PLOS ONE: [sortOrder=DATE_NEWEST_FIRST, sort=Date, newest first, q=subject:"Medicine and health sciences"]PLOShttps://journals.plos.org/plosone/webmaster@plos.orgaccelerating the publication of peer-reviewed sciencehttps://journals.plos.org/plosone/search/feed/atom?sortOrder=DATE_NEWEST_FIRST&unformattedQuery=subject:%22Medicine+and+health+sciences%22&sort=Date,+newest+firstAll PLOS articles are Open Access.https://journals.plos.org/plosone/resource/img/favicon.icohttps://journals.plos.org/plosone/resource/img/favicon.ico2024-03-29T02:35:33ZA novel sORF gene mutant strain of <i>Yersinia pestis</i> vaccine EV76 offers enhanced safety and improved protection against plagueXiao GuoYouquan XinZehui TongShiyang CaoYuan ZhangGengshan WuHongyan ChenTong WangYajun SongQingwen ZhangRuifu YangZongmin Du10.1371/journal.ppat.10121292024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Xiao Guo, Youquan Xin, Zehui Tong, Shiyang Cao, Yuan Zhang, Gengshan Wu, Hongyan Chen, Tong Wang, Yajun Song, Qingwen Zhang, Ruifu Yang, Zongmin Du</p>
We recently identified two virulence-associated small open reading frames (sORF) of <i>Yersinia pestis</i>, named <i>yp1</i> and <i>yp2</i>, and null mutants of each individual genes were highly attenuated in virulence. Plague vaccine strain EV76 is known for strong reactogenicity, making it not suitable for use in humans. To improve the immune safety of EV76, three mutant strains of EV76, Δ<i>yp1</i>, Δ<i>yp2</i>, and Δ<i>yp1&yp2</i> were constructed and their virulence attenuation, immunogenicity, and protective efficacy in mice were evaluated. All mutant strains were attenuated by the subcutaneous (<i>s</i>.<i>c</i>.) route and exhibited more rapid clearance in tissues than the parental strain EV76. Under iron overload conditions, only the mice infected with EV76Δ<i>yp1</i> survived, accompanied by less draining lymph nodes damage than those infected by EV76. Analysis of cytokines secreted by splenocytes of immunized mice found that EV76Δ<i>yp2</i> induced higher secretion of multiple cytokines including TNF-α, IL-2, and IL-12p70 than EV76. On day 42, EV76Δ<i>yp2</i> or EV76Δ<i>yp1&yp2</i> immunized mice exhibited similar protective efficacy as EV76 when exposed to <i>Y</i>. <i>pestis</i> 201, both via <i>s</i>.<i>c</i>. or intranasal (<i>i</i>.<i>n</i>.) routes of administration. Moreover, when exposed to 200–400 LD<sub>50</sub> <i>Y</i>. <i>pestis</i> strain 201Δ<i>caf1</i> (non-encapsulated <i>Y</i>. <i>pestis</i>), EV76Δ<i>yp2</i> or EV76Δ<i>yp1&yp2</i> are able to afford about 50% protection to <i>i</i>.<i>n</i>. challenges, significantly better than the protection afforded by EV76. On 120 day, mice immunized with EV76Δ<i>yp2</i> or EV76Δ<i>yp1&yp2</i> cleared the <i>i</i>.<i>n</i>. challenge of <i>Y</i>. <i>pestis</i> 201-<i>lux</i> as quickly as those immunized with EV76, demonstrating 90–100% protection. Our results demonstrated that deletion of the <i>yp2</i> gene is an effective strategy to attenuate virulence of <i>Y</i>. <i>pestis</i> EV76 while improving immunogenicity. Furthermore, EV76Δ<i>yp2</i> is a promising candidate for conferring protection against the pneumonic and bubonic forms of plague.A clinically attenuated double-mutant of porcine reproductive and respiratory syndrome virus-2 that does not prompt overexpression of proinflammatory cytokines during co-infection with a secondary pathogenChia-Ming SuJineui KimJunyu TangYu Fan HungFederico A. ZuckermannRobert HusmannPatrick RoadyJiyoun KimYoung-Min LeeDongwan Yoo10.1371/journal.ppat.10121282024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Chia-Ming Su, Jineui Kim, Junyu Tang, Yu Fan Hung, Federico A. Zuckermann, Robert Husmann, Patrick Roady, Jiyoun Kim, Young-Min Lee, Dongwan Yoo</p>
Porcine reproductive and respiratory syndrome virus (PRRSV) is known to suppress the type I interferon (IFNs-α/β) response during infection. PRRSV also activates the NF-κB signaling pathway, leading to the production of proinflammatory cytokines during infection. In swine farms, co-infections of PRRSV and other secondary bacterial pathogens are common and exacerbate the production of proinflammatory cytokines, contributing to the porcine respiratory disease complex (PRDC) which is clinically a severe disease. Previous studies identified the non-structural protein 1β (nsp1β) of PRRSV-2 as an IFN antagonist and the nucleocapsid (N) protein as the NF-κB activator. Further studies showed the leucine at position 126 (L126) of nsp1β as the essential residue for IFN suppression and the region spanning the nuclear localization signal (NLS) of N as the NF-κB activation domain. In the present study, we generated a double-mutant PRRSV-2 that contained the L126A mutation in the nsp1β gene and the NLS mutation (ΔNLS) in the N gene using reverse genetics. The immunological phenotype of this mutant PRRSV-2 was examined in porcine alveolar macrophages (PAMs) in vitro and in young pigs in vivo. In PAMs, the double-mutant virus did not suppress IFN-β expression but decreased the NF-κB-dependent inflammatory cytokine productions compared to those for wild-type PRRSV-2. Co-infection of PAMs with the mutant PRRSV-2 and <i>Streptococcus suis (S</i>. <i>suis)</i> also reduced the production of NF-κB-directed inflammatory cytokines. To further examine the cytokine profiles and the disease severity by the mutant virus in natural host animals, 6 groups of pigs, 7 animals per group, were used for co-infection with the mutant PRRSV-2 and <i>S</i>. <i>suis</i>. The double-mutant PRRSV-2 was clinically attenuated, and the expressions of proinflammatory cytokines and chemokines were significantly reduced in pigs after bacterial co-infection. Compared to the wild-type PRRSV-2 and <i>S</i>. <i>suis</i> co-infection control, pigs coinfected with the double-mutant PRRSV-2 exhibited milder clinical signs, lower titers and shorter duration of viremia, and lower expression of proinflammatory cytokines. In conclusion, our study demonstrates that genetic modification of the type I IFN suppression and NF-κB activation functions of PRRSV-2 may allow us to design a novel vaccine candidate to alleviate the clinical severity of PRRS-2 and PRDC during bacterial co-infection.Chronic viral infection impairs immune memory to a different pathogenCheng YangZhicui LiuYing YangLuis J. CockaYongguo LiWeihong ZengHao Shen10.1371/journal.ppat.10121132024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Cheng Yang, Zhicui Liu, Ying Yang, Luis J. Cocka, Yongguo Li, Weihong Zeng, Hao Shen</p>
Chronic viral infections cause T cell dysfunction in both animal models and human clinical settings, thereby affecting the ability of the host immune system to clear viral pathogens and develop proper virus-specific immune memory. However, the impact of chronic viral infections on the host’s immune memory to other pathogens has not been well described. In this study, we immunized mice with recombinant <i>Listeria monocytogenes</i> expressing OVA (Lm-OVA) to generate immunity to Lm and allow analysis of OVA-specific memory T (Tm) cells. We then infected these mice with lymphocytic choriomeningitis virus (LCMV) strain Cl-13 which establishes a chronic infection. We found that chronically infected mice were unable to protect against <i>Listeria</i> re-challenge. OVA-specific Tm cells showed a progressive loss in total numbers and in their ability to produce effector cytokines in the context of chronic LCMV infection. Unlike virus-specific T cells, OVA-specific Tm cells from chronically infected mice did not up-regulate the expression of inhibitory receptors, a hallmark feature of exhaustion in virus-specific T cells. Finally, OVA-specific Tm cells failed to mount a robust recall response after bacteria re-challenge both in the chronically infected and adoptively transferred naïve hosts. These results show that previously established bacteria-specific Tm cells become functionally impaired in the setting of an unrelated bystander chronic viral infection, which may contribute to poor immunity against other pathogens in the host with chronic viral infection.Behind the scenes: Centromere-driven genomic innovations in fungal pathogensAswathy NarayananMd. Hashim RezaKaustuv Sanyal10.1371/journal.ppat.10120802024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Aswathy Narayanan, Md. Hashim Reza, Kaustuv Sanyal</p>The <i>Wolbachia</i> WalE1 effector alters <i>Drosophila</i> endocytosisMaryAnn MartinSergio López-MadrigalIrene L. G. Newton10.1371/journal.ppat.10112452024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by MaryAnn Martin, Sergio López-Madrigal, Irene L. G. Newton</p>
The most common intracellular bacterial infection is <i>Wolbachia pipientis</i>, a microbe that manipulates host reproduction and is used in control of insect vectors. Phenotypes induced by <i>Wolbachia</i> have been studied for decades and range from sperm-egg incompatibility to male killing. How <i>Wolbachia</i> alters host biology is less well understood. Previously, we characterized the first <i>Wolbachia</i> effector–WalE1, which encodes an alpha-synuclein domain at the N terminus. Purified WalE1 sediments with and bundles actin and when heterologously expressed in flies, increases <i>Wolbachia</i> titer in the developing oocyte. In this work, we first identify the native expression of WalE1 by <i>Wolbachia</i> infecting both fly cells and whole animals. WalE1 appears as aggregates in the host cell cytosol. We next show that WalE1 co-immunoprecipitates with the host protein Past1, although might not directly interact with it, and that WalE1 manipulates host endocytosis. Yeast expressing WalE1 show deficiency in uptake of FM4-64 dye, and flies harboring mutations in <i>Past1</i> or overexpressing WalE1 are sensitive to AgNO<sub>3</sub>, a hallmark of endocytosis defects. We also show that flies expressing WalE1 suffer from endocytosis defects in larval nephrocytes. Finally, we also show that <i>Past1</i> null flies harbor more <i>Wolbachia</i> overall and in late egg chambers. Our results identify interactions between <i>Wolbachia</i> and a host protein involved in endocytosis and point to yet another important host cell process impinged upon by <i>Wolbachia’s</i> WalE1 effector.Early prediction of the impact of public health policies on obesity and lifetime risk of type 2 diabetes: A modelling approachPierre BauvinClaire DelacôteLine Carolle Ntandja WandjiGuillaume LassaillyVioleta RaverdyFrançois PattouSylvie Deuffic-BurbanPhilippe Mathurin10.1371/journal.pone.03014632024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Pierre Bauvin, Claire Delacôte, Line Carolle Ntandja Wandji, Guillaume Lassailly, Violeta Raverdy, François Pattou, Sylvie Deuffic-Burban, Philippe Mathurin</p>
Objective <p>Help public health decision-making requires a better understanding of the dynamics of obesity and type 2 diabetes and an assessement of different strategies to decrease their burdens.</p> Methods <p>Based on 97,848 individual data, collected in the French Health, Health Care and Insurance Survey over 1998–2014, a Markov model was developed to describe the progression of being overweight to obesity, and the onset of type 2 diabetes. This model traces and predicts 2022–2027 burdens of obesity and type 2 diabetes, and lifetime risk of diabetes, according to different scenarios aiming at minimum to stabilize obesity at 5 years.</p> Results <p>Estimated risks of type 2 diabetes increase from 0.09% (normal weight) to 1.56% (obesity II-III). Compared to the before 1995 period, progression risks are estimated to have nearly doubled for obesity and tripled for type 2 diabetes. Consequently, over 2022–2027, the prevalence of obesity and type 2 diabetes will continue to increase from 17.3% to 18.2% and from 7.3% to 8.1%, respectively. Scenarios statibilizing obesity would require a 22%-decrease in the probability of move up (scenario 1) or a 33%-increase in the probability of move down (scenario 2) one BMI class. However, this stabilization will not affect the increase of diabetes prevalence whereas lifetime risk of diabetes would decrease (30.9% to 27.0%). Combining both scenarios would decrease obesity by 9.9%. Only the prevalence of obesity III shows early change able to predict the outcome of a strategy: for example, 6.7%-decrease at one year, 13.3%-decrease at two years with scenario 1 stabilizing obesity at 5 years.</p> Conclusions <p>Prevalences of obesity and type 2 diabetes will still increase over the next 5 years. Stabilizing obesity may decrease lifetime risks of type 2 diabetes without affecting its short-term prevalence. Our study highlights that, to early assess the effectiveness of their program, public health policy makers should rely on the change in prevalence of obesity III.</p>Factors associated with hepatitis A susceptibility among men who have sex with men using HIV pre-exposure prophylaxis in Northeastern Brazil: A cross-sectional studyHareton Teixeira VechiMônica Baumgardt BayCláudio Henrique Silva de FreitasJúlia Gomes Fernandes Costa de Sant’annaCarlos BritesKenio Costa de Lima10.1371/journal.pone.03013972024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Hareton Teixeira Vechi, Mônica Baumgardt Bay, Cláudio Henrique Silva de Freitas, Júlia Gomes Fernandes Costa de Sant’anna, Carlos Brites, Kenio Costa de Lima</p>
Hepatitis A virus (HAV) infection has disproportionately affected more men who have sex with men (MSM), occurring in outbreaks, despite being vaccine-preventable. We determined the prevalence and factors associated with HAV susceptibility among cisgender MSM on HIV pre-exposure prophylaxis (PrEP) in Northeastern Brazil. From September 30, 2021 to June 19, 2023, 282 cisgender MSM receiving HIV PrEP were enrolled into this cross-sectional study. Sociodemographic and clinical information were collected. Blood samples were collected for screening of sexually transmitted infections (STIs) and serum samples were tested for IgM and total anti-HAV antibodies. Non-reactive results for total anti-HAV antibodies were found in 106 of 282 (37.6%) participants. Factors associated with HAV susceptibility included age <30 years (prevalence ratio [PR]: 2.02; 95% confidence interval [95% CI]: 1.61–2.53), having health insurance (PR: 1.39; 95% CI: 1.19–1.64), sex only with cisgender men (PR: 1.52; 95% CI: 1.23–1.89), non-steady partner (PR: 1.20; 95% CI: 1.01–1.43) and no lifetime history of STIs (PR: 1.25; 95% CI: 1.03–1.53). Identifying clinical correlates of HAV susceptibility in key populations is a fundamental step towards development of public policy focused on prevention, especially following the recent hepatitis A outbreak in Brazil.Validity and reliability of the Balance Error Score System (BESS) Thai version in patients with chronic non-specific neck painArisa LeungbootnakRungthip PuntumetakulThiwaphon ChatpremSurachai Sae-JungRose Boucaut10.1371/journal.pone.03013862024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Arisa Leungbootnak, Rungthip Puntumetakul, Thiwaphon Chatprem, Surachai Sae-Jung, Rose Boucaut</p>
Background <p>Neck pain has been found to affect the somatosensory system, which can lead to impaired balance control. To assess the balance of patients with neck pain and other conditions, the balance error scoring system (BESS) is commonly used as a static balance measurement tool. However, this tool is seldom used in Thailand due to its English language format.</p> Objective <p>To translate and determine the content, convergent validity, and reliability of a Thai version of the BESS tool.</p> Material and methods <p>A process of cross-cultural adaptation was utilized to translate BESS into a Thai version, called BESS-TH. To assess content validity, five physical therapy lecturers specializing in the musculoskeletal field used BESS to measure balance in participants with neck pain. For the convergent validity process, 130 patients diagnosed with chronic non-specific neck pain (CNSNP) were randomly assessed using four static balance tests (BESS, Single-leg balance test (SLBT), Romberg test, and Tandem stance test). For reliability, two assessors with varying years of work experience independently assessed videos of the participants twice using the BESS-TH, with a minimum 7-day interval between assessments.</p> Results <p>The BESS-TH used to assess balance of patients with neck pain demonstrated acceptable content validity (index of item objective congruence (IOC) = 0.87). The Spearman’s Rank Correlation Coefficient was calculated between the BESS-TH and three other measures: the SLBT with eyes open and eyes closed, the Romberg test with eyes open and eyes closed, and the Tandem stance test with eyes open and Tandem stance test with eyes closed. The values obtained were as follows: -0.672, -0.712, -0.367, -0.529, -0.570, and -0.738, respectively. The inter-rater and intra-rater reliability were 0.922 (95% CI = 0.864–0.956) and 0.971 (95% CI = 0.950–0.983), respectively. Minimum detectable change (MDC) for the total BESS score of inter-rater and intra-rater reliability were 7.16 and 4.34 points, respectively.</p> Conclusion <p>The BESS-Thai version was acceptable, reliable, and valid for evaluating balance performance in patients with CNSNP. This tool can be used and applied to clinically evaluate postural control in Thailand.</p>Quantitative imaging and semiotic phenotyping of mitochondrial network morphology in live human cellsSophie CharrasseVictor RacineCharlotte Saint-OmerTitouan PoquillonLoïc LionnardMarine LedruChristophe GonindardSandrine DelaunoisKarima KissaRichard E. FryeManuela PastoreChristelle ReynesMathilde FrechetHanane ChajraAbdel Aouacheria10.1371/journal.pone.03013722024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Sophie Charrasse, Victor Racine, Charlotte Saint-Omer, Titouan Poquillon, Loïc Lionnard, Marine Ledru, Christophe Gonindard, Sandrine Delaunois, Karima Kissa, Richard E. Frye, Manuela Pastore, Christelle Reynes, Mathilde Frechet, Hanane Chajra, Abdel Aouacheria</p>
The importance of mitochondria in tissue homeostasis, stress responses and human diseases, combined to their ability to transition between various structural and functional states, makes them excellent organelles for monitoring cell health. There is therefore a need for technologies to accurately analyze and quantify changes in mitochondrial organization in a variety of cells and cellular contexts. Here we present an innovative computerized method that enables accurate, multiscale, fast and cost-effective analysis of mitochondrial shape and network architecture from confocal fluorescence images by providing more than thirty features. In order to facilitate interpretation of the quantitative results, we introduced two innovations: the use of Kiviat-graphs (herein named MitoSpider plots) to present highly multidimensional data and visualization of the various mito-cellular configurations in the form of morphospace diagrams (called MitoSigils). We tested our fully automated image analysis tool on rich datasets gathered from live normal human skin cells cultured under basal conditions or exposed to specific stress including UVB irradiation and pesticide exposure. We demonstrated the ability of our proprietary software (named MitoTouch) to sensitively discriminate between control and stressed dermal fibroblasts, and between normal fibroblasts and other cell types (including cancer tissue-derived fibroblasts and primary keratinocytes), showing that our automated analysis captures subtle differences in morphology. Based on this novel algorithm, we report the identification of a protective natural ingredient that mitigates the deleterious impact of hydrogen peroxide (H2O2) on mitochondrial organization. Hence we conceived a novel wet-plus-dry pipeline combining cell cultures, quantitative imaging and semiotic analysis for exhaustive analysis of mitochondrial morphology in living adherent cells. Our tool has potential for broader applications in other research areas such as cell biology and medicine, high-throughput drug screening as well as predictive and environmental toxicology.Older women’s experience with COVID-19 pandemic: A study of risk perception and coping among culturally and linguistically diverse population in South AustraliaNoore Alam SiddiqueeMohammad HamiduzzamanHelen McLarenEmi Patmisari10.1371/journal.pone.03013662024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Noore Alam Siddiquee, Mohammad Hamiduzzaman, Helen McLaren, Emi Patmisari</p>
Background <p>A global catastrophe–the COVID-19 pandemic–appears to have two-dimensional health consequences for older adults: high risk of being infected and psychological distress. There is limited evidence on how the pandemic has impacted the life and coping of older adults who are culturally and linguistically diverse (CALD), women in particular. This study explored the COVID-19 risk perception and coping strategies of older CALD women in South Australia.</p> Methods <p>A mixed-methods research design was employed, involving a 31-items coping and emergency preparation scale for survey and semi-structured interviews with participants. The older CALD women were approached through 11 multicultural NGOs. One hundred and nine women participants from 28 CALD communities completed the online surveys; 25 of them agreed to a telephone interview and provided their contact details. 15 older CALD women ultimately participated in interviews.</p> Results <p>Mean sum-score of dread risk, unknown risk, and fear (M: 43.5; SD: 4.9) indicated that the participants were somewhat anxious and worried. Mean sum-score of coping (M: 79.8; SD: 9.3) reported their compliance with expert advice and disinfection practices but accessing health information (M: 2.8; SD 1.4) and tendency to minimize anxiety (M: 2.1; SD: 1.2) were below neutral. Significant variations were found in coping in terms of age, meaning that the women aged 75 years and older were less likely to cope with the pandemic (<i>P</i> = 0.01). Emergency preparation differed based on the participants’ residence and occupation status. The deductive-inductive thematic analysis of interview data was framed around three priori themes: risks of being affected, emotional and behavioral coping, and emergency preparation and access to services.</p> Conclusions <p>Evidence shows a fear among the older CALD women with an endeavor to cope and prepare for emergency situations. This suggests the requirements for interventions that improve coping and reduce the risk of stress among them.</p>Prevalence and associated factors of occupational injuries in an industrial city in GhanaMichael Tetteh AsieduDouglas Aninng OpokuNana Kwame Ayisi-BoatengJoseph OsarfoAlhassan SulemanaAliyu MohammedJohn AmissahJennifer AshileviAyongo Mate-KoleFelix Agyemang OpokuIsaac Kofi YanksonEmmanuel Kweku Nakua10.1371/journal.pone.03013392024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Michael Tetteh Asiedu, Douglas Aninng Opoku, Nana Kwame Ayisi-Boateng, Joseph Osarfo, Alhassan Sulemana, Aliyu Mohammed, John Amissah, Jennifer Ashilevi, Ayongo Mate-Kole, Felix Agyemang Opoku, Isaac Kofi Yankson, Emmanuel Kweku Nakua</p>
Background <p>Workers are exposed to workplace hazards which increase their risk of occupational injury. Data on occupational injuries and associated factors are important for planning and informing national policy regarding workplace health and safety. This study sought to estimate the prevalence and factors associated with occupational injuries among workers in an industrial city in Ghana.</p> Methods <p>A community-based cross-sectional survey was conducted among 459 workers in the Tema industrial enclave in Ghana from 22<sup>nd</sup> December 2020 to 27<sup>th</sup> February 2021. Participants were recruited using a two-stage sampling technique. Eight communities were randomly selected from twenty-five communities in the first stage while households in each community were randomly selected in the second stage. Data on socio-demographic characteristics, occupational health and safety and occupational injuries were collected. Logistic regression was used to examine the relationship between occupational injuries and associated factors.</p> Results <p>The mean age of the workers was 33.9 (±6.8) years with a range of 21–53 while over 18.1% of them were working at the Port and Harbour. The prevalence of occupational injury among the workers in the preceding twelve months was 64.7%. The mechanism of injury was mainly the use of working tools (45.8%) and hot surfaces, substances or chemicals (14.1%). Being a casual staff (AOR: 2.26, 95%CI: 1.04–4.92), working at Port and Harbour (AOR: 3.77, 95%CI: 1.70–8.39), no health and safety training (AOR: 2.18, 95%CI: 1.08–4.39), dissatisfaction with health and safety measures (AOR: 4.31, 95%CI: 2.12–8.78) and tertiary education (AOR: 0.03, 95%CI: 0.01–0.10) were significantly associated with occupational injuries.</p> Conclusion <p>The prevalence of occupational injuries in this study was high. Promoting machine tools’ safety, health and safety training, and satisfaction with health and safety measures through rewarding workers who do not sustain injuries could be key to employees’ health and safety.</p>Tobacco use among in-school young adolescents in Indonesia: Exploring availability, affordability, and accessibilityYeni RosilawatiZain RafiqueErwan Sudiwijaya10.1371/journal.pone.03012912024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Yeni Rosilawati, Zain Rafique, Erwan Sudiwijaya</p>
The research on Indonesian adolescents’ perception of tobacco control in schools is limited. This study aimed to explore the availability, affordability, and accessibility of tobacco among young adolescents in Yogyakarta Municipality, Indonesia, with a focus on advocating for school teenagers. Focus groups, comprising participants from diverse backgrounds and stakeholders, were conducted in Yogyakarta, Indonesia, to systematically collect varied data. The subsequent analysis employed a robust thematic approach, combining both inductive and deductive processes to ensure a nuanced exploration of emerging patterns and pre-existing frameworks. In addition to focus group data, the study incorporated insights from extensive field observations and research group discussions. The multifaceted approach enhanced the depth of analysis but also facilitated a comprehensive understanding of the complex dynamics. The findings of this study revealed that young adolescents found it extremely easy to purchase cigarettes from local markets. The smoking prevalence among young adolescents was relatively low, with only 10% of the respondents admitting to smoking. Although the Indonesian government has increased surveillance and regulations regarding smoking among young individuals, the actual implementation and effectiveness of these measures remain questionable. The existing anti-smoking approaches in Indonesia have been unsuccessful in curbing smoking among Indonesian school students. The study argues that it is crucial to recognize and value students’ perceptions of smoking, as their knowledge of smoking is actively constructed. To address this issue, future anti-smoking education in schools should incorporate interactive sessions rather than solely relying on didactic approaches that highlight the harms of smoking. By engaging students in interactive discussions, they can actively participate in constructing their understanding of the consequences of smoking. Additionally, efforts should be made to enhance the implementation of tobacco control measures within schools and extend the reach of these measures to off-campus environments.Enhanced amygdala–anterior cingulate white matter structural connectivity in Sahaja Yoga MeditatorsOscar Perez-DiazDaylín GóngoraJosé L. González-MoraKatya RubiaAlfonso Barrós-LoscertalesSergio Elías Hernández10.1371/journal.pone.03012832024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Oscar Perez-Diaz, Daylín Góngora, José L. González-Mora, Katya Rubia, Alfonso Barrós-Loscertales, Sergio Elías Hernández</p>
Objective <p>To study the white matter connections between anterior cingulate cortex, anterior insula and amygdala as key regions of the frontal-limbic network that have been related to meditation.</p> Design <p>Twenty experienced practitioners of Sahaja Yoga Meditation and twenty nonmeditators matched on age, gender and education level, were scanned using Diffusion Weighted Imaging, using a 3T scanner, and their white matter connectivity was compared using diffusion tensor imaging analyses.</p> Results <p>There were five white matter fiber paths in which meditators showed a larger number of tracts, two of them connecting the same area in both hemispheres: the left and right amygdalae and the left and right anterior insula; and the other three connecting left anterior cingulate with the right anterior insula, the right amygdala and the left amygdala. On the other hand, non-meditators showed larger number of tracts in two paths connecting the left anterior insula with the left amygdala, and the left anterior insula with the left anterior cingulate.</p> Conclusions <p>The study shows that long-term practice of Sahaja Yoga Meditation is associated with larger white matter tracts strengthening interhemispheric connections between limbic regions and connections between cingulo-amygdalar and cingulo-insular brain regions related to top-down attentional and emotional processes as well as between top-down control functions that could potentially be related to the witness state perceived through the state of mental silence promoted with this meditation. On the other hand, reduced connectivity strength in left anterior insula in the meditation group could be associated to reduced emotional processing affecting top-down processes.</p>OXIDATIVE study: A pilot prospective observational cohort study protocol examining the influence of peri-reperfusion hyperoxemia and immune dysregulation on early allograft dysfunction after orthotopic liver transplantationElizabeth A. WilsonAnna WoodburyKirsten M. WilliamsCraig M. Coopersmith10.1371/journal.pone.03012812024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Elizabeth A. Wilson, Anna Woodbury, Kirsten M. Williams, Craig M. Coopersmith</p>
Early allograft dysfunction (EAD) is a functional hepatic insufficiency within a week of orthotopic liver transplantation (OLT) and is associated with morbidity and mortality. The etiology of EAD is multifactorial and largely driven by ischemia reperfusion injury (IRI), a phenomenon characterized by oxygen scarcity followed by paradoxical oxidative stress and inflammation. With the expanded use of marginal allografts more susceptible to IRI, the incidence of EAD may be increasing. This necessitates an in-depth understanding of the innate molecular mechanisms underlying EAD and interventions to mitigate its impact. Our central hypothesis is peri-reperfusion hyperoxemia and immune dysregulation exacerbate IRI and increase the risk of EAD. We will perform a pilot prospective single-center observational cohort study of 40 patients. The aims are to determine (1) the association between peri-reperfusion hyperoxemia and EAD and (2) whether peri-reperfusion perturbed cytokine, protein, and hypoxia inducible factor-1 alpha (HIF-1α) levels correlate with EAD after OLT. Inclusion criteria include age ≥ 18 years, liver failure, and donation after brain or circulatory death. Exclusion criteria include living donor donation, repeat OLT within a week of transplantation, multiple organ transplantation, and pregnancy. Partial pressure of arterial oxygen (PaO<sub>2</sub>) as the study measure allows for the examination of oxygen exposure within the confines of existing variability in anesthesiologist-administered fraction of inspired oxygen (FiO<sub>2</sub>) and the inclusion of patients with intrapulmonary shunting. The Olthoff et al. definition of EAD is the primary outcome. Secondary outcomes include postoperative acute kidney injury, pulmonary and biliary complications, surgical wound dehiscence and infection, and mortality. The goal of this study protocol is to identify EAD contributors that could be targeted to attenuate its impact and improve OLT outcomes. If validated, peri-reperfusion hyperoxemia and immune perturbations could be targeted via FiO<sub>2</sub> titration to a goal PaO<sub>2</sub> and/or administration of an immunomodulatory agent by the anesthesiologist intraoperatively.Factors related to a sense of economic insecurity among older adults who participate in social activitiesYuriko InoueHisae NakataniIchie OnoXuxin Peng10.1371/journal.pone.03012802024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Yuriko Inoue, Hisae Nakatani, Ichie Ono, Xuxin Peng</p>
Japan has the highest life expectancy worldwide. Older adults who experience economic insecurity may refrain from seeking medical consultation or using long-term care insurance, and these behaviors may increase the incidence and progression of frailty. This study conducted a cross-sectional survey to identify factors related to a sense of economic insecurity among older adults who participate in social activities, and identified support measures. In total, 1,351 older adults aged ≥65 years who had participated in social activities voluntarily completed an anonymous self-administered questionnaire. The questionnaire encompassed their physical, cognitive, social, and psychological conditions, and economic insecurity. We performed univariate analysis considering a sense of economic insecurity as the dependent variable, and conducted multiple logistic regression analysis (forced entry method) considering the independent variables with p<0.1 as the covariates. Among the 872 filled questionnaires, 717 were analyzed as they had no missing data with respect to the responses to survey questions (valid response rate was 53.1%). Analysis results showed that 43.6% of the older adults had a sense of economic insecurity, which was most common among those aged 75–84 years, accounting for 47.3%, followed by those aged 65–74 years accounting for 44.1%, and those aged ≥85 years accounting for 31.5% (p<0.05). The sense of economic insecurity was not associated with physical conditions, subjective symptoms of dementia, or social conditions; however, it grew with increased loneliness (OR: 1.71, 1.002–2.92, p = 0.049) and decreased with an increased subjective sense of well-being (OR: 0.86, 0.81–0.92, <0.001). Economic insecurity among older adults was not associated with physical, cognitive, or social aspects, as reported in previous studies. The survey respondents constituted older adults who participate in social activities. Maintaining interactions within the community, even in old age, may prevent loneliness and improve subjective health.