PLoS ONE最新文献

{"title":"Cardiovascular disease risk prediction models for people living with HIV in Sub-Saharan Africa: A scoping review protocol.","authors":"Nchidzi Ntiyani, Gobopamang Letamo, Mpho Keetile, Mpho Disang","doi":"10.1371/journal.pone.0352716","DOIUrl":"10.1371/journal.pone.0352716","url":null,"abstract":"<p><strong>Background: </strong>The landscape of Human Immunodeficiency Virus (HIV) care has dramatically shifted with the advent of effective antiretroviral therapy (ART), transforming HIV from a rapidly fatal illness into a chronic, manageable disease. This success, however, has unveiled new challenges, primarily the increased prevalence of non-AIDS-related comorbidities, with non-communicable diseases (NCDs) such as cardiovascular disease (CVD) emerging as a critical concern for people living with HIV (PLWH). CVD has now become a leading cause of morbidity and mortality in this population, and its risk assessment is imperative. However, there is scanty data on CVD risk prediction models developed and/or applied among PLWH in sub-Saharan Africa (SSA). Therefore, this planned scoping review aims to systematically map existing literature on CVD risk prediction models developed and/or used among PLWH in SSA. The review will identify the models that have been developed, used, and validated in the region.</p><p><strong>Methods: </strong>The scoping review protocol will follow an established framework for conducting scoping reviews. The study will employ the methodological approaches by Arksey and O'Malley and its recent advances, the Joanna Briggs Institute, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. The objective of the scoping review will be achieved through a comprehensive published literature search from 01 January 2000 to 03 June 2026 across five selected databases: PubMed, Scopus, Web of Science, Google Scholar, and CINAHL, based on a predefined strategy. Inclusion criteria will focus on studies written in English that develop, validate, or apply CVD risk prediction models among PLWH in SSA. The screening of search results and data extraction will be conducted by two independent reviewers.</p><p><strong>Expected outcomes and conclusions: </strong>The review will synthesize and summarize the existing literature on CVD risk prediction developed and used among PLWH in SSA, identify knowledge gaps, and provide insights to inform the development of a novel CVD risk prediction model specific to PLWH in SSA. Registration: Open Science Framework https://doi.org/10.17605/OSF.IO/XVFUA.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0352716"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13743019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357915","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":"Effectiveness of dose-matched immersive virtual reality-stationary cycling combined with neurological physiotherapy versus neurological physiotherapy alone in individuals with chronic stroke (CIVIS): A single-blind, randomized crossover trial protocol.","authors":"Daniel Asensio-Perez, David Lucena-Anton, Jose A Moral-Munoz","doi":"10.1371/journal.pone.0362132","DOIUrl":"10.1371/journal.pone.0362132","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stroke is a leading cause of long-term disability worldwide and frequently results in persistent motor and functional impairments, particularly affecting gait and balance. Given the high prevalence and impact of these limitations on independence and quality of life, innovative rehabilitation strategies are needed. Immersive virtual reality combined with stationary cycling (IVR-SC) has emerged as an innovative rehabilitation approach with the potential to improve mobility and functional outcomes after stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To analyze the comparative effectiveness of two dose-matched programs, one combining IVR-SC plus neurological physiotherapy (NP), versus the other consisting of NP alone, in individuals with chronic stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A randomized, single-blind, crossover clinical trial will be conducted. After calculating the sample size, a minimum of 8 participants with chronic stroke (≥6 months), hemiparesis, and gait and balance impairments will be randomly assigned to one of two sequences of intervention. Each participant will receive both neurological physiotherapy and IVR-SC across two 4-week intervention periods separated by a washout period (4 weeks). Each intervention period consists of 8 sessions delivered over a 4-week period, with each session lasting 60 minutes. The primary outcome will be gait quality, assessed using Wisconsin Gait Scale (WGS), while secondary outcomes will include walking endurance, balance, motor function, and muscle tone. Clinical outcomes will be assessed at baseline and after each intervention period. Satisfaction with using the IVR-SC intervention will also be evaluated. Statistical analyses will follow an intention-to-treat approach using a linear mixed-effects model (LMM) with treatment, period, sequence, baseline, and center as fixed effects, and participant as a random effect. Statistical significance will be set at p &lt; 0.05. An individual responder analysis will be performed to determine if participants exceeded the minimal clinically important difference (MCID) of 2.25 points on the WGS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;This study will contribute to understanding the potential comparative effects of IVR-SC in stroke rehabilitation. Given the heterogeneity of individuals with stroke, which may limit the conclusiveness of findings in parallel-group studies, the crossover design allows each participant to serve as their own control, reducing inter-individual variability and strengthening the interpretation of the results. If effective, IVR-SC could represent a feasible and scalable option for partially replacing NP within standard neurorehabilitation, with potential for implementation in both clinical and home-based settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;ClinicalTrials.gov ID: NCT07529665. Effectiveness of dose-matched rehabilitation with immersive virtual reality-stationary cycling combined with neurological physiotherapy ","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0362132"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13742934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357924","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":"Spruce-derived extracellular vesicles (SDEVs) improve hair loss by activating the proliferation of dermal papilla cells.","authors":"Kunchi Zhang, Ying Cao, Zitong Wang","doi":"10.1371/journal.pone.0358041","DOIUrl":"10.1371/journal.pone.0358041","url":null,"abstract":"<p><p>Hair loss is a global health problem, and current conventional treatments, despite their effectiveness in delaying hair loss and improving hair growth, suffer from significant side effects and limitations in individualized treatment. In recent years, the application of novel nanotechnology in dermatology and regenerative medicine has gained attention. In this context, researchers explored the potential of applying Spruce-Derived Extracellular Vesicles (SDEVs) to hair loss intervention. Through in vitro experiments and in vivo animal models, it was found that Spruce-Derived Extracellular Vesicles (SDEVs) could improve hair follicles by activating the proliferation of Dermal papilla cells (DPCs) to intervene in hair loss. Spruce-Derived Extracellular Vesicles (SDEVs) significantly improved hair weight, thickness, and luster, and reduced the inflammatory response associated with hair loss compared with conventional treatments. These findings provide new ideas for hair regrowth treatments and demonstrate the potential therapeutic value of Spruce-Derived Extracellular Vesicles (SDEVs) in hair loss prevention.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0358041"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13742931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357945","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":"Validation of chemical inactivation methods for Select Agent compliance using HPAIV and low-pathogenicity influenza A virus in tissues and cultured cells.","authors":"Yuekun Lang, Anthony Griffiths","doi":"10.1371/journal.pone.0362117","DOIUrl":"10.1371/journal.pone.0362117","url":null,"abstract":"<p><p>The US Federal Select Agent program requires that inactivation procedures be validated before treated materials can be removed from biocontainment for downstream use. Although H5 avian influenza viruses are subject to temporary exemption from the Select Agent regulatory requirements, validated inactivation workflows remain critical for safe downstream handling of HPAIV-containing materials. Common treatments, including TRIzol, TRIzol LS, formalin, and ice-cold methanol, are frequently used to facilitate virus inactivation and downstream processing. However, facility-specific inactivation validation is required for Select Agent workflows and for safe handling of HPAIV-containing materials. In this study, HPAIV (H5N1)-infected samples were used to validate inactivation of material generated in cell culture, and low-pathogenicity (H1N1)-infected lung homogenates were used to validate inactivation of animal-derived tissues. Following inactivation, column-based buffer exchange was used to remove cytotoxic inactivants before viability testing. This step did not significantly reduce recovery of infectious virus, supporting the sensitivity of this approach. In inactivation tests, residual infectious virus was assessed by plaque assay and serial blind passages. No infectious virus was detected following any of the tested conditions. These data validate several procedures for inactivating influenza A virus-containing cell cultures, fluids, and tissue samples and provide a framework for facility-specific validation of similar workflows.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0362117"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13742933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357952","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":"Experimental and theoretical investigation of parameter-driven stability and chaos in a non-linear neuron circuit model.","authors":"Haiqa Ehsan, Haseeba Sajjad, Adil Jhangeer, Lubomír Říha","doi":"10.1371/journal.pone.0360729","DOIUrl":"10.1371/journal.pone.0360729","url":null,"abstract":"<p><p>In this study, a neural-inspired electronic circuit consisting of a pressure-sensitive FitzHugh-Nagumo model with the addition of a piezoelectric bi-membrane and two capacitors is explored. The governing equations are obtained analytically from Kirchhoff's laws, which represent the nonlinear interactions, oscillatory response, and stability of the circuit. A perturbation term is added to investigate the deviations from the system potential, and the transitions in the system are studied under the assumption of the model. By applying statistical methods and eigenvalue analysis, the parameter space is systematically subdivided and examined, and the results show that the behavior of the system is dominated by divergent behavior, although some periodic oscillatory behavior is seen in certain regions. This highlights the importance of initial conditions and parameter selection on the behavior of the system, which are essential to obtaining stable behavior and developing an efficient control design. Furthermore, an ensemble-size sensitivity analysis is performed to verify the robustness and convergence of the statistical characterization across different numbers of initial conditions. Phase disturbance plots, power spectrum density plots, attractor reconstruction plots, return maps, and noise detection maps are used to analyze the system dynamics. In addition, a multi-sum (multi-parameter interaction) diagram is created to depict the interactions between circuit variables and the overall system behavior.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0360729"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13742968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357847","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":"Exploratory cluster analysis of noninvasive vascular measures reveals heterogeneous vascular profiles after stroke.","authors":"Bria L Bartsch, Amanda N Engler, Sandra A Billinger","doi":"10.1371/journal.pone.0362305","DOIUrl":"10.1371/journal.pone.0362305","url":null,"abstract":"<p><p>Vascular dysfunction is prevalent after stroke and contributes to elevated cardiovascular risk; however, the extent to which vascular heterogeneity exists in this population remains unclear. This study examined whether distinct multi-domain cluster-derived vascular profiles are present in individuals with chronic stroke and whether these profiles are associated with functional performance. Vascular structure and function were assessed using flow-mediated dilation, carotid intima-media thickness, pulse wave velocity, and augmentation index, with age included in vascular clustering to account for vascular aging. Unsupervised k-means clustering was applied to identify vascular profiles. Functional performance was assessed using gait speed and predicted peak oxygen consumption (VO2peak) derived from a submaximal exercise test. Between-cluster differences were characterized using analysis of variance. Forty-five individuals with chronic stroke (62 ± 12 years; 29 ± 30 months post-stroke) were included. Three vascular profiles were identified (cluster 1: n = 13; cluster 2: n = 11; cluster 3: n = 21), with significant differences across clusters for all vascular measures (p < 0.01). Although age increased across clusters, vascular structure and function did not change uniformly. One profile exhibited elevated arterial wave reflection despite relatively preserved endothelial function and arterial structure, whereas another demonstrated impairment in all vascular variables. Vascular profile was not associated with predicted VO2peak (p = 0.31) or gait speed (p = 0.65). Three exploratory cluster-derived vascular profiles emerged among participants with chronic stroke, and age did not fully account for the observed vascular heterogeneity. Multi-domain cluster-derived vascular profiling revealed heterogeneous vascular profiles in individuals with chronic stroke, providing a basis for future studies to evaluate their relevance to cardiovascular risk stratification and long-term health management. NCT05936008: https://clinicaltrials.gov/study/NCT05936008.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0362305"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13742943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357848","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":"GT-PNID: A lightweight graph-temporal network integrating GCN and transformer for power network intrusion detection.","authors":"Heng Zhou, Mianting Wu, Weixiong Chen, Qiang Zhou","doi":"10.1371/journal.pone.0360854","DOIUrl":"10.1371/journal.pone.0360854","url":null,"abstract":"<p><p>Driven by the advancement of information technology, the transformation of traditional power grids toward intelligence has rendered power systems more vulnerable to cybersecurity risks arising from greater openness and connectivity. Smart grid communication networks exhibit high heterogeneity, diverse protocols, and strict real-time constraints. Existing intrusion detection systems suffer from two key limitations: neglect of spatiotemporal dependencies in network traffic, which hinders the modeling of complex attack evolution, and absence of a unified detection framework with cross-scenario generalization capability. To overcome these limitations, this study develops GT-PNID, a graph-temporal network-based intrusion detection model designed for grid communication networks. The model utilizes a sliding-window dynamic graph construction mechanism to transform heterogeneous traffic into spatiotemporal graph structures. Subsequently, graph convolutional layers are applied to extract local spatial features, while a multilayer Transformer is introduced to model long-range temporal dependencies, followed by graph-level feature fusion for joint spatiotemporal representation. Experiments on CICIDS2017 and NSL-KDD datasets demonstrate that accuracy and F1-scores exceed 99.98%, while the model's parameter count (424,478) and per-sample inference time (0.09 ms) are substantially lower than mainstream methods, confirming its superior detection capability, lightweight efficiency, and cross-dataset generalization potential for smart grid security.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0360854"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13742970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357867","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":"Protocol for investigating the association between Helicobacter pylori exposure, antigen-specific serological responses, and resistant versus non-resistant hypertension in a South African cohort.","authors":"Mathilda C Mennen, Michael Z Zulu, Koketso C Mabatha, Richard Baguma, Sango Skelem, Nandipha N Mbundwini, Olukayode O Aremu, Marguerite Adriaanse, Daphne van Dijk, Preyanka Pillay, Sam Africa, Erika Jones, Mashiko Setshedi, Adrian Brink, Wendy A Burgers, Ntobeko A B Ntusi","doi":"10.1371/journal.pone.0362215","DOIUrl":"10.1371/journal.pone.0362215","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a leading contributor to cardiovascular morbidity and mortality, with poor control in low- and middle-income countries. Helicobacter pylori (H. pylori) has been associated with hypertension through inflammatory, endothelial, metabolic and immune pathways, but data from sub-Saharan Africa, particularly in resistant hypertension, are limited.</p><p><strong>Methods: </strong>This cross-sectional observational study will enrol 200 adults aged ≥18 at a tertiary academic hospital in Cape Town, South Africa: 80 with resistant hypertension, 80 with non-resistant hypertension and 40 with normotension. Participants will undergo standardised clinical assessment, blood pressure measurement, and collection of blood, urine and saliva. H. pylori exposure will be assessed using the Pylori DuoTect® point-of-care assay, which detects antibodies to CagA and FliD. Laboratory analyses will include lipid profile, inflammatory and nitric oxide-related markers, homocysteine, insulin indices, complete blood count, ghrelin, multiplex cytokine profiling and flow cytometric immunophenotyping. PAXgene® blood RNA samples will be retained for future exploratory analyses. Saliva will undergo exploratory H. pylori antigen testing using CerTest® kits, which are validated for stool rather than saliva. Saliva analysis will be exploratory, and results will not define the primary H. pylori exposure variable. Remaining saliva will be kept for potential future oral microbiome analyses not defined in this protocol. Multivariable logistic regression will evaluate associations between H. pylori exposure and hypertension phenotype, adjusting for demographic, lifestyle, and clinical covariates.</p><p><strong>Discussion: </strong>To our knowledge, this will be the first African study to integrate point-of-care H. pylori serology with detailed clinical, inflammatory, metabolic, and immunological profiling across resistant hypertension, non-resistant hypertension and normotension. Findings may clarify biological pathways linking H. pylori exposure to blood pressure dysregulation and inform future mechanistic and interventional studies.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0362215"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13742878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357894","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":"A Kampo medicine, kamishoyosan, ameliorates menstruation-associated symptoms in patients with premenstrual syndrome: An exploratory open-label, randomized controlled trial.","authors":"Jun Chikumi, Eri Sato, Ai Ikebuchi, Yohei Tokita, Mitsuto Fukushige, Mayu Yamamoto, Hiroshi Sunada, Yusuke Endo, Hisashi Noma, Tasuku Harada, Fuminori Taniguchi","doi":"10.1371/journal.pone.0362303","DOIUrl":"10.1371/journal.pone.0362303","url":null,"abstract":"<p><p>Premenstrual syndrome (PMS) is a psychological or physical symptom. We conducted an open-label, randomized, exploratory trial with the aim of evaluating the efficacy and safety of kamishoyosan (KSS) for PMS. KSS was administered orally during three menstrual cycles. The primary endpoint was the change in the premenstrual Menstrual Distress Questionnaire (MDQ) total score. The secondary endpoints included MDQ total and subscale scores, a daily symptom questionnaire, the Work Productivity and Activity Impairment (WPAI) Questionnaire, overall impressions, sleep status, and heart rate. A total of 50 patients were enrolled. The primary endpoint, the premenstrual MDQ total score, was significantly ameliorated after KSS treatment. Furthermore, KSS reduced MDQ scores during the menstrual cycle. Among the MDQ subscales, KSS decreased score of pain, concentration, behavioral change, and negative feelings during the premenstrual cycle. In addition, hyperthymia reduced during the menstrual cycle. The results of the daily symptom questionnaire indicated that KSS treatment alleviated irritability, easy anger, anxiety, emotional instability, abdominal distension, coldness, and stiff shoulders.The WPAI activity impairment score was lower in the KSS group, and overall impression favoured in KSS treatment.. The only adverse event related to KSS was headache in one case. These exploratory findings suggest that KSS may improve menstrual-related symptoms in PMS.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0362303"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13742958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357898","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":"Quality of maternal health services in Lagos, Nigeria: Women's perspectives across healthcare districts.","authors":"Jonathan Odumegwu, Adedayo Aderibigbe, Onoseta Momodu, Ozi Obiamalu, Ayokunle Olumodeji, Precious Tettehfio, Folashade Oludara, Melody Ucho, Joyce Gyamfi, Michael Amegbor, Emmanuel Peprah, Ololade Wright","doi":"10.1371/journal.pone.0359548","DOIUrl":"10.1371/journal.pone.0359548","url":null,"abstract":"<p><strong>Background: </strong>Women's perceptions of care quality during maternal health visits influence service use and maternal and neonatal outcomes. This study assesses perceived quality of maternal health services across healthcare districts in Lagos, Nigeria.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from 7,324 women aged 15-49 years in Lagos State from the 2022 LARCHIS Survey. It examined how demographic, reproductive, care-use, and facility factors predicted perceived maternal healthcare quality (poor/fair, good, or excellent) using multinomial logistic and mixed-effects models.</p><p><strong>Results: </strong>Among 7,324 women (mean age: 31.2 ± 5.9 years), perceived service quality varied significantly by district and facility type. Compared with District I, women in District III were less likely to rate services as good (aOR = 0.37; 95% CI: 0.24-0.56) or excellent (aOR = 0.08; 95% CI: 0.05-0.14), whereas women in District V had higher odds. Lack of response to inquiries was associated with lower odds of rating services as good (aOR = 0.12; 95% CI: 0.08-0.18) or excellent (aOR = 0.06; 95% CI: 0.03-0.16). Rude staff behavior similarly reduced the odds of good ratings (aOR = 0.15; 95% CI: 0.11-0.21) and excellent ratings (aOR = 0.06; 95% CI: 0.06-0.13). Missionary and private facilities received higher ratings than public facilities. Facility readiness-24-hour services, doctor availability, and skilled staff-predicted higher ratings, whereas long waits and closures predicted lower ratings. Staff courtesy and responsiveness were the strongest predictors.</p><p><strong>Conclusion: </strong>Women's perceptions of maternal healthcare in Lagos are shaped by structural and interpersonal factors. Improving facility readiness, reducing delays, and promoting respectful care may improve experiences, service use, and maternal and neonatal outcomes.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 11","pages":"e0359548"},"PeriodicalIF":2.8,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13743031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357904","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}