PLoS ONE最新文献

{"title":"Serum cholinesterase as a biomarker for sepsis-associated immunosuppression via Hub gene RORA.","authors":"Qian He, Xu Huang","doi":"10.1371/journal.pone.0348979","DOIUrl":"10.1371/journal.pone.0348979","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-induced immunosuppression is a key factor contributing to high mortality rates. However, suitable biomarkers for routine clinical monitoring of immune function are currently lacking. Serum cholinesterase levels are markedly diminished in sepsis and are associated with unfavorable prognoses, its role in the immunosuppression pathology and the mechanisms involved remain inadequately understood.</p><p><strong>Methods: </strong>We conducted a translational study integrating clinical research, bioinformatics analysis and animal experiments. Initially, within a single-center clinical cohort, we investigated the correlation between serum cholinesterase levels and lymphocyte subsets in patients suffering from sepsis, subsequently evaluating its association with disease severity (APACHE-II and SOFA scores) and clinical outcomes. Subsequently, by integrating sepsis transcriptome data with cholinergic anti-inflammatory pathways and immune-related gene sets, we identified the hub gene RORA and validated it across multiple dimensions using public databases. Finally, in the CLP sepsis mouse model, we measured cholinesterase activity and specifically quantified RORA mRNA expression in the spleen. We then analyzed the correlation between these measurements and changes in key immune cell counts.</p><p><strong>Results: </strong>Clinical data revealed significantly reduced serum cholinesterase activity in sepsis patients. Decreased cholinesterase levels positively correlated with elevated disease severity scores (APAChE-II, SOFA) and reduced counts of CD4 ⁺ T cells, CD8 ⁺ T cells, and NK cells. Bioinformatics analysis identified RORA as a hub gene linking sepsis, cholinesterase, and immune responses. Across eight independent GEO datasets, RORA expression exhibited a consistent downregulation trend in sepsis with high diagnostic value. Analysis of immune cell infiltration revealed significant positive correlations between RORA and counts of CD4 ⁺ T, CD8 ⁺ T, and NK cells in sepsis. In the CLP mouse model, reductions in spleen CD3 ⁺ T, CD4 ⁺ T, and CD8 ⁺ T cell counts coincided with notable decreases in serum cholinesterase and spleen RORA mRNA levels. Both serum cholinesterase concentration and spleen RORA mRNA expression exhibited positive correlations with CD4 ⁺ T and CD8 ⁺ T cell counts.</p><p><strong>Conclusion: </strong>This study establishes serum cholinesterase as a valuable clinical biomarker for assessing sepsis diagnosis, disease severity, and immunosuppression. For the first time, through multiomics integration and experimental validation, RORA has been identified as the key molecular bridge linking the cholinesterase activity and immunosuppression in sepsis. This not only provides a new direction for understanding immune dysregulation in sepsis but also lays a theoretical foundation for the future development of RORA-targeted immunomodulation and treatment strategies for sepsis.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0348979"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaerobic bacteria Cetobacterium sp. nov C33 plays a crucial role in the intestinal microbial balance and regulation of gene expression to immune and metabolic responses in Nile tilapia.","authors":"Mario Andrés Colorado Gómez, Javier Fernando Melo-Bolívar, Ruth Yolanda Ruíz Pardo, Howard Junca, Juan F Alzate, Luisa Marcela Villamil Díaz","doi":"10.1371/journal.pone.0344851","DOIUrl":"10.1371/journal.pone.0344851","url":null,"abstract":"<p><p>Aquaculture ranks among the largest global food production industries, with Nile tilapia (Oreochromis niloticus) being one of the most widely farmed species. However, increasing consumer demand and higher stocking densities place considerable stress on aquaculture systems, often leading to a rise in fish diseases. Probiotics have emerged as valuable tools in this sector, promoting fish health by modulating physiological functions such as metabolism, digestion, immune responses, stress tolerance, and disease resistance. Here, the probiotic potential of Cetobacterium sp. nov C33, an anaerobic bacterium isolated from the intestine of Nile tilapia, was evaluated on short-term dietary supplementation in fingerlings in laboratory conditions. Using 16S rRNA amplicon sequencing, we assessed the impact of Cetobacterium sp. nov C33 on gut microbiota, while transcriptomic analysis of the head kidney provided insights into immune system modulation. Results indicate that dietary inclusion of this anaerobic bacterium significantly alters the gut microbiota structure in tilapia fingerlings and regulates genes associated with key metabolic pathways, including the immune system, underscoring its potential as a probiotic for enhancing tilapia health. Our results offer promising evidence of its potential as a probiotic to improve tilapia health.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0344851"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of deconstructed Tai Chi step training combined with conventional rehabilitation on lower limb function in brunnstrom stage III stroke patients: A randomized controlled trial.","authors":"Jinxin Chang, Pengcheng Qu, Yindong Li","doi":"10.1371/journal.pone.0348765","DOIUrl":"10.1371/journal.pone.0348765","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether a deconstructed Tai Chi stepping protocol adapted for patients with Brunnstrom Stage III stroke, when combined with conventional rehabilitation, improves lower limb motor function, walking ability, and joint mobility compared with conventional rehabilitation plus limb synergy training.</p><p><strong>Methods: </strong>In this assessor-blinded randomized controlled trial, 52 patients with subacute stroke (Brunnstrom Stage III, ≤ 6 months post-stroke) were randomized in a 1:1 ratio to an experimental group (conventional rehabilitation plus adapted Tai Chi stepping training) or a control group (conventional rehabilitation plus limb synergy training). Both interventions were delivered 5 days per week for 8 weeks. Fifty participants completed the study and were included in the final per-protocol analysis (25 per group). Outcomes were assessed at baseline and after intervention. The primary outcomes were the Fugl-Meyer Assessment for Lower Extremity (FMA-LE) and Holden Walking Function Classification. Secondary outcomes were hip, knee, and ankle range of motion (ROM).</p><p><strong>Results: </strong>Both groups improved after treatment, with greater improvement observed in the experimental group. FMA-LE scores increased by 5.6 ± 1.5 points in the experimental group and 1.8 ± 0.8 points in the control group (p < 0.001, Cohen's d = 1.32). In addition, 92% (23/25) of participants in the experimental group achieved Holden Grades II-III compared with 60% (15/25) in the control group (p < 0.001). The experimental group also showed larger gains in joint ROM, including hip flexion (+19.9° vs. + 4.2°), knee external rotation (+9.9° vs. + 3.7°), and ankle dorsiflexion (+7.6° vs. + 1.3°) (all p < 0.001).</p><p><strong>Conclusion: </strong>Deconstructed Tai Chi stepping training combined with conventional rehabilitation was associated with greater improvement in lower limb motor function, walking ability, and joint mobility than conventional rehabilitation plus limb synergy training in patients with Brunnstrom Stage III stroke. This stage-specific protocol may represent a practical adjunct to stroke rehabilitation, although confirmation in larger trials is still needed.</p><p><strong>Clinical trial registration: </strong>International Traditional Medicine Clinical Trial Registry (ITMCTR; a WHO ICTRP Primary Registry), registration number ITMCTR2025000972.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0348765"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative taxonomy of Haemaphysalis (Acari: Ixodidae) from the Western Ghats, India: Morphological and molecular characterization and implications.","authors":"K R Reshma, K Prakasan, R Aswathi, A P Ranjith","doi":"10.1371/journal.pone.0348592","DOIUrl":"10.1371/journal.pone.0348592","url":null,"abstract":"<p><p>Haemaphysalis ticks (Ixodidae) are important vectors of pathogens affecting humans and animals, yet their genetic diversity and subgeneric relationships remain insufficiently resolved. We combined detailed morphological examination with cytochrome c oxidase subunit I (COI) -based molecular analyses to provide an integrative taxonomic assessment of the genus. A total of 239 ticks representing ten species were collected from three zones of the Western Ghats, Kerala, India, with Haemaphysalis (Kaiseriana) spinigera Neumann, 1897 and Haemaphysalis (Kaiseriana) turturis Nuttall & Warburton, 1915 being the most abundant. Morphological identifications were confirmed by COI sequence analyses, generating 29 new sequences from 10 species, including five sequenced for the first time. These data were analysed together with publicly available sequences to infer phylogenetic relationships. Maximum Likelihood and Bayesian analyses produced largely congruent topologies but did not support the monophyly of most subgenera. Instead, the subgenus Allophysalis was recovered as sister to the remaining Haemaphysalis, with H. (Allophysalis) kopetdaghica Kerbabaev, 1962 forming an exception that may represent a distinct lineage requiring further taxonomic evaluation. Species delimitation analyses based on ASAP and PTP recovered 55 and 59 MOTUs, respectively, showing high congruence between methods. Inter-subgeneric divergence ranged from 12-19%, where most species exhibited less than 2% intraspecific variation, several taxa showed patterns consistent with cryptic diversity. Population genetic analyses of H. (Kaiseriana) bispinosa Neumann, 1897 revealed high within-population variation, moderate among-population differentiation, and 20 geographically structured haplotypes across 10 countries. Overall, our results support the utility of COI for Haemaphysalis identification at the species level and highlight the need for broader integrative approaches to resolve persistent taxonomic uncertainties in this medically important genus.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0348592"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methicillin-resistant Staphylococcus aureus along the beef production line: Phenotypic resistance and mecA phylogeny in two ethiopian municipal abattoirs.","authors":"Samuel Abie, Solomon Lulie Abey, Gashaw Getaneh Dagnaw, Wassie Molla, Mebrie Zemene Kinde, Seleshe Nigatu, Mebrat Ejo, Habtamu Tassew, Anmaw Shite Abat, Eyerusalem Belay, Shimelis Dagnachew, Abebe Tesfaye Gessese, Takele Adugna, Bemrew Admassu Mengistu, Yitayew Demessie, Melkie Dagnaw Fenta, Asnakew Mulaw Berihun, Wudu Temesgen Jemberu, Adugna Berju, Getaw Deresse Tadesse, Yoseph Kerie Kebede, Kenaw Birhanu, Takele Abayneh, Esayas Gelaye, Abebe Belete Bitew","doi":"10.1371/journal.pone.0334585","DOIUrl":"10.1371/journal.pone.0334585","url":null,"abstract":"<p><p>Staphylococcus aureus (S. aureus) is a common zoonotic bacteria, responsible for a wide range of infections and is well known for developing resistance to multiple antibiotics. In Ethiopia, information on methicillin-resistant S. aureus (MRSA), particularly from a One-Health perspective, is limited. This study aimed to detect S. aureus, identify MRSA strains, and assess their antibiogram patterns in swab samples collected from two municipal abattoirs in Northwest Ethiopia. A cross-sectional study was conducted between January 2021 and April 2022. A total of 150 swab samples were collected from beef carcasses, abattoir equipment, surfaces, workers' hands and clothes. Isolation and identification of S. aureus followed ISO 6888-2 standards. Antimicrobial susceptibility was tested against ten commonly used antibiotics using the disk diffusion method. Conventional PCR was used for detection of the mecA gene and Sanger method was used for sequencing. Overall, S. aureus was isolated from 25.3% (38/150) of the samples. The prevalence of S. aureus was 27.1% in beef carcasses, 26.9% in abattoir workers, and 23.1% in the abattoir environment. The prevalence was 22.7% in Bahir Dar and 28.0% in Debre Markos abattoirs. The highest detection rate (35.7%) was from workers' hands and hooks, while the lowest (11.1%) was from splitting axes. All isolates were susceptible to gentamicin but resistant to penicillin and methicillin. Multidrug resistance was observed in 60.5% of the isolates. Sequencing and phylogenetic analysis of the mecA gene showed that the current isolates were highly similar and clustered closely with mecA from Staphylococcus capitis and Staphylococcus fleurettii, but were distinct from other S. aureus strains. The detection of S. aureus and MRSA in beef carcasses, abattoir environments, and workers highlights potential risks to workers, consumers, and surrounding environments exposed to abattoir waste. Strengthening hygiene and sanitary practices in abattoirs is essential within a One Health framework.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0334585"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of unbiased metagenomic next generation sequencing to targeted multiplex diagnostic assays for the detection of respiratory viruses.","authors":"Justin Hardick, Raghavendran Anantharam, Jennifer Lu, Steven L Salzberg, Richard E Rothman, Katherine Z J Fenstermacher, Andrew Pekosz, Annet Onzia, Lydia Nakiyingi, Yukari C Manabe, Abraham J Kandathil","doi":"10.1371/journal.pone.0347750","DOIUrl":"10.1371/journal.pone.0347750","url":null,"abstract":"<p><strong>Objectives: </strong>Accurate diagnosis of existing and emerging respiratory pathogens is important. We evaluated the capability of unbiased metagenomic next generation sequencing (mNGS) to identify pathogenic RNA viruses from two cohorts of nasopharyngeal (NP) swabs previously tested by commercial multiplex respiratory diagnostics.</p><p><strong>Methods: </strong>NP swabs (N = 100) in viral transport media (VTM) were assessed using mNGS for this study. Cohort 1 (N = 52) consisted of symptomatic individuals who tested negative for SARS-CoV-2, influenza A/B, and RSV by the Xpert Xpress CoV-2/Flu/RSV Plus multiplex respiratory virus panel and were tested by mNGS for undetected pathogens. Cohort 2 (N = 48) included symptomatic individuals who were positive (N = 26) or negative (N = 22) by the ePlex RP2 multiplex respiratory pathogen panel. Samples were positive for influenza A (N = 8), rhinovirus/enterovirus (N = 5), RSV (N = 4), adenovirus (N = 3), parainfluenza (N = 2), seasonal coronaviruses (N = 2), and human metapneumovirus (N = 1), as well as a rhinovirus/enterovirus/human metapneumovirus co-infected sample (N = 1). mNGS results were compared with ePlex RP2 findings, and symptomatic negative samples were evaluated for additional pathogen detection.</p><p><strong>Results: </strong>Cohort 1 contained 8% (4/52) viral and 19% (10/52) bacterial reads. In cohort 2, positive concordance between ePlex RP2 and mNGS was 31% (8/26). mNGS did not identify any viral reads in ePlex RP2-negative samples. However, it detected other microbial reads, such as Acanthamoeba castellanii, in 21% (10/48) of samples.</p><p><strong>Conclusion: </strong>In this study, targeted multiplex amplification methods demonstrated better overall sensitivity in NPs of symptomatic respiratory individuals than mNGS. Other mNGS approaches may produce different results. This study suggests that mNGS may offer adjunctive information, including the detection of rare pathogens, which may be helpful in some clinical contexts.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0347750"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Diversity of root system architecture and root-shoot biomass allocation in industrial hemp (Cannabis sativa L.).","authors":"","doi":"10.1371/journal.pone.0349068","DOIUrl":"10.1371/journal.pone.0349068","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pone.0339929.].</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0349068"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rigid versus flexible: The effect of destination revitalization policy on tourists' travel behavioral intention.","authors":"Wen Qin, Weilong Li, Yanli Peng, Juan Su","doi":"10.1371/journal.pone.0348289","DOIUrl":"10.1371/journal.pone.0348289","url":null,"abstract":"<p><p>Destination revitalization policies have been considered functional or institutional ones that would stimulate the tourism markets. This paper redefines the concept of destination revitalization policies as social cues and how they influence the social judgments and intention to travel by tourists. Based on the stereotype content model and temporal construal theory, we differentiate between two kinds of revitalization policies: flexible and rigid, and form a theoretical model to describe the differentiated psychological mechanisms of these policies and boundary conditions. Evidence from seven studies, including one semi-structured interview study and six scenario-based experiments, shows that flexible revitalization policies generally elicit stronger travel behavioral intention than rigid policies. This is brought about by differentiated social judgments: the flexible policies lead to increased perceptions of warmth, and the rigid policies to increased perceptions of competence. In addition, the effects are conditional to temporal distance. The flexible policies are more effective in case of close-term travel choices and rigid policies in case of long-term planning. By placing the destination revitalization policy in a new perspective as destination communication, the given study contributes to the existing knowledge on destination marketing and tourism policy governing and presents practical outcomes of how the policy should be designed to respond to how tourists make decisions and to ensure the sustainability of the development of a destination.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0348289"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Richness and biogeography of Pteridoflora in montane forests of eastern Mexico.","authors":"J Daniel Tejero-Díez, Perla V Rodríguez-Sánchez, Raúl Contreras-Medina, Julio Cesar Ramírez-Martínez, Jonathan D Amith, Leccinum J García-Morales, Celia Sanginés-Franco, Isolda Luna-Vega","doi":"10.1371/journal.pone.0346965","DOIUrl":"10.1371/journal.pone.0346965","url":null,"abstract":"<p><p>This study compiles and updates the checklist of ferns and lycophytes from the Sierra Madre Oriental (SMOR), Mexico. We analyzed the distribution and richness of these groups of seedless vascular plants to ensure the accuracy and reliability of the data. We reviewed information on these taxa from regional floristic studies, field explorations, and herbarium specimens. Our updated list includes 567 species, of which 511 are ferns and 56 lycophytes, organized into 37 families and 137 genera. The five most species-rich families are Pteridaceae (131), Polypodiaceae (76), Dryopteridaceae (68), Aspleniaceae (45), and Selaginellaceae (41). The five most species-rich genera are Asplenium (42), Elaphoglossum (30), Pleopeltis (24), Myriopteris (22), and Selaginella (21). The Mexican states with the greatest species richness within the SMOR are Puebla (423), Hidalgo (322), Querétaro (227), and Tamaulipas (181). The five grid cells with the highest richness, each containing more than 190 species, are situated in the southern part of the SMOR (Puebla and adjacent parts of Veracruz). The physiographic provinces with the greatest diversity are Carso Huasteco and the Gran Sierra Plegada, with 523 and 175 species, respectively. Latitudinal analysis indicated low richness at the northern extreme (28 °- 29 ° N, 11 species) and high richness at the southern extreme (19 °- 20 ° N, 469 species), with a notable peak at 24 °- 25 ° N (350 species). The highest diversity within elevation intervals occurs at 1,000-1,500 m (455 species). The SMOR contains 22 species of the pteridoflora classified under various risk categories according to the Mexican Official Norm NOM-059-SEMARNAT-2010, including seven listed on the IUCN Red List and ten protected under CITES. The taxonomic diversity index shows that the SMOR is among Mexico's most species-rich mountain ranges. The species richness documented here in the SMOR accounts for 50-54% of the pteridophyte diversity recorded in Mexico, increasing to 59.3% based on recent floristic studies conducted in the region.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0346965"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide trends and regional variation in intravitreal injections and anti-VEGF agent use in Japan from 2017 to 2022: An analysis of the NDB Open Data.","authors":"Yoshiaki Kabata, Ryo Terauchi, Tadashi Nakano","doi":"10.1371/journal.pone.0348087","DOIUrl":"10.1371/journal.pone.0348087","url":null,"abstract":"<p><p>Intravitreal injections are an essential treatment modality for retinal vascular and macular diseases, yet nationwide evidence describing long-term trends, regional variation, drug composition, seasonality, and the impact of the COVID-19 pandemic in Japan remains limited. We conducted a nationwide retrospective observational study using aggregated National Database of Health Insurance Claims and Specific Health Checkups (NDB) Open Data for fiscal years (FYs) 2017-2022 (April-March). Total intravitreal injection procedures were identified using procedure code G016, and drug-specific counts of aflibercept, ranibizumab, brolucizumab, and faricimab were extracted using drug codes. Crude utilization rates (per 100,000 population) were calculated using official population estimates. Annual trends were assessed using linear regression, regional variation was summarized descriptively and compared across predefined geographic groupings, monthly patterns were evaluated using Friedman tests, and the pandemic impact was examined by comparing FY 2019 (pre-COVID), FYs 2020-2021 (COVID period), and FY 2022 (post-COVID). National total intravitreal injection procedures (G016) increased from 600,068 in FY 2017-936,715 in FY 2022 (anti-VEGF injections: 591,469-929,704), corresponding to an average increase of approximately 65,000 injections per year. The mean crude utilization rates rose from 478.6 ± 109.2 to 775.7 ± 143.1 per 100,000 population, while relative inter-prefectural variability decreased modestly (coefficient of variation 0.228 to 0.184). Aflibercept remained the predominant anti-VEGF agent, with diversification after the introduction of brolucizumab (FY 2020) and faricimab (FY 2022). Monthly volumes showed modest seasonality, with higher counts toward the end of the fiscal year. Injection volumes showed no marked decline during the pandemic; April-May 2020 totals (119,100 injections) were only 0.9% lower than the same months in 2019 (120,202 injections). These findings indicate sustained growth in intravitreal injection activity in Japan, persistent but modestly narrowing regional variation, and maintenance of injection services during COVID-19.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 5","pages":"e0348087"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}