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Authors: Dominique Guillaume, Laetitia Mélissande Amédée, Maria Alcaide, Joy Chepkorir, Ashley Gresh, Ann Augustin, Laeticia Jean Baptiste, Kamila Alexander

Haitian migrant women in the U.S. experience disproportionate rates of cervical cancer. Intravaginal practices (IVPs) are widely used among Haitian women and have been linked to an increased risk of human papillomavirus (HPV) infection. Although IVPs are well-documented in the Haitian community, little is known about Haitian migrant women’s perceptions and motivations underlying their use. This exploratory sequential mixed-methods study examined Haitian migrant women’s motivations for engaging in IVPs, products used for IVPs, and indications for their use. A convenience sample of Haitian migrant women in South Florida were recruited through active and passive recruitment approaches in community-based centers. Semi-structured qualitative interviews (n = 25) explored perceptions, motivations, and products used for IVPs. Qualitative results informed the development of survey items measuring IVPs, which were administered to participants (n = 151). Chi-square analysis with a Bonferroni adjustment examined associations between IVP products and IVP indications. All women in the qualitative sample (n = 25, 100%) confirmed IVP use compared to 68.9% (n = 104) of women in the quantitative sample. Qualitative interviews revealed that IVP preferences were rooted in cultural expectations with most women starting these practices either during puberty or after sexual debut. IVP products (e.g., plant and herbal agents, astringent washes, and antibiotics) were often chosen based on specific gynecologic indications, with this finding being consistent across both samples. Pigeon pea (pwa kongo) was the most frequently used IVP product in the quantitative sample (n = 74, 71.2%) and was associated with nearly all IVP indications (p ≤ 0.004). Given the high prevalence of IVPs in our sample, researchers and practitioners should further examine the meaningful health risks and protective effects associated with IVPs.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007394. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Mehdi Farhadi, Afsaneh Pakdaman, Mahdia Gholami

Background Nutrition plays a crucial role in oral health, influencing the risk of caries, periodontal disease, erosion, and oral cancers. Dentists are key providers of dietary guidance, but require adequate knowledge to do this effectively. This study compared the impact of multimedia versus audio-based educational interventions on the knowledge and self-reported behavior of general dentists in Tehran regarding nutrition and oral health. Methods In this randomized controlled trial, 166 general dentists in Tehran were recruited in 2023 through professional online platforms and randomly allocated to either a multimedia-based or an audio-based educational intervention. Knowledge (11 items) and behavior (9 items) regarding the impact of nutrition on periodontal health, dental caries, oral cancer, and erosion were assessed using a validated questionnaire. The educational intervention was delivered over a one-month period. Within-group changes were assessed using paired t-tests, between-group differences using repeated-measures ANOVA, and the effect of demographic variables on post-intervention scores using ANCOVA, with baseline values as covariates (α = 0.05). Results Of the participants, 53.6% were women, and 37.9% worked in private practice. Both groups demonstrated significant improvements in knowledge and behavior scores following the intervention (p < 0.001), with greater gains observed in the multimedia group. Analysis of covariance indicated that baseline knowledge and behavior were not significantly associated with age, gender, dental school, years of professional experience, or practice setting. Conclusion Both multimedia- and audio-based educational interventions effectively improved dentists’ knowledge and self-reported behaviors related to nutrition and oral health. Therefore, given dentists’ busy work schedules, the use of these educational approaches may enhance their capacity to provide evidence-based counseling in the field of nutrition and oral health.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360426. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Linda Frost, Jana Borras, Ariel Dysangco, Vimbayi Carine Makwaira

Nursing students experience high levels of stress that can negatively affect mental health and well-being. This study explored practical nursing students’ perceptions of the acceptability and perceived value of a brief mental fitness workshop integrated into nursing education. Two sessions from a condensed version of the Mastering My Mental Fitness for Nurses program were embedded within a fourth‑semester laboratory course. A qualitative descriptive design was used, drawing on reflexive thematic analysis of semi‑structured interviews (n = 5) and free‑text post‑session feedback forms (n = 49). Participants reported enhanced awareness of stress and burnout, reframed self‑care as a professional responsibility, and valued opportunities for peer connection through small‑group discussions. Students recommended earlier and more frequent integration within the curriculum and greater flexibility in delivery. While the findings reflect short‑term perceptions rather than clinical outcomes, the workshops were perceived as feasible and acceptable, with implications for mental health promotion and burnout prevention among nursing students. Future research should examine impact using validated mental health and well-being measures.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000760. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Ruhul Amin, A S M Rafad Asgar

Bullying victimization is an important public health concern that has been linked to adverse psychological outcomes among adolescents. The study used mental health well-being data collected in the most recent Bangladesh Adolescent Health and Wellbeing Survey (2019–2020) (BAHWS). A total of 9,116 adolescents aged 15–19 years with complete depression data were included in the analysis. A three-level linear mixed-effects model was employed to account for the hierarchical structure of the survey, with adolescents nested within primary sampling units and districts. Additional analyses examined gender and marital status interactions, subgroup differences, and the cumulative association between multiple forms of bullying and depressive symptoms using a composite bullying measure. The findings revealed that verbal bullying (β = 1.39, p < 0.001) and cyberbullying (β = 1.15, p = 0.012) were independently associated with higher depressive symptom scores. The association between physical bullying and depressive symptoms differed significantly by gender, whereas interactions of gender with verbal and cyberbullying were not statistically significant. Exploratory subgroup analyses showed variation in the magnitude of estimated associations across ever-married females, unmarried females, and unmarried males. A graded association was observed for cumulative bullying exposure: compared with adolescents reporting no bullying exposure, those exposed to on (β = 1.25), two (β = 2.61), and three (β = 4.99) bullying types had progressively higher depressive symptom scores (all p < 0.001). Adolescent Age, Current school or college attendance and higher household wealth were associated with lower depressive symptom scores. Bullying victimization, particularly verbal bullying, cyberbullying, and exposure to multiple forms of bullying, was associated with higher depressive symptoms among Bangladeshi adolescents. These findings highlight the need for comprehensive bullying prevention strategies and accessible psychosocial support services, with particular attention to adolescents experiencing multiple forms of bullying and other vulnerable groups.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000722. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Akira Hayasaka, Yasuhiro Nakanishi, Marika Nomura, Eri Osawa

Universal health coverage (UHC) and human development are closely linked, but whether this relationship differs across UHC domains remains unclear. We conducted a retrospective country-level longitudinal panel study using publicly available data from 2000 to 2021 to examine associations of the UHC service coverage index (SCI) and its four sub-indices with the Human Development Index (HDI) and its component indices for gross national income (GNI), education, and life expectancy. We also quantified differences in the UHC SCI, its sub-indices, and the HDI across World Bank income groups and World Health Organization regions using population-averaged generalized estimating equation models. UHC service coverage improved over time across income groups and regions, but progress was uneven. Persistent income-group disparities were observed for the overall UHC SCI, infectious diseases (IDs), service capacity and access (SCA), and the HDI, whereas disparities were smaller for reproductive, maternal, newborn, and child health (RMNCH) and less pronounced for noncommunicable diseases (NCDs). After covariate adjustment, regional differences were generally smaller than income-group disparities; RMNCH showed little regional variation, whereas SCA remained significantly lower in the African Region. Higher HDI was associated with better UHC performance, with adjusted increases of 6.8 points (95% CI 5.6–8.1) for the UHC SCI, 11.7 (95% CI 9.2–14.1) for SCA, 6.2 (95% CI 4.2–8.1) for ID, and 4.9 (95% CI 3.2–6.7) for RMNCH per 0.1-unit increase, whereas the increase for NCD was smaller (2.2 points, 95% CI 0.4–4.0). Among HDI components, the education index was not associated with NCD after adjustment, whereas the GNI and life expectancy indices were positively associated with NCD, although the estimated increases were smaller than those for most other sub-indices. These findings may help policymakers interpret the UHC SCI and its sub-indices in the context of their countries’ broader development trajectories.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007328. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Sarah Tong, Grace Faulkner, Sarah Rhea, Annette Greer, Emily S. Bailey

An increasing number of households in the United States keep backyard poultry, including small hobby flocks, or purchase eggs from backyard poultry farmers. Concerns about rising grocery prices and a growing interest in homesteading have driven a surge in poultry-related sales. Some research has been conducted to understand the prevalence of zoonotic bacteria and antimicrobial resistance of the backyard environment; however, with the expansion of backyard hobby flocks and increasing availability in chicken breeds, more information is needed about these interactions at the human-animal interface. This study aimed to identify the presence of three common bacterial species (Salmonella spp., E. coli, and Campylobacter spp.), and describe their antimicrobial resistance (AMR) profiles, among samples taken from backyard hobby poultry owners and their flocks. During January−June 2024, a total of 99 samples were collected, including 17 human nasopharyngeal swabs, 15 poultry fecal matter swabs, 12 poultry water bowl swabs, 14 soil samples, 10 poultry bedding samples, and 31 other environmental swabs, from across 15 participating farms. Analysis of resistance by Kirby-Bauer disc diffusion showed that 40% (40/99) tested positive for E. coli and 46% (46/99) tested positive for Campylobacter, with 32.5% (13/40) of E.coli having TEM and 91.3% (42/46) of Campylobacter strains exhibiting resistance to erythromycin. Antimicrobial resistance in backyard hobby poultry settings could contribute to the spread of resistant strains – and harder-to-treat infections - in poultry and humans. Future studies, including additional participants and serial environmental sampling, could help inform backyard hobby poultry-related public health interventions like enhanced husbandry practices and biosecurity.

Source: PLOS Water. DOI: 10.1371/journal.pwat.0000565. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Yueh-Hsin Wang, Ajay Aggarwal, Elizabeth A. Davies

People with pre-existing mental health disorders (PMHD) often have lower cancer screening uptake and later-stage diagnoses. It remains unclear whether these disparities persist within highly accessible universal healthcare systems without strict gatekeeping. We simultaneously investigated the associations between PMHD and both screening participation and stage at diagnosis of breast and bowel cancers within the Taiwan health service. Using nationwide National Health Insurance and Cancer Registry data covering over 99% of the population, we compared outcomes between individuals with and without PMHD. Propensity score matching was applied for the screening cohort. Adjusted odds ratios were estimated using logistic regression, with subgroup analyses for severe PMHD. Overall, PMHD was associated with higher screening participation (adjusted odds ratios [aOR]: breast = 1.04, bowel = 1.12) and reduced odds of metastatic disease at diagnosis (breast = 0.72, bowel = 0.93), although the magnitude of these associations was modest, particularly for bowel cancer. Conversely, individuals with severe PMHD had significantly lower odds of screening (breast = 0.81, bowel = 0.88) despite high outpatient use. Furthermore, while the severe group retained reduced odds of metastatic breast cancer at diagnosis (aOR = 0.79), they showed no staging advantage for bowel cancer. While Taiwan’s highly accessible universal healthcare system may contribute to a surveillance effect benefiting the general PMHD population, significant disparities persist for individuals with severe illnesses. Targeted interventions, procedural simplifications for self-administered tests, and multidisciplinary person-centred care models, may be needed to ensure health equity.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0361617. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Haoyuan Yu, Zhibiao Yang

Objective Problematic micro-drama use (PMDU) has received increasing attention as micro-dramas have become widely consumed among young adults in China. This study examined the associations between academic stress and PMDU among Chinese university students, explored which dimensions of academic stress were uniquely associated with PMDU, and examined the associations between PMDU and loneliness, anxiety symptoms, and depressive symptoms. Methods A cross-sectional online survey was conducted among 510 Chinese university students. Participants completed measures of academic stress, PMDU, loneliness, anxiety symptoms, and depressive symptoms. Multiple linear regression analyses were conducted while controlling for gender and age. The Benjamini–Hochberg false discovery rate (FDR) procedure was applied to relevant families of multiple tests. Results Higher academic stress was associated with greater PMDU (β = .447, p < .001). Among the five dimensions of academic stress, learning effectiveness pressure remained significantly associated with PMDU after correction for multiple comparisons (β = .292, FDR-adjusted p < .001), whereas the other dimensions did not show statistically significant unique associations after correction. PMDU was positively associated with loneliness (β = .331), depressive symptoms (β = .323), and anxiety symptoms (β = .305), and all three associations remained significant after FDR correction (all FDR-adjusted p < .001). Conclusions Academic stress, particularly stress related to perceived learning effectiveness, was associated with greater problematic micro-drama use among Chinese university students. Higher PMDU was also associated with greater loneliness, depressive symptoms, and anxiety symptoms. These findings identify PMDU as a media-use behavior relevant to both academic stress and psychological well-being, although the cross-sectional design does not establish the direction of these associations.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0361597. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Benedict Ayobi, Gwendolyn Otwiwa Attram, Bright Vandyke Okyere, Belinda Aba Osrah, John Kwesi Assan, Samuel Abokyi

Purpose Dry Eye Disease (DED) is highly prevalent among university students and may be influenced by modifiable factors such as psychological stress and sleep disturbance. The primary objective of this study was to investigate the associations of sleep disturbance and perceived stress with DED, while the secondary objective was to evaluate their potential interaction. Methods This analytical cross-sectional study included a random sample of university students aged 18–34 years. Perceived stress was assessed using the Perceived Stress Scale, and sleep quality was evaluated using the Pittsburgh Sleep Quality Index. DED was diagnosed according to TFOS DEWS II criteria using the Ocular Surface Disease Index, tear break-up time, corneal staining, and Schirmer testing. Robust Poisson regression models were used to estimate relative risks (RRs) for DED associated with sleep disturbance and stress. Interaction effects were assessed on both additive and multiplicative scales. Results The prevalence of DED was 77.9%. Sleep disturbance was present in 75.9% of participants, while 21.3% reported high perceived stress. In univariate analyses, both sleep disturbance and stress were significantly associated with DED prevalence (sleep disturbance: χ²(1, 403) = 14.57, p < 0.0001; stress: χ²(1, 403) = 4.20, p = 0.040). After adjustment for sex and the alternate exposure, poor sleep quality (adjusted RR = 1.11, 95% CI: 1.05–1.18; p = 0.001) and high perceived stress (adjusted RR = 1.06, 95% CI: 1.01–1.11; p = 0.015) remained independently associated with increased DED risk. Participants with both poor sleep quality and high stress exhibited the highest DED risk (RR = 1.18, 95% CI: 1.10–1.27; p < 0.0001), although no significant interaction. Conclusion Sleep disturbance and perceived stress were independently associated with an increased risk of DED in this student population. However, there was no evidence that stress modified the association between sleep disturbance and DED.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0361053. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Yijiang Liu, Yiman Chi, Jiefeng Yin, Jun Yao

Knee osteoarthritis (KOA) is a progressive degenerative joint disease characterized by cartilage degeneration, synovial inflammation, and subchondral bone remodeling. Oxidative stress plays a critical role in KOA pathogenesis. This study aimed to identify oxidative stress–related hub genes by integrating single-cell RNA sequencing (scRNA-seq) with machine learning to uncover potential diagnostic and prognostic biomarkers for KOA. ScRNA-seq data from KOA cartilage tissues were obtained from the GEO database to characterize cellular heterogeneity and identify disease-associated chondrocyte subsets. CellChat was used to analyze intercellular communication, and Monocle2 was applied to reconstruct cell differentiation trajectories. Oxidative stress activity at the single-cell level was evaluated using AUCell, while high-dimensional weighted gene co-expression network analysis (hdWGCNA) was performed to identify oxidative stress–related gene modules. Candidate genes were screened using Venn analysis and further refined by LASSO regression, SVM-RFE, and XGBoost combined with SHAP analysis. Diagnostic performance was assessed, and biological relevance was explored through immune infiltration and pathway analyses. Experimental validation was conducted using qRT-PCR and western blot assays in H2O2-treated chondrocytes. InfC and ProFC were detected specifically in OA cartilage and exhibited high oxidative stress activity. InfC was enriched in inflammatory and immune-related pathways, whereas ProFC was associated with cell cycle regulation and extracellular matrix remodeling. Integrated hdWGCNA and machine-learning analyses consistently identified CYBA and SPP1 as candidate genes. The two-gene model achieved bootstrap-corrected AUCs of 0.937 and 0.825 in the training and validation cohorts, respectively. qRT-PCR and western blot analyses further showed increased CYBA and SPP1 expression in H2O2-treated chondrocytes. Conclusion InfC and ProFC may represent OA-associated chondrocyte states characterized by enhanced oxidative stress, while CYBA and SPP1 may serve as candidate diagnostic biomarkers. Given the small cohort sizes and preliminary in vitro validation, these findings require confirmation in larger independent cohorts and functional studies.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360537. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Sejal D. Patel, Naveen Karthik, Grant A. Justin, Alice Haystead, Stephanie J. Chiu, Sandra S. Stinnett, Kim G. Johnson, Dilraj S. Grewal, Sharon Fekrat

Purpose To assess individual retinal layer thickness and volume changes on optical coherence tomography (OCT) in individuals with post-traumatic stress disorder (PTSD) compared to controls. Methods Adults ≥18 years with a PTSD diagnosis were identified. Age- and sex-matched controls (±5 years) without PTSD were recruited. Exclusion criteria included any cognitive disorder, brain injury, glaucoma, diabetes, optic nerve or vitreoretinal disease, uncontrolled hypertension, refractive error >±6 diopters, or best corrected visual acuity <20/40. Non-mydriatic OCT macular cube 512x128 images were obtained using Zeiss Cirrus HD-5000 AngioPlex. The Duke Reading Center DRCVisualizer software was used to segment the ganglion cell/inner plexiform (GC-IPL), inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL), photoreceptor, and retinal pigment epithelium (RPE) layers. Mean retinal thickness and volume were calculated for all layers within the central 1-mm subfield and 3- and 6-mm ETDRS rings, further divided into nasal, superior, temporal, and inferior quadrants. Results 81 eyes of 42 PTSD patients and 81 eyes of 42 controls were analyzed. Average ages were 48 ± 15 years for PTSD and 51 ± 19 years for controls. Groups were 36% male. PTSD eyes showed significantly decreased photoreceptor thickness and volume and increased RPE thickness/volume across all ETDRS rings and quadrants (all p < 0.05). OPL thicknesses were decreased in PTSD eyes versus controls for temporal 3-mm (25.29 ± 1.36 µm vs. 26.64 ± 3.80µm) and temporal 6-mm (23.47 ± 0.88µm vs. 24.00 ± 1.54µm) rings (p < 0.05). OPL inferior 6-mm thickness was decreased in PTSD eyes (23.98 ± 1.58 µm vs. 24.78 ± 2.34 µm) versus controls (p < 0.05). The ONL nasal 6-mm thickness was decreased in PTSD versus controls (55.96 ± 7.90 µm vs. 56.74 ± 7.47µm) (p < 0.05). After adjusting for multiple testing, RPE differences remained significant across all evaluated regions, while photoreceptor differences remained significant within the central 1-mm and 3-mm ETDRS regions. Conclusions PTSD eyes demonstrated decreased photoreceptor layer and increased RPE thickness and volume.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360471. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.