PLoS ONE最新文献

{"title":"Early hospital discharge following delivery during wartime is not associated with increased rates of postpartum hospital referrals.","authors":"Shlomit Blumenfeld, Lital Shaham, Noa Brenner, Gad Segal, Michal J Simchen, Keren Zloto, Mordechai Dulitzky, Eyal Sivan, Nirit Agay, Alina Weissmann-Brenner","doi":"10.1371/journal.pone.0335688","DOIUrl":"10.1371/journal.pone.0335688","url":null,"abstract":"<p><strong>Background: </strong>During war, significant adaptations take place in hospitals to improve the treatment of soldiers and civilians. For example, low-risk women were discharged earlier from hospitals following delivery. The aim of the study was to compare the rate of postpartum-visits to the gynecological-emergency-room (GER) between wartime to a similar period in the previous year.</p><p><strong>Methods: </strong>A retrospective study compared the visits of postpartum-women in the GER to a similar period in the previous year.</p><p><strong>Results: </strong>The study included 801 women who delivered in the first month of the war in 2023 and 913 who delivered in the parallel period in the previous year. There were no significant changes in maternal age, gravidity, parity, mode of delivery, birthweight, meconium, low Apgar scores, and the rate of admissions to the neonatal intensive care unit. There were significantly less elective cesarean sections during wartime (57% vs. 92%; p < 0.0001). The duration of postpartum hospitalization was significantly shorter during wartime [median length of 53.2 [Interquartile-range (IQR] 42.4-72.4) hours vs. 64.1 (IQR 47.4-82.8) in the previous year (p < 0.0001)]. There were no significant differences in the rate of total referrals of postpartum-women to the GER (8.7% vs. 8.8%; p > 0.05), and no differences in referrals due to infections or bleeding. There was no difference in the rate of admission of postpartum-women (17% vs. 14%; p = 0.73).</p><p><strong>Conclusions: </strong>Shortening of hospitalization following delivery during war is feasible, does not cause increase postpartum visits to the GER, and does not increase GER visits due to infections or bleeding.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0335688"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207748","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":"Design and verification of an interlocked centrifugal exhaust system for hatch-type boiling disinfectors.","authors":"Xiaoxue Sun, Qinqin Wang, Wei Zheng","doi":"10.1371/journal.pone.0360909","DOIUrl":"10.1371/journal.pone.0360909","url":null,"abstract":"<p><strong>Objective: </strong>To address the occupational exposure risks caused by instantaneous steam overflow when opening the top cover of hatch-type boiling disinfectors in the central sterile supply department, this study developed an interlocked centrifugal exhaust system (ICES) characterized by operational simplicity and high adaptability.</p><p><strong>Methods: </strong>The ICES was assembled using a centrifugal fan, Hall effect switch, instant relay, time-delay relay, solid-state relay, and piping. The system achieved automatic start/stop of the fan based on the open‑or‑closed status of the top cover. A self-controlled design was adopted on one hatch-type boiling disinfector. Temperature was measured at the chamber edge (T1) and at the technician's facial position (T2). Airborne particle counts were also measured at the technician's facial position. Measurements were performed under conditions with and without the ICES enabled. Data were analyzed using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>After enabling the ICES, T1 and T2 decreased by 20.89% and 31.31%, respectively. The median temperature at T2 was 21.5 °C, which was close to the ambient temperature. The reduction ratios for airborne particle counts of six different sizes at the technician's facial position ranged from 53.09% to 67.83%. All differences between groups were statistically significant (all P < 0.001).</p><p><strong>Conclusion: </strong>The ICES effectively reduces steam overflow upon the top-cover opening of hatch-type boiling disinfectors and lowers the risk of occupational injury. With advantages such as wide installation adaptability, imperceptible operation, and convenient maintenance, it provides a stable and reliable solution for the safety retrofitting of existing hatch-type boiling disinfectors.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0360909"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207751","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":"The double-edged sword of human-AI collaboration on design students' competence development: The mediating roles of challenge and hindrance appraisals and the asymmetric moderation of teacher AI leadership.","authors":"Xiang Wang, MingXing Li, Jia Du, Y U Yao, Jiabei Jiang","doi":"10.1371/journal.pone.0360722","DOIUrl":"10.1371/journal.pone.0360722","url":null,"abstract":"<p><p>The deepening integration of generative AI into design education is driving a paradigm shift in human-computer AI collaboration (HAIC) -from mere tool assistance toward intelligent synergy. However, its dual impact on the competency development of design students and the underlying mechanisms remain insufficiently understood. Grounded in the Theory of Stress Appraisal, this study constructs a research model to examine the double-edged sword effect of HAIC on Design Competence (DC), introducing teacher AI Leadership (AIL) as a moderating variable. The aim is to reveal the psychological mechanisms and boundary conditions through which HAIC influences DC. Employing a questionnaire survey, this study conducted an empirical investigation involving 483 design students in East China. Data analysis was performed using SPSS 24.0 and Amos 23.0, encompassing reliability and validity tests, regression analysis, and Bootstrap mediation analysis. The results indicate that HAIC influences DC through dual pathways: it positively enhances DC by fostering Challenge Appraisal (CA) (β = 0.283, p < 0.01), which in turn positively predicted competence development (β = 0.363, p < 0.01), yielding a significant indirect effect of 0.103 (p < 0.01). Simultaneously, HAIC triggered Hindrance Appraisal (HA) (β = 0.271, p < 0.01), which negatively predicted competence development (β = -0.229, p < 0.01), yielding a significant indirect effect of -0.062 (p < 0.01). This constitutes a partial mediating mechanism characterized by \"one positive, one negative\" effect. Furthermore, Teacher AIL exhibits an asymmetric moderating effect: it significantly buffers the positive impact of HAIC on HA (β = -0.112, p < 0.01), indicating that high AIL can mitigate cognitive load and anxiety arising from technological uncertainty, yet it does not significantly amplify the positive pathway via CA (β = 0.001, p > 0.05). The findings suggest that the impact of HAIC on DC is not linear but rather a dialectical process contingent upon individual cognitive appraisal. The core value of Teacher AIL lies in \"risk mitigation\" rather than \"creativity stimulation,\" offering a theoretical foundation for the intelligent transformation of educational design. At the practical level, it is imperative to facilitate from knowledge deliverers to cognitive facilitators in AI-augmented design education. By systematically developing AI instructional competencies and reforming assessment systems, educators can guide students toward establishing a healthy relationship with HAIC, thereby achieving the synergistic advancement of technological empowerment and humanistic literacy.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0360722"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207876","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":"Risk factors for syphilis among newly admitted prisoners: A case-control study.","authors":"Thanaset Hiranbandit, Wutthichai Jariya","doi":"10.1371/journal.pone.0360956","DOIUrl":"10.1371/journal.pone.0360956","url":null,"abstract":"<p><strong>Background: </strong>Syphilis remains a major global public health concern in various groups, including people in prisons, where the burden is substantial. This study aimed to identify factors associated with syphilis infection among newly admitted prisoners in a province of Thailand.</p><p><strong>Methods: </strong>A case-control study was conducted among newly admitted prisoners in three correctional facilities. Cases and controls were randomly selected from newly admitted prisoners who had undergone syphilis screening at prison entry between 01/04/2025 and 30/09/2025. Data were collected using validated data collection instruments, including case record forms and structured questionnaires. Multivariable logistic regression analysis was used to identify factors associated with syphilis infection among newly admitted prisoners, with statistical significance set at p-value < 0.05.</p><p><strong>Results: </strong>A total of 51 cases and 204 controls were included in the study. In multivariable logistic regression analysis, homosexual or bisexual orientation (adjusted odds ratio [AOR] = 9.59; 95% confidence interval [CI]: 1.81-50.92), a history of sexually transmitted infections (AOR = 38.03; 95% CI: 10.46-138.31), anal intercourse (AOR = 4.47; 95% CI: 1.05-19.12), sexual intercourse without condom use (AOR = 13.82; 95% CI: 3.38-56.43), and injection drug use (AOR = 45.60; 95% CI: 2.88-722.12) were significantly associated with syphilis infection among newly admitted prisoners.</p><p><strong>Conclusions: </strong>Prison entry represents a critical opportunity for syphilis screening. Risk-based screening strategies targeting individuals with high-risk sexual behaviors and substance use should be prioritized to reduce syphilis transmission in correctional facilities.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0360956"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207901","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":"Metaphor, multimodality and generative AI: Synthetic images prompted by figurative expressions in anti-immigration discourse.","authors":"Christopher Hart","doi":"10.1371/journal.pone.0359980","DOIUrl":"10.1371/journal.pone.0359980","url":null,"abstract":"<p><p>Complex social processes like migration are frequently understood via metaphors. In right-wing media and far-right political discourses, two metaphors that abound draw on flood and invasion frames to problematise immigration and legitimise hostile attitudes and actions towards it. In so far as metaphor involves the construction of mental imagery, it is intimately bound with visual experience, including semiotically mediated visual experience. In a semiotic landscape increasingly populated by synthetic images, I argue that the meaning of metaphors may be modulated by AI-generated visual content and that this is especially important in contexts of political communication. The study investigates images generated by prompts instantiating an immigration is flood versus an immigration is invasion metaphor to inquire if and how they differ by source-frame and what are the ideological implications of the images returned. Following an initial pilot study, several specific semiotic features are analysed, including colour, properties of the figure (size, shape, orientation) and ground elements (environment, securitising features and frame-consistent features like fire and water). Results show significant differences between metaphorical frames and highlight the potential that AI-generated images have to reflect and reinforce ideological positions.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0359980"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207815","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":"Histopathologic spectrum of focal liver lesions diagnosed by ultrasound-guided percutaneous liver biopsy and predictors of hepatocellular carcinoma: A single-center experience from Sub-Saharan Africa.","authors":"Tamrat Petros Elias, Abate Bane Shewaye, Kaleb Assefa Berhane, Abdu Mohammed, Zebeaman Tibebu, Amanuel Getu Gebreselassie, Abraham Sisay Abie","doi":"10.1371/journal.pone.0357210","DOIUrl":"10.1371/journal.pone.0357210","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Focal liver lesions (FLLs) encompass a wide spectrum of benign and malignant pathologies, and accurate diagnosis is essential for appropriate management. Although advances in imaging have improved lesion characterization, histopathologic assessment remains the diagnostic gold standard for indeterminate lesions. Data on the histopathologic spectrum and diagnostic utility of ultrasound-guided percutaneous liver biopsy (US-PLB) in sub-Saharan Africa (SSA) are limited. This study aimed to characterize the histopathologic findings of US-PLB performed for FLLs at a tertiary referral center in SSA and to identify factors associated with hepatocellular carcinoma (HCC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective observational study of adult patients (≥18 years) who underwent US-PLB for FLL between January 2021 and December 2024 at Adera Medical and Surgical Center. Patients with indeterminate pathology results, incomplete records, biopsies performed for diffuse liver disease, or lesions classified as LI-RADS 1, 2, or 5 were excluded. Demographic, clinical, laboratory, imaging, histopathologic, and outcome data were extracted from medical records. Descriptive statistics were used to summarize patient characteristics and histopathologic diagnoses. Logistic regression analysis was performed to identify factors associated with HCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 119 were included in the final analysis. The median age was 56 years (IQR 45-65), and 59.7% were male. The median focal liver lesion size was 8.20 cm (IQR: 5.1-11.0 cm), with 38.7% presenting as multifocal lesions. No major biopsy-related complications were reported. HCC was the most common histopathologic diagnosis, accounting for 42.9% of cases, followed by secondary metastatic tumors (15.9%) and regenerative nodules (15.9%). Other diagnoses included chronic hepatitis (8.4%), cholangiocarcinoma (5.9%), and hepatic abscess (3.4%). Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were present in 14.3% and 12.4% of patients, respectively. On multivariate analysis, HBV infection (AOR 7.85, 95% CI 1.45-42.60; p = 0.017), HCV infection (AOR 9.03, 95% CI 1.41-57.76; p = 0.020), Fibrosis-4 (FIB-4) score (AOR 1.45, 95% CI: 1.05-2.34: p &lt; 0.01), and larger tumor size (AOR 1.27, 95% CI 1.11-1.46; p &lt; 0.01) were significantly associated with HCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Ultrasound-guided percutaneous liver biopsy demonstrated a favorable safety profile for the evaluation of FLL. HCC was the predominant histopathologic diagnosis, reflecting the substantial burden of primary liver cancer in this setting. Chronic viral hepatitis and larger tumor size were significantly associated with HCC. These findings support the continued role of US-PLB in the diagnostic evaluation of indeterminate focal liver lesions and underscores the importance of viral hepatitis prevention, surveillance, and early detection strategies in sub-Saharan Afr","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0357210"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207334","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":"Visual tools for 3D plasma simulation: GPU-based isosurface extraction and particle-based rendering.","authors":"Jong-Hyun Kim, Mintae Na, Junho Kim, Sejin Yun, Jung Lee, Sun-Jeong Kim","doi":"10.1371/journal.pone.0359294","DOIUrl":"10.1371/journal.pone.0359294","url":null,"abstract":"<p><p>This paper presents a GPU-accelerated visualization framework for interactive exploration of fusion-plasma simulation data represented as scalar fields and particle trajectories. The primary technical contribution is a capacity-safe isosurface-extraction pipeline that combines inclusive slab partitioning with a two-pass counting and exact allocation strategy. This design prevents slab-boundary omissions and output-buffer overflow while supporting large scalar grids. The generated positions and normals are written directly to CUDA-OpenGL interoperable buffers, enabling the standalone renderer to display explicit isosurfaces without an intermediate CPU-side copy. The extracted geometry and scalar-volume data are additionally integrated into Unreal Engine through a separate staging interface. This integration provides a unified environment for volume rendering, explicit-isosurface inspection, particle-trajectory visualization, clipping, and VR-based spatial exploration. These engine-side functions are used as interaction and visualization mechanisms rather than being presented as new rendering algorithms. Experiments on electromagnetic-potential fields with resolutions up to 5123 demonstrate stable isosurface extraction across different isovalues. In the most geometrically complex tested case, the method generates approximately 42.81 million vertices in 44.7 ms, uses less than 11 GB of GPU memory, and renders the resulting geometry at 28.6 FPS. The results indicate that the proposed framework provides a practical explicit-surface visualization path for large plasma datasets while complementing direct volume rendering and established scientific-visualization toolkits.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0359294"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207509","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":"Relation-aware dynamic knowledge subgraph enhanced large language models for medical multiple-choice question answering.","authors":"Yu Ma, Tianning Di, Jiangpeng Xu, Yue Wu","doi":"10.1371/journal.pone.0349628","DOIUrl":"10.1371/journal.pone.0349628","url":null,"abstract":"<p><p>Medical multiple-choice question answering requires models to simultaneously understand question semantics, candidate-answer differences, and structured relations among medical entities in complex clinical contexts. To address the limitations that existing knowledge-enhanced methods often adopt question-level unified modeling and thus struggle to characterize local relational differences among different candidate options, while conventional low-rank adaptation lacks relation-pattern adaptivity, this paper proposes a knowledge-enhanced large language model framework that combines option-level knowledge subgraph representation fusion with relation-aware dynamic LoRA adaptation. The proposed method first constructs a local medical knowledge subgraph for the question stem and each candidate answer separately, and then injects structured knowledge into candidate representations through a graph encoder and gated fusion mechanism. Subsequently, multiple learned LoRA expert branches are dynamically combined through candidate-conditioned routing based on the relational information encoded in the enhanced candidate representations, enabling the model to obtain more suitable parameter update paths. The experimental results are reported as the mean and standard deviation over three random-seed runs. On the MedQA dataset, the proposed method achieves Accuracy scores of 62.90%±0.82% and 62.84%±1.04%, together with F1-Score values of 62.97%±1.07% and 62.79%±0.78%, using Llama3 8B and Qwen 7B, respectively. On the MedMCQA dataset, the corresponding Accuracy scores are 61.04%±0.30% and 58.59%±0.65%, while the F1-Score values reach 61.21%±0.54% and 57.77%±0.57%, respectively. Experimental results show that the proposed method can effectively improve knowledge understanding, candidate discrimination, and reasoning stability in medical multiple-choice question answering.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0349628"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207921","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":"Medical rehabilitation use and regional bypass among children and adolescents with disabilities: Lessons from South Korea.","authors":"Sungbae Jo","doi":"10.1371/journal.pone.0360753","DOIUrl":"10.1371/journal.pone.0360753","url":null,"abstract":"<p><p>This cross-sectional secondary analysis examined medical rehabilitation use and regional bypass among Korean children and adolescents with registered disabilities, using a two-stage access framework that distinguished entry into medical-institution rehabilitation from out-of-region use after entry. We analyzed public-use data from the 2023 National Survey on Persons with Disabilities, restricting the sample to respondents younger than 19 years (n = 399; weighted national estimate, 88,611). Weighted descriptive statistics and modified Poisson regression with robust standard errors were used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Overall, 50.0% had no medical-institution rehabilitation use, 31.5% used in-region rehabilitation, and 18.6% used out-of-region rehabilitation; among rehabilitation users, 37.1% reported out-of-region care. In stage 1, non-developmental disability type was associated with higher medical rehabilitation use (PR, 1.61; 95% CI, 1.28-2.03), whereas eup/myeon residence was associated with lower use (PR, 0.66; 95% CI, 0.46-0.94). In stage 2, province residence (PR, 2.13; 95% CI, 1.38-3.27) and non-developmental disability type (PR, 1.74; 95% CI, 1.13-2.69) were associated with out-of-region use, while male sex was associated with lower out-of-region use (PR, 0.62; 95% CI, 0.42-0.92). The most common reason for non-use was use of non-medical facilities (27.4%); better treatment and absence of nearby medical institutions were leading reasons for out-of-region care. Pediatric medical rehabilitation access involves challenges to both non-use and out-of-region use, with implications for local entry support, regional capacity-building, and cross-sector service integration.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0360753"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207732","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":"Joint associations of 2D-3D urban form with land surface temperature along an urban-rural gradient: Implications for sustainable urban planning.","authors":"Liang Zhang, Xue Liu, Xianfan Shu","doi":"10.1371/journal.pone.0358985","DOIUrl":"10.1371/journal.pone.0358985","url":null,"abstract":"<p><p>As fundamental urban units, buildings are closely associated with urban thermal environments, and their morphological attributes are related to spatial variations in thermal conditions. Although significant progress has been made in characterizing building morphology, the relative importance and joint associations between 2D horizontal characteristics and 3D vertical structures in shaping neighborhood-scale thermal environments along urban-rural gradients remain underexplored. This study integrated multi-source remote-sensing data and Geodetector analysis to examine the joint, grid-level associations of 2D and 3D urban-form indicators with land surface temperature (LST) in Hangzhou, China. Multi-temporal LST data from 2000, 2010, 2015, and 2020 were used to characterize the thermal context, whereas the building-morphology data in 2020 supported a cross-sectional spatial association analysis. The results revealed clear spatial variation in the relative explanatory power of morphological indicators. Specifically, 3D building configurations exhibited the greatest explanatory power in the Core Built-up Area, whereas 2D characteristics showed stronger associations with LST in the Suburban Built-up Area. Interactions between 2D and 3D features generally provided greater explanatory power than individual factors, with several factor pairs showing nonlinear enhancement. These findings highlight the value of jointly considering horizontal land-cover patterns and vertical building form when assessing urban thermal environments. By elucidating gradient-specific thermal regulation processes and multidimensional interactions among built-environment features, this study provides a scientific foundation for spatially targeted, climate-responsive heat mitigation strategies and sustainable urban development.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"21 10","pages":"e0358985"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207656","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}