PLoS ONE最新文献

{"title":"Psychometric validation of the Malay CMNI-30: A study among male healthcare professionals in Malaysia.","authors":"Muhammad Iqbal Haji Mukhti, Mohd Ismail Ibrahim, Tengku Alina Tengku Ismail, Najib Majdi Yaacob","doi":"10.1371/journal.pone.0320765","DOIUrl":"https://doi.org/10.1371/journal.pone.0320765","url":null,"abstract":"<p><p>Masculinity norms significantly influence men's health behaviors and outcomes, yet existing instruments to measure these norms often lack cultural adaptability. This study addresses this gap by validating the Malay version of the Conformity to Masculine Norms Inventory (CMNI-30) to assess masculinity norms among Malay men. A cross-sectional study was conducted with 438 male healthcare professionals in Malaysia. Confirmatory Factor Analysis (CFA) revealed that the final model, consisting of 26 items across multiple factors, demonstrated strong fit indices (χ²/df =  1.72, CFI =  0.931, TLI =  0.911, RMSEA =  0.042, SRMR =  0.052). However, certain factors, such as 'self-reliance' (Raykov's rho =  0.270) and 'violence' (Raykov's rho =  0.431), exhibited lower reliability, reflecting cultural nuances in their interpretation. The study concludes that the Malay CMNI-30 is a valid and culturally relevant tool for assessing masculinity norms in this context. Practical applications include using this tool to identify gender-related barriers to health-seeking behaviors and inform gender-sensitive public health interventions. Future research should validate this instrument across diverse populations to enhance its generalizability and utility.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0320765"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764807","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":"Analysis of University Students' Mental Health from the Perspective of Occupational Harmony.","authors":"Yijun Liu, Ruiqi She, Jin Xing","doi":"10.1371/journal.pone.0309490","DOIUrl":"https://doi.org/10.1371/journal.pone.0309490","url":null,"abstract":"<p><strong>Background: </strong>Mental health problems are common among university students. Based on the Model of Occupational Harmony, we investigated the relationship between occupational engagement and mental health among Chinese university students.</p><p><strong>Methods: </strong>A mixed methods approach was adopted. A total of 734 Chinese university students responded to online questionnaires: a socio-demographic questionnaire, the Depression Anxiety Stress Scale, the WHOQOL-BREF, and a self-designed Occupational Harmony Questionnaire. Individual interviews with 11 university students and a focus group of four students provided qualitative data.</p><p><strong>Results: </strong>Anxiety, depression, and stress were reported by 11.9%, 9.4%, and 2.9% of the participants, respectively. The level of occupational harmony was negatively correlated with depression, anxiety, and stress (p <  .001). The DASS-21 score was significantly different among students who spent different amounts of time on the following activities: exercise, sleep, rest, reflective and consulting activities, study, work, and leisure and entertainment (P < .05). In the context of the COVID-19 pandemic, the key occupational factors contributing to university students' mental health problems included excessive mental engagement and insufficient physical engagement, excessive active engagement and insufficient quiet engagement, insufficient social engagement, excessive or insufficient Gong (productive) engagement, and insufficient De (virtuous) engagement, Zhi (rational) engagement, and Kang (health maintenance) engagement, lack of coherence within the family, school, social systems, as well as inadequate schedule planning and time management.</p><p><strong>Conclusions: </strong>Occupational disharmony is related to university students' mental health problems. Occupational therapy can promote university students' mental well-being by enhancing occupational harmony.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0309490"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764558","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":"Associations of subjective age trajectories with loneliness and stress across adulthood.","authors":"Anna E Kornadt, Markus Wettstein, Anthony Lepinteur, Claus Vögele, Conchita D'Ambrosio","doi":"10.1371/journal.pone.0320673","DOIUrl":"https://doi.org/10.1371/journal.pone.0320673","url":null,"abstract":"<p><p>Subjective age, that is the age a person feels like in relation to their chronological age, is indicative of a variety of biological, psychological, and social aging processes. Despite its importance, studies that investigate multi-variate, dynamic, longitudinal relations of subjective age with its potential determinants and potential mechanisms of these relations have so far rarely been employed. In the current study, we focus on loneliness as a potential subjective age determinant. As loneliness affects a variety of psychosocial and health outcomes across life and is stereotypically perceived as a feature of old age, we investigate whether loneliness is related with levels and changes in subjective age. We furthermore test whether this association is mediated via self-reported stress. N =  5,594 participants aged 18 - 93 years (Mage =  50.41, SD =  15.99) who participated in a longitudinal survey comprising up to three measurement occasions over a time span of 2.5 years reported their loneliness, subjective age, and stress as well as sociodemographic and health-related covariates. We employed latent growth modeling and found that, when controlling for sociodemographic and health-related covariates, higher loneliness was related to an older subjective age cross-sectionally and to a steeper increase in subjective age over time. These relations were mediated via stress; however, the relation between stress and subjective age was no longer statistically significant when including the covariates. All associations were qualified by significant interactions with chronological age, albeit in different directions. Our findings attest to associations between loneliness, stress and subjective aging experiences and highlight the need for an age-informed approach when planning further studies and interventions.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0320673"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764576","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":"Analyzing anomalous events in passageways with high-frequency ship signals.","authors":"Cherryl Chico, Macario O Ii Cordel, Mahinthan Joseph Mariasingham, Elaine S Tan","doi":"10.1371/journal.pone.0320129","DOIUrl":"https://doi.org/10.1371/journal.pone.0320129","url":null,"abstract":"<p><p>Passageways are critical gateways in maritime trade, providing efficient routes for global commerce. This means that disruptions such as natural disasters or human error at these crucial points can significantly impact numerous economies across various facets of trade. Thus, real-time monitoring of such events and their impact on different vessel types is crucial for developing timely mitigation strategies, policies, and penalties. This paper proposes a novel framework for analyzing anomalous events in passageways using Automated Information System (AIS). This framework enables monitoring of affected vessels and quantifies the impact in terms of the number of vessels, dwell and idle times, and the emergence of new routes. To demonstrate its potential, we applied the proposed framework to the Suez Canal blockage in March 2021. Results revealed distinct phases during the event, with each phase impacting average dwell times. Additionally, the analysis identified the emergence of passageway event-driven routes utilized by vessels to bypass the blockage. These findings highlight the ability of the proposed framework to capture previously obscured information compared to existing indicators and port analysis methods. To further demonstrate its generalizability, the methodology was also applied to two other passageways: the Bosporus Strait, following the policy implemented in February 2022 due to the Russian invasion of Ukraine, and the Bab el-Mandeb Strait, following the disruption caused by the Houthi attacks beginning in the last quarter of 2023.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0320129"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764637","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":"Artificial intelligence (AI) in nursing administration: Challenges and opportunities.","authors":"Omar Qaladi, Mukhlid Alshammari, Abdullah Abdulrahim Almalki","doi":"10.1371/journal.pone.0319588","DOIUrl":"https://doi.org/10.1371/journal.pone.0319588","url":null,"abstract":"<p><p>Artificial Intelligence (AI) is increasingly transforming nursing administration by enhancing operational efficiency and supporting data-driven decision-making. This study explores registered nurses perceptions of AI in Saudi Arabia, focusing on both challenges and opportunities. A cross-sectional survey of 202 nurses revealed that 93.6% believe AI improves understanding, and 88.1% feel it enhances the quality of learning. Significant correlations were found between years of experience and AI usage (r =  0.342, p <  0.001) and between sources of information and AI perception (r =  0.146, p =  0.039). While 80.7% expressed concern that AI could reduce critical thinking, 76.8% feared job displacement. These findings underscore the need for training, ethical guidelines, and support systems to foster effective AI integration, enhancing nursing practice while addressing concerns around professional roles.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0319588"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764639","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":"Association of excessive screen time exposure with ocular changes leading to astigmatism in children.","authors":"Mutahir Shah, Satheesh Babu Natarajan, Nafees Ahmad","doi":"10.1371/journal.pone.0317961","DOIUrl":"https://doi.org/10.1371/journal.pone.0317961","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to find the relationship between excessive screen time exposure and the development of astigmatism in children.</p><p><strong>Methods: </strong>A cross-sectional correlational study was conducted at tertiary care hospital, Islamabad between June 2023 to May 2024. In total, 431 patients were included in this study after informed written consent. Screen time exposure was assessed through smartphone usage history or parental reports of daily use of smart gadget(s). Tear break-up time was measured using a fluorescein strip, cobalt blue filter on a slit-lamp biomicroscope and a stopwatch. Data was analyzed using univariate and multivariate statistical tests including Spearman's correlation and regression analyses.</p><p><strong>Results: </strong>The study included 431 children (mean age: 6.70 ±  1.80 years; 55% male, 45% female). Mean screen time was 4.54 ±  1.52 hours/day. A positive correlation between screen time and the magnitude of astigmatism was observed (r = 0.33, p < 0.001). Regression analysis showed a significant relationship among screen time and astigmatism (B = 0.177, CI: 0.80-0.25). Tear break- up time (TBUT) showed a significant negative correlation with screen time (r = -0.167, p < 0.001), and reduced TBUT was linked to a higher risk of inflammatory conjunctivitis and lid thickening (B = -0.431, CI: -0.12 to -0.49, p < 0.001). The results highlighted that inflammatory conjunctivitis/lid thickness have three times greater risk of developing high astigmatism (OR =  3.31, p-value <  0.001, CI =  1.91 to 5.73) while the risk of moderate astigmatism in such cases was two times higher (2.12, p-value =  0.004, CI = 1.26-3.56). However, the effect of lid thickness on astigmatism when combining with screen time has a little effect that is not significant (p-value = 0.053). Thus, excessive screen time is an independent risk factor of causing astigmatism in children (p < 0.001). The Wilcoxon Signed Ranks Test demonstrated significant improvement in visual acuity after correction (p < 0.001).</p><p><strong>Conclusion: </strong>Excessive screen time in children is significantly associated with astigmatism, tear film instability, inflammatory ocular conditions, including conjunctivitis and lid thickening. These findings suggest the need for preventive strategies, such as reducing screen time and encouraging regular eye examinations, to protect children's ocular health.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0317961"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764647","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":"Implications for Precision Accelerated Clinically Embedded Research (PACER): A novel technology-enabled approach to conducting minimal-risk research in outpatient community healthcare settings.","authors":"Emma Friedman, Kelly Nicole Michelson, Shruti Sehgal, Russell Steans, Mohammad Hosseini, Matthew J Baumann, Amanda K Venables, Theresa L Walunas, Justin Starren","doi":"10.1371/journal.pone.0318533","DOIUrl":"https://doi.org/10.1371/journal.pone.0318533","url":null,"abstract":"<p><p>Current challenges in the clinical research landscape include insufficient enrollment of study participants, lack of study participant diversity, protracted study progression, and the siloing of research within academic medical centers. Recent advances in technology could minimize barriers to producing effective, timely, and comprehensive clinical research by addressing issues from study design to dissemination of results. Particularly, the Fast Health Interoperability Resources standards and Clinical Decision Support Hooks could support data acquisition, sharing, and expansion of research across organizations and disparate electronic health records. We developed a novel approach, Precision Accelerated Clinically Embedded Research (PACER), that leverages these advances in healthcare technology to integrate very short, minimal-risk research activities into clinical encounters. PACER could enable scalable, efficient, and cost-effective clinical research and has enormous potential. However, PACER also presents potential ethical, sociotechnical, and implementation quandaries. The current study aimed to obtain insights on these matters from relevant individuals. We conducted 47 qualitative semi-structured interviews with patients, clinicians, research experts (individuals involved in developing and conducting research), and bioethicists. We sought participants' perspectives on the potential ethical, sociotechnical, and implementation issues raised by PACER. We identified five key domains: impacts on clinical research, consent, compensation, impacts on people and organizations, and implementation. We examined interview participants' views using bioethical principles of autonomy, justice/fairness, beneficence, and nonmaleficence. While participants had diverse views, these insights highlight important considerations for PACER implementation and suggest areas for future empirical work.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0318533"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764657","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":"Correction: Cost-effectiveness of Left Ventricular Assist Devices (LVADs) as destination therapy in the UK: An economic modelling study.","authors":"Tuba Saygın Avşar, Louise Jackson, Pelham Barton, Sophie Beese, Hoong S Lim, David Quinn, Malcolm Price, David J Moore","doi":"10.1371/journal.pone.0321324","DOIUrl":"https://doi.org/10.1371/journal.pone.0321324","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pone.0312912.].</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0321324"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764691","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":"Characterization of Human Balance through a Reinforcement Learning-based Muscle Controller.","authors":"Kübra Akbaş, Carlotta Mummolo, Xianlian Zhou","doi":"10.1371/journal.pone.0320211","DOIUrl":"https://doi.org/10.1371/journal.pone.0320211","url":null,"abstract":"<p><p>Objective characterization of human balance remains a challenge and clinical observation-based balance tests during physical rehabilitation are often affected by subjectivity. On the other hand, computational approaches mostly rely on center of pressure (COP) tracking and inverted pendulum models, which do not capture the multi-joint and muscle contributions to whole-body balance. This study proposes a novel musculoskeletal modeling and control methodology to investigate human balancing capabilities in the center of mass (COM) state space. A musculoskeletal model is integrated with a balance controller trained through reinforcement learning (RL) to explore the limits of dynamic balance during postural sway. The RL framework consists of two interlinked neural networks (balance recovery and muscle coordination) and is trained using Proximal Policy Optimization (PPO) under multiple training strategies. By exploring recovery from random initial COM states with a trained controller, a balance region (BR) is obtained that encloses successful state-space trajectories. Comparing BRs obtained from different trained controllers with the analytical postural stability limits of a linear inverted pendulum model, we observe a similar trend in COM balanced states, but reduced recoverable areas. Furthermore, the effects of muscle weakness and neural excitation delay on the BRs are investigated, revealing reduced balancing capability in the COM state space. The novel approach of determining regions of stability through learning muscular balance controllers provides a promising avenue for personalized balance assessments and objective quantification of balance capability in humans with different health conditions.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0320211"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764697","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":"Comparison of the surgical efficacy of total hip replacement versus hemiarthroplasty in the treatment of femoral neck fractures in elderly patients with sarcopenia.","authors":"Zhaoyang Yin, Zhuzhi Zhu, Chao Wang, Xiaolong Jia, Xiuqiang Zou","doi":"10.1371/journal.pone.0321070","DOIUrl":"https://doi.org/10.1371/journal.pone.0321070","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) and hemiarthroplasty (HA) are common surgical procedures for femoral neck fracture (FNF) in elderly patients; however, optimal treatment options remain controversial. Currently, limited research has compared the effectiveness of THA versus HA, specifically in patients with FNF and sarcopenia.</p><p><strong>Methods: </strong>This retrospective study included data from 109 patients who fulfilled the inclusion criteria for the period between January 2015 and December 2017. Among these, 48 underwent THA, and 61 underwent hip arthroplasty (HA). The cross-sectional area (cm2) of muscle tissue at the pedicle level of the 12th thoracic vertebra (T12) was measured using chest computed tomography. The skeletal muscle index (SMI) was calculated by dividing the cross-sectional area of the muscle at the T12 pedicle by height squared. Sarcopenia was diagnosed when grip strength and SMI values were below the diagnostic cut-off value. Various factors were compared, including age, sex, SMI, body mass index (BMI), perioperative surgery-related indicators, postoperative 5-year survival, satisfaction, complication, and re-revision surgery rates between the 2 groups.</p><p><strong>Results: </strong>There were no statistically significant differences between the THA and HA groups in terms of age (P =  0.227), sex (P =  0.870), SMI (P =  0.946), BMI (P =  0.310), postoperative time to ambulation (P =  0.803), length of hospitalization (P =  0.777), postoperative visual analog scale score (P =  0.933), and postoperative Harris score (P =  0.379). At the 5-year follow-up, there were no statistical differences in patient survival rate (P =  0.896), satisfaction (P =  0.945), incidence of complications (P =  0.796), or re-revision rate (P =  0.807). Patients who underwent THA had significantly longer operative times (P =  0.000) and larger surgical incisions (P =  0.000). They also experienced greater blood loss (P =  0.000) and blood transfusion volumes (P =  0.017), as well as increased hemoglobin (P =  0.000) and albumin (P =  0.000) loss. Furthermore, patients who underwent THA incurred higher surgical costs (P =  0.000).</p><p><strong>Conclusion: </strong>THA and HA demonstrated comparable effectiveness and outcomes in patients with FNF and sarcopenia. HA was a less invasive and more cost-effective surgical option, making it the preferred choice.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 4","pages":"e0321070"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764722","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}