PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0329139
Chong-Bin Tsai, Chien-Liang Fang
{"title":"Comparison of different positioning techniques for reduction of induced vertical deviation following Nishida procedure for the treatment of sixth nerve palsy.","authors":"Chong-Bin Tsai, Chien-Liang Fang","doi":"10.1371/journal.pone.0329139","DOIUrl":"https://doi.org/10.1371/journal.pone.0329139","url":null,"abstract":"<p><strong>Purpose: </strong>Induced vertical deviation is a potential complication following the Nishida procedure for the treatment of sixth nerve palsy. This study aims to compare different positioning techniques for the reduction of this complication.</p><p><strong>Methods: </strong>We retrospectively examined medical records from consecutive patients who underwent the Nishida procedure, classifying them into three positioning groups: intra-quadrant (IQP), lateral rectus border (LRBP), and horizontal meridian (HMP). Surgical and pre/postoperative data were compared.</p><p><strong>Results: </strong>Among the 27 included patients (8 IQP, 9 LRBP, 10 HMP), all three groups demonstrated similar reductions in esodeviation: IQP, 44.0 ± 18.7 Prism Diopters (PD); LRBP, 42.2 ± 15.3 PD; HMP, 42.2 ± 7.8 PD; (P = 0.675). After surgery, one patient in the IQP group developed hypertropia of 18 PD, necessitating a secondary surgery to treat the vertical diplopia. In the LRBP group, two patients had hypotropia of 30 PD and 10 PD, respectively, and one patient had hypertropia of 6 PD. In the HMP group, one patient initially had hypertropia of 2 PD, which resolved during subsequent follow-up. A lower incidence of induced vertical deviation was observed in the HMP (10%) and IQP (13%) groups compared to the LRBP group (33%). However, this difference did not reach statistical significance due to the small sample size.</p><p><strong>Conclusion: </strong>There is no statistically significant difference among the three positioning techniques (IQP, LRBP, HMP) in the correction of esodeviation and reduction of incidence of induced vertical deviation following Nishida procedure.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0329139"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0325158
Shailesh M Gondivkar, Monal Yuwanati, Sachin C Sarode, Amol R Gadbail, Vidya Lohe
{"title":"Development of a core outcome set for trials for management of oral submucous fibrosis (OSFCOS): A consensus study protocol.","authors":"Shailesh M Gondivkar, Monal Yuwanati, Sachin C Sarode, Amol R Gadbail, Vidya Lohe","doi":"10.1371/journal.pone.0325158","DOIUrl":"https://doi.org/10.1371/journal.pone.0325158","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of oral submucous fibrosis (OSF) treatment is currently assessed with a broad range of clinical outcome measures. This heterogeneity complicates study comparison, synthesis of results, and evidence-based clinical practice guideline development. A core outcome set (COS) is a set of agreed, standardized outcomes that will be measured and reported across all clinical trials for a particular condition.</p><p><strong>Objective: </strong>Our aim is to create a COS (OSFCOS) for efficacy trials that look at the management OSF.</p><p><strong>Methods: </strong>An initial list of the potentially relevant outcomes will be drawn by a systematic review of randomized controlled trials focused on OSF treatment. An e-Delphi process will be done to obtain agreement among important stakeholders. The stakeholders will consist of OSF patients, members of the Indian Academy of Oral Medicine & Radiology, the representatives from the Indian Dental Association, clinical researchers, and other oral health specialists. Participants will be asked to rate the importance of each outcome on a structured online questionnaire. Participants will also be allowed to propose new outcomes in Round 1. Feedback and the aggregated scores will be given in later rounds to guide re-rating. If after the second round, there is still no consensus, a third round will be taken.Final consensus on outcome inclusion will be determined based on predefined criteria.</p><p><strong>Conclusion: </strong>This protocol outlines a structured, inclusive approach to developing a core outcome set for OSF. The finalized OSFCOS will be made publicly available to guide outcome selection in clinical trials, improve the quality of systematic reviews, and support evidence-based clinical recommendations for the treatment of OSF.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0325158"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0329202
Hailei Yuan, Qiang Ren
{"title":"Divide-and-conquer routing for learning heterogeneous individualized capsules.","authors":"Hailei Yuan, Qiang Ren","doi":"10.1371/journal.pone.0329202","DOIUrl":"https://doi.org/10.1371/journal.pone.0329202","url":null,"abstract":"<p><p>Capsule Networks (CapsNets) have demonstrated an enhanced ability to capture spatial relationships and preserve hierarchical feature representations compared to Convolutional Neural Networks (CNNs). However, the dynamic routing mechanism in CapsNets introduces substantial computational costs and limits scalability. In this paper, we propose a divide-and-conquer routing algorithm that groups primary capsules, enabling the model to leverage independent feature subspaces for more precise and efficient feature learning. By partitioning the primary capsules, the initialization of coupling coefficients is aligned with the hierarchical structure of the capsules, addressing the limitations of existing initialization strategies that either disrupt feature aggregation or lead to excessively small activation values. Additionally, the grouped routing mechanism simplifies the iterative process, reducing computational overhead and improving scalability. Extensive experiments on benchmark image classification datasets demonstrate that our approach consistently outperforms the original dynamic routing algorithm as well as other state-of-the-art routing strategies, resulting in improved feature learning and classification accuracy. Our code is available at: https://github.com/rqfzpy/DC-CapsNet.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0329202"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0328303
Yilin Zhu, Bhimanagouda S Patil, Shuyang Zhen
{"title":"From ultraviolet-B to red photons: Effects of end-of-production supplemental light on anthocyanins, phenolics, ascorbic acid, and biomass production in red leaf lettuce.","authors":"Yilin Zhu, Bhimanagouda S Patil, Shuyang Zhen","doi":"10.1371/journal.pone.0328303","DOIUrl":"https://doi.org/10.1371/journal.pone.0328303","url":null,"abstract":"<p><p>Plants possess an array of photoreceptors, such as UVR8, cryptochromes, and phytochromes, that perceive the spectral quality of light and regulate plant morphology, growth, and physiology. The use of light-emitting diodes enables the application of targeted light spectra to elicit specific plant responses during cultivation. However, there is a lack of comparative studies evaluating the effects of different spectral regions within the same crop. We comprehensively quantified how various light spectra, ranging from ultraviolet-B to red, affect plant growth and the accumulation of beneficial phytochemicals, including anthocyanins, phenolics, and ascorbic acid, in red leaf lettuce (Lactuca sativa) cv. Red Salad Bowl and Rouxai. Plants were grown under a background white LED light of 200 µmol m-2 s-1 for 16 hours per day (control), and supplemented with red (peak at 659 nm), blue (444 nm), violet (404 nm), ultraviolet-A (UVA; 368 nm) radiation at 60 µmol m-2 s-1, or ultraviolet-B (UVB; 309 nm) radiation at 3 µmol m-2 s-1 during the last 7 days of a 28-day production period (end-of-production stage, EOP). For both lettuce cultivars, red, blue and UVB treatments significantly enhanced leaf anthocyanin content compared to the control, with UVB being the most effective despite its low application dosage, followed by the blue and red light treatments. UVB radiation significantly increased total phenolic content in both cultivars (by 80%-99.1% compared to the control), while blue light treatment increased total phenolics by 31.4% in 'Red Salad Bowl' only. However, supplemental UVB radiation did not affect total ascorbic acid in either cultivar; the other EOP treatments (red to UVA) increased total ascorbic acid by 19%-35% in 'Red Salad Bowl' but had no significant effects in 'Rouxai'. Notably, crop yield under the UVB treatment was the lowest in both cultivars, with 8.9%-49% lower shoot fresh weight compared to other treatments. In contrast, the violet light treatment resulted in the highest leaf area and shoot biomass in both lettuce cultivars, although it was not effective in enhancing anthocyanins and total phenolics. Our result indicated that there is often a tradeoff between nutritional quality and crop yield, and specific light spectra can be strategically used to enhance nutritional quality or biomass. Low-intensity UVB was the most effective at maximizing anthocyanins and total phenolics, followed by blue light, while supplemental violet light most significantly enhanced lettuce leaf expansion and biomass compared to other light spectra.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0328303"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Study on the propagation law of hydraulic fractures in heterogeneous permeability reservoirs.","authors":"Linhao Zou, Yinao Su, Xingsheng Xu, Wei Li, Huan Zhao, Mingxiu Zhang, Shengjie Jiao","doi":"10.1371/journal.pone.0328689","DOIUrl":"https://doi.org/10.1371/journal.pone.0328689","url":null,"abstract":"<p><p>The development of unconventional oil and gas resources is increasingly shifting toward heterogeneous reservoirs with complex permeability distributions, making the effective control of hydraulic fracture propagation patterns critical for optimizing production. To this end, this study establishes a 3D multilayered heterogeneous reservoir model using the finite element method to analyze fracture mechanisms. The impacts of permeability heterogeneous, injection rate, and fracturing fluid viscosity on fracture morphology are systematically investigated, and the elasticity coefficient method was used to evaluate the influence weights of each parameter.The main conclusions are as follows: (1) Permeability distribution is the core factor controlling the fracture propagation direction, with HPL dominating the extension path while MPL and LPL show limited efficiency. (2) An increase in the number of permeability layers inhibits the overall expansion of cracks, and the shape of the cracks gradually changes to rectangular. (3) Higher injection rates significantly expand fracture area, whereas fracturing fluid viscosity ≥50 mPa·s stabilizes fracture morphology. (4) The elastic coefficient method identifies injection rate, permeability heterogeneous, and fracturing fluid viscosity as the key control parameters in order. This work provides theoretical guidance for optimizing hydraulic fracturing parameters in complex geological settings.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0328689"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0329368
Nusrat Jahan Mishu, Md Robiul Hasan, Shah Mohammad Naimul Islam, Jannatun Nayeema, Md Motaher Hossain
{"title":"Additive effects of Trichoderma isolates for enhancing growth, suppressing southern blight and modulating plant defense enzymes in tomato.","authors":"Nusrat Jahan Mishu, Md Robiul Hasan, Shah Mohammad Naimul Islam, Jannatun Nayeema, Md Motaher Hossain","doi":"10.1371/journal.pone.0329368","DOIUrl":"https://doi.org/10.1371/journal.pone.0329368","url":null,"abstract":"<p><p>Southern blight, caused by Sclerotium rolfsii, poses a significant economic threat to tomato cultivation. This study involved the isolation, characterization, and evaluation of three selected Trichoderma isolates (Tri2, Tri3, and Tri6), applied individually and in combination, for their potential to promote plant growth and suppress southern blight under both in vitro and in vivo conditions. These isolates exhibited multiple plant growth-promoting traits, including cellulase, protease, amylase, lipase, catalase, and phosphate-solubilizing activities. Furthermore, they performed as efficient antagonists, inhibiting the mycelial growth by up to 88.8% and the oxalic acid production of S. rolfsii by up to 81.9%. The Trichoderma isolates significantly enhanced tomato seed germination and seedling vigor (p < 0.05). In seed tray and pot, experiments, consortium treatments (dual and triple application) demonstrated significantly greater plant height (≤168.8%), biomass (≤507.3%), leaf number (≤150%), leaf diameter (≤86.2%), chlorophyll content (≤322%), stem diameter (≤129.1%), gas exchange parameters, and root colonization than control and single treatments (p < 0.05). Additionally, these consortium treatments exhibited significantly higher efficacy in reducing damping-off (≤92%) and southern blight severity (≤80%) caused by S. rolfsii, compared to untreated plants (p < 0.05). Biochemical analyses revealed that Trichoderma-treated plants challenged with S. rolfsii showed reduced oxidative stress, evidenced by lower hydrogen peroxide (H₂O₂) and malondialdehyde (MDA) levels. The treatments also increased osmoprotectant levels such as soluble sugars, proline, phenolics, and flavonoids, along with the activities of defense-related enzymes, including peroxidase (PO), polyphenol oxidase (PPO), and phenylalanine ammonia-lyase (PAL), compared to S. rolfsii-infected controls (p < 0.05). Under field conditions, treating S. rolfsii-inoculated plants with Trichoderma isolates, whether singly, in pairs, or as a trio, significantly increased plant height, yield, and fruit Brix content (p < 0.05). The consortium application (Tri2 + Tri3 and Tri2 + Tri3 + Tri6) led to the highest increases in plant height (≤94%), fruit number (≤114%), yield (≤19.59 t/ha), and Brix (≤4.88). These findings suggest that the additive interactions among Trichoderma isolates enhance tomato growth and suppress S. rolfsii, offering an eco-friendly and effective strategy for managing southern blight.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0329368"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0329299
Martin K H Ho, Araniy Santhireswaran, Tara Gomes, Muhammad Mamdani, Mina Tadrous
{"title":"Comparative effectiveness and safety of insulin reference biologics versus biosimilars for types 1 and 2 diabetes mellitus: Protocol for a systematic review of real-world studies.","authors":"Martin K H Ho, Araniy Santhireswaran, Tara Gomes, Muhammad Mamdani, Mina Tadrous","doi":"10.1371/journal.pone.0329299","DOIUrl":"https://doi.org/10.1371/journal.pone.0329299","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus is characterized by insulin deficiency or resistance. The two main types of diabetes mellitus are type 1 (T1DM) and type 2 (T2DM). Insulin is the mainstay of therapy for T1DM and often the last-line therapy for T2DM. Biosimilar insulins are cost-saving alternatives to reference products that may improve access for patients and sustainability for healthcare systems. Despite supporting evidence from randomized controlled trials, biosimilar insulin uptake is poor, and real-world evidence of their safety and effectiveness is limited.</p><p><strong>Objective: </strong>Our objective is to compare the real-world effectiveness and safety of insulin biosimilars versus reference products in adults with diabetes mellitus.</p><p><strong>Eligibility criteria: </strong>We will include observational studies and open-label pragmatic randomized controlled trials. We will exclude other randomized controlled trials, literature reviews, meta-analyses, case series, case reports, study protocols, opinion pieces, and conference abstracts. Our primary effectiveness outcome will be glycated hemoglobin (HbA1c) and our primary safety outcome will be hypoglycemia. Our secondary outcomes will include fasting plasma glucose; time in range; microvascular complications; health-related quality of life; physician visits, emergency department visits, and hospital admissions for hypoglycemia, hyperglycemia, and diabetic ketoacidosis; weight gain; immunogenicity; injection site reactions; and incident cancers.</p><p><strong>Methods: </strong>The search strategy combines three key concepts: diabetes, insulin, and biosimilars. We will conduct a structured search in MEDLINE, EMBASE, and International Pharmaceutical Abstracts. We will also search in grey literature databases, targeted websites, and the Google search engine. Finally, we will scan forward and backward citations. Articles will be screened, extracted, and appraised independently by two reviewers. Data will be descriptively summarized.</p><p><strong>Discussion: </strong>Our systematic review of the real-world evidence on biosimilar insulins can help support clinical and policy decisions that impact the care of patients with T1DM or T2DM.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0329299"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0329126
Mohamed E Elnageeb, Imadeldin Elfaki, Gad Allah Modawe, Abdelrahman Osman Elfaki, Othman R Alzahrani, Hytham A Abuagla, Hayam A Alwabsi, Adel I Alalawy, Mohammad Rehan Ajmal, Elsiddig Idriss Mohamed, Hussein Eledum, Syed Khalid Mustafa, Elham M Alhathli
{"title":"Computational prediction of the pathogenic variants of arachidonate 5-lipoxygenase activating protein using Molecular Dynamics simulation.","authors":"Mohamed E Elnageeb, Imadeldin Elfaki, Gad Allah Modawe, Abdelrahman Osman Elfaki, Othman R Alzahrani, Hytham A Abuagla, Hayam A Alwabsi, Adel I Alalawy, Mohammad Rehan Ajmal, Elsiddig Idriss Mohamed, Hussein Eledum, Syed Khalid Mustafa, Elham M Alhathli","doi":"10.1371/journal.pone.0329126","DOIUrl":"https://doi.org/10.1371/journal.pone.0329126","url":null,"abstract":"<p><p>The arachidonate 5-lipoxygenase activating protein (ALOX5AP) regulates leukotrienes (LTs) synthesis. LTs are involved in inflammation which is implicated in cardiovascular diseases (CVDs) and stroke. Variations in ALOX5AP gene are associated with CVDs, stroke and others because of their possible effects on ALOX5AP stability and function. In this study we investigated with molecular dynamics (MD) simulation the structural impacts of L12F, A56V, G75R, and G87R variants on ALOX5AP. We employed an array of bioinformatics techniques, including SIFT, PolyPhen-2, PANTHER, SNPs&GO, PhD-SNP, i-Mutant, MuPro, MutPred, ConSurf, and GROMACS. Results showed that the L12F variant increased structural compactness, as indicated by diminished solvent accessibility, a reduced radius of gyration, and a decrease in hydrogen bonding capacity. The A56V variant destabilized the ALOX5AP, demonstrating elevated root mean square deviation (RMSD), augmented solvent-accessible surface area, and diminished ALOX5AP compactness. The G75R and G87R variants exhibited mild effects on ALOX5AP wildtype. However, simulation trajectory snapshots results indicated G75R and G87R variants induce instability leading to structural perturbations of ALOX5AP probably due to the charge of arginine introduced by the G75R and G87R mutation. The G75R and G87R variants potentially influence ALOX5AP dynamics, stability, and function. These results require further verification in future case-control and protein functional studies.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0329126"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0310066
Joanne Igoli, Jeremiah Oluwatomi Itodo Daniel, Halleluyah Oludele, Adedoyin Esther Alao, Idemudia Stephen Ogedegbe, Adewale Olaniyan, Michael Adeshola Adebayo, Damilola Matthew, Temidayo Elizabeth Oyepitan, Daniel Brabi, Olatomiwa Olukoya, Temidayo Osunronbi
{"title":"Serum fibrinogen level and fibrinogen administration in patients with traumatic brain injury: A systematic review and meta-analysis protocol.","authors":"Joanne Igoli, Jeremiah Oluwatomi Itodo Daniel, Halleluyah Oludele, Adedoyin Esther Alao, Idemudia Stephen Ogedegbe, Adewale Olaniyan, Michael Adeshola Adebayo, Damilola Matthew, Temidayo Elizabeth Oyepitan, Daniel Brabi, Olatomiwa Olukoya, Temidayo Osunronbi","doi":"10.1371/journal.pone.0310066","DOIUrl":"https://doi.org/10.1371/journal.pone.0310066","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic Brain Injury (TBI) is a leading cause of disability and death globally. It has a significant economic burden. Coagulopathy has been identified as one of the key factors contributing to the poor outcomes observed in TBI patients, and it has been theorised that the management of coagulopathy will improve patient outcomes. Low serum fibrinogen levels denote a coagulopathic state, and the therapeutic administration of fibrinogen has been proposed to correct this state. However, there is no consensus on its efficacy in patients with TBI. Hence, this systematic review and meta-analysis seeks to ascertain the prognostic value of serum fibrinogen levels in patients with TBI and assess the effect of fibrinogen administration on these patients.</p><p><strong>Methods: </strong>Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, we will perform a comprehensive search of Scopus, Medline, Embase and Cochrane Library to retrieve all original articles that investigate the prognostic value of fibrinogen levels and/or the effect of fibrinogen administration in TBI patients. Primary outcomes include functional outcome and mortality assessments such as the Glasgow Outcome Score and modified Rankin Score. Secondary outcomes include progressive intracranial haemorrhage/contusion and need for surgical intervention. Data collected will encompass participant demographics, measured fibrinogen levels, dose of fibrinogen administered and specified outcome measures.</p><p><strong>Conclusion: </strong>Findings from this study, specifically the evidence if fibrinogen level has prognostic value and if fibrinogen administration improves patient outcomes, will help inform future TBI management. It will also enhance shared decision-making between healthcare professionals and patients if fibrinogen has a prognostic value, as this value could be used to communicate more effectively the expected prognosis post-TBI. Thus, TBI patient outcomes can be optimised accordingly.</p><p><strong>Prospero registration number: </strong>CRD42024556497. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024556497.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0310066"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PLoS ONEPub Date : 2025-07-30eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0327294
Yuwei Liu, Sheng Ma, Mei Sun
{"title":"Digital infrastructure policies, local fiscal and financing constraints of Non-SOEs: Evidence from China.","authors":"Yuwei Liu, Sheng Ma, Mei Sun","doi":"10.1371/journal.pone.0327294","DOIUrl":"https://doi.org/10.1371/journal.pone.0327294","url":null,"abstract":"<p><p>Digital infrastructure serves as a cornerstone of urban digital transformation and smart city development, yet its implications for local fiscal systems and micro-level enterprises remain underexplored. This study empirically investigates the impact of digital infrastructure policies on the financing constraints of Non-SOEs in China. The contributions of this paper are as follows: (1) Theoretical innovation: It develops a comprehensive theoretical framework connecting macro-level digital policies, regional fiscal dynamics, and micro-enterprise financing constraints, offering a novel perspective on how macro policies influence micro-enterprises. (2) Systemic analysis: It enhances understanding of the systemic effects of digital infrastructure policies by demonstrating their ability to alleviate financing constraints through mitigating fiscal burdens, improving budgetary revenue quality, and strengthening regional financial development. Analysis of heterogeneity reveals that digital infrastructure policies implemented by Chinese provincial governments are particularly effective. (3) Practical insights: It offers practical guidance for policymakers to design targeted strategies that reduce financing constraints and support private sector growth in the digital economy. Non-SOEs in the growth and decline periods benefit more from digital infrastructure due to higher financing demands. Non-SOEs independent of SOEs in the supply chain are more responsive to digital infrastructure, effectively alleviating financing constraints. Moreover, the construction of digital infrastructure is highly conducive to the attraction of Non-SOEs and does not result in the vertical imbalances in local fiscals that are associated with traditional infrastructure construction. This evidence offers valuable guidance for local governments to optimize digital transformation policies and foster private economy growth.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 7","pages":"e0327294"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}