state-of-the-art measurement during so-tDCS. The successful implement of this signal will provide researchers with access to an “add-on” setting that enables them to easily, quickly and quantitatively evaluate real-time neurophysiological signals, thereby facilitating the incorporation of transcranial brain stimulation into clinical practice. Trial registration ClinicalTrials.gov Identifier: NCT07433738

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360573. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Olufunke Fasawe, Abubakar Abba, Abubakar Yerima Mohammed, Cynthia Kukoyi, Kabiru A. Gulma, Ashiru A. Abubakar, Abdulrahman Shuaibu, Bello Jamoh, Mohammed Nasir Mahmoud, Yahaya Shamsudeen, Ibrahim A. Mustafa, Ibrahim A. Dangana, Abubakar Yakubu, Ahmed Sani, Babawale Peter, Oyewole Oladapo, Nazeef Mohammed, Nasir Umar, Lawrence N. Anyanwu, Adebowale S. Ayo

Background Nigeria’s poor health indicators have been linked to its dysfunctional Primary Health Care (PHC) facilities. Policy gaps remain in achieving sustainable and equitable provision of PHC for Nigerians. Therefore, this study examined the relationship between health facilities’ readiness and service provision in Nigeria. Methods This was a cross-sectional assessment of 204 PHC facilities enrolled under the Basic Health Care Provision Fund program, in six prioritized states in Nigeria. The facilities were assessed for the provision of ≥80% of the three levels of primary healthcare services—Tier 1, Tier 2, Tier 3—as the outcome variables. The three tiers represent the minimum, intermediate, and comprehensive levels of essential PHC services, respectively, defined under Nigeria’s Minimum Service Package. Health Facility (HF) readiness (explanatory variable) was assessed across six domains, with five of the domains disaggregated into 3 levels (poor, fair, and good). Data were analysed using Principal Component Analysis (PCA) and multivariable logistic regression model (alpha = 0.05). Results The majority (81.9%) of the HFs have a functional management committee, 54.4% have an updated BHCPF annual quality improvement plan, 81.9% have standard operating procedures. While 16.2% met the World Health Organization standard ≥2.3 Health Care Workers (HCWs)/1000 population, none met the Minimum Service Package standard for HCWs across all cadres. The proportion of facilities with good readiness in each domain was: management and finance (42.6%); Health Management Information System tools/registers, supply chain tools/registers, and guidelines (40.2%); infrastructure and utility (33.3%); tracer equipment (34.8%); and tracer drugs (29.9%). The percentage of HF that provided ≥80% services was: Tier 1 (65.2%), Tier 2 (46.6%), and Tier 3 (35.8%); while 31.9% met ≥ 80% across all the service Tiers. Common predictors of providing ≥80% across the service Tiers were tracer drugs and equipment availability. The likelihood of delivering all Tiers of services was higher in HF with fair (aOR=2.38, 95% CI = 1.92-11.14, p < 0.05) and good (aOR=3.93, 95% CI = 1.96-8.49) levels of tracer equipment readiness compared to the poor. Conclusion Good PHC facility readiness supports the provision of health care services in Nigeria. Availability of tracer drugs and equipment predicts the provision of healthcare services in PHC facilities. Investment in PHC facility functionality and prioritization of funds for tracer drugs and equipment will therefore improve service availability and delivery in Nigerian public PHC facilities.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360425. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Pavan Kumar, Megha Paul, Preeti Kumari, Manmohan Dobriyal, Pankaj Lavania, Manish Srivastav, Prem Chandra Pandey, Benson Turyasingura

Accurate modeling of species distribution is essential for effective biodiversity conservation, afforestation planning, and land-use management. This study presents a comparative analysis of two prominent presence-only species distribution models Maximum Entropy (MaxEnt) and MaxNet to evaluate their efficacy in predicting the ecological niche of Eucalyptus tereticornis in a semi-arid agro-climatic region. A total of 138 georeferenced occurrence records and 25 pseudo-absence points were used, incorporating key environmental variables such as wind speed, temperature range, precipitation, and root zone soil wetness. Both models were optimized and assessed using metrics including accuracy, precision, recall, F1-score, and the Area Under the Curve (AUC). Results indicate that MaxEnt outperformed MaxNet in most metrics, achieving an accuracy of 87.5% and an AUC of 0.956, compared to MaxNet’s accuracy of 75% and AUC of 0.926. Environmental variable importance varied by model, with MaxEnt highlighting surface pressure and MaxNet emphasizing wind speed. Probability density plots revealed that MaxEnt distinctly identified high suitability zones, whereas MaxNet offered a more balanced, conservative distribution across the landscape. These differences underscore the influence of algorithm design on ecological inference. This study emphasizes the importance of model selection and tuning in species distribution modeling and suggests that integrating outputs from both models can yield robust insights for habitat suitability assessment. The findings support data-driven afforestation strategies, especially under changing climatic conditions, and provide valuable guidance for sustainable plantation efforts involving Eucalyptus tereticornis in similar agro-ecological zones.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360385. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Caroline Feldthusen, Magnus Hallström, Erik Hulander, Anna Deminger, Helena Forsblad-d’Elia

Objectives To evaluate the impact of physical function and level of physical activity on health status and health-related quality of life (HRQoL) in patients with long-standing radiographic axial spondyloarthritis (r-axSpA). Methods In total, 141 patients with long-standing r-axSpA were included in this cross-sectional cohort study. Assessments included physical function (Bath Ankylosing Spondylitis Functional Index (BASFI)), spinal mobility (modified Bath Ankylosing Spondylitis Metrology Index (BASMI)), muscle function for leg strength (Timed Stands Test (TST)) and handgrip force (Grippit), amount of self-reported physical activity (vigorous physical activity, moderate physical activity, sedentary behavior), health status by ASAS Health Index (ASAS HI) and HRQoL with Short Form Survey Instrument 36-Item. Multivariable linear regression was used to analyze associations between health status, HRQoL, physical activity, muscle function, and physical function. Results The mean (SD) age was 60 (12) years, diagnosis duration was 25 (10) years, and 57% were male. Physical function and vigorous physical activity were the strongest determinants of health status and HRQoL. The models explained approximately 50% of the variation in ASAS HI and the physical aspects of HRQoL and 21% of the mental aspects of HRQoL. Participants displayed good health status (62%) by ASAS HI ≤ 5, reached the recommended level of health-enhancing physical activity (77%), had normal muscle function (TST 82% and Grippit 91%), and demonstrated physical function (55%), and spinal mobility (45%) within reference values. Conclusion This study highlights the importance of regular vigorous physical activity in older individuals living with long-standing r-axSpA since it was strongly associated with health status and HRQoL.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360248. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Firayad Ayele, Tesfaye Assebe, Miheret Mandefro, Desalegn Admassu Ayana, Nega Assefa

Background Rotavirus and norovirus are the leading viral causes of acute diarrheal disease worldwide. Both viruses encompass multiple genotypes and subgenotypes, and this genetic diversity presents a significant challenge to rotavirus vaccine effectiveness and development. High-quality evidence on the prevalence and circulating genotypes of these enteric viruses among children under five years of age remains limited, particularly following the introduction of rotavirus vaccination in low and middle-income countries (LMICs). Therefore, this systematic review and meta-analysis aimed to synthesizes available evidence on the prevalence and genotype distribution of norovirus and rotavirus in this population. Methods A systematic literature search was conducted across five major databases PubMed, Scopus, ScienceDirect, Embase, and Web of Science between February 20 and 28, 2026. Duplicate removal, title and abstract screening, full-text review and data extraction were performed independently by two investigators using the Rayyan web-based platform. STATA version 17 software was used for statistical analysis. A random-effects model was applied to estimate pooled prevalence and effect sizes. Heterogeneity was evaluated using Cochran’s Q statistic, the I2 statistic, forest plots, and Galbraith plots. Publication bias was assessed using both graphical (funnel plots) and statistical methods. Results A total of 35,704 children under five years with diarrheal infection from LMICs were included across eligible studies. The overall pooled prevalence of norovirus and rotavirus combined was 18% (95% CI: 15–21%). Rotavirus had a higher pooled prevalence than norovirus, at 24% (95% CI: 19.6–28.3%) and 13% (95% CI: 11–15%), respectively. Substantial heterogeneity was observed across studies (I2 = 98.72%, p < 0.001). Among norovirus genotypes, GII was predominant (76%), with subgenotype GII.4 accounting for 53% of cases, followed by GI (23%). The most frequently identified rotavirus genotypes were G3[P8] (39%) and G1[P8] (17%). Conclusions Norovirus and rotavirus remain significant causes of diarrheal disease among children under five in LMICs, even after the introduction of rotavirus vaccination. Approximately one in five children with diarrheal illness were infected with at least one of these virusesGII, particularly subgenotype GII.4, was the dominant norovirus strain, while G3[P8] and G1[P8] were the most prevalent rotavirus genotypes. These findings underscore the need to strengthen surveillance systems, consider circulating genotypes in vaccine formulation, and continuously monitor genotype shifts within the population.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0359886. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Kuo-Ying Wang, Philippe Nedelec, Valerie Thouret, Hannah Clark, Andreas Wahner, Andreas Petzold

Carbon monoxide (CO) is not a greenhouse gas, but as the dominant sink of the hydroxyl radical it governs the oxidising capacity of the troposphere and so indirectly forces climate. Its trends in the North Pacific upper troposphere matter disproportionately: this is the principal outflow corridor for Asian anthropogenic emissions, the fastest-growing combustion source of the past half-century, yet it has almost no routine ground-based monitoring and satellite retrievals resolve it poorly. We therefore combine in-situ CO measurements from the In-service Aircraft for a Global Observing System (IAGOS; 2012–2018) with earlier in-situ data from NASA/NSF/NOAA campaigns (1991–2019), the Measurements of Pollution in the Troposphere (MOPITT) satellite record, and the Integrated Modelling System (IMS) global chemistry transport model. Trends are computed separately for the monthly maximum, percentile, minimum and mean statistics, using a 10,000-sample perturbation regression framework. Mean CO increases by 0.15 ppb month–1 (18.0 ppb decade–1; 95% CI: −0.02 to 0.32) over 150∘E−140∘W, 45∘N−60∘N and by 0.06 ppb month–1 (7.2 ppb decade–1; 95% CI: −0.04 to 0.16) over 25∘N−45∘N; both intervals include zero but lie predominantly positive. The monthly maximum rises significantly over 25∘N−45∘N, by 0.31 ppb month–1 (37.2 ppb decade–1; 95% CI: 0.06 to 0.57), while the monthly minimum declines weakly. The most polluted air masses over the North Pacific are thus becoming more polluted even as background CO falls. The North Atlantic upper troposphere shows significantly decreasing CO over the same period. The opposing signs track the opposing trajectories of the upwind inventories: Asian emissions rose through most of the record and are lifted efficiently by summertime convection and warm conveyor belts, whereas North American and European emissions fell steadily and the Atlantic receives a larger share of CO-poor stratospheric air.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0359855. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.