PLoS ONE最新文献

{"title":"Antihypertensive medication adherence and associated factors among adult hypertensive patients at public hospitals in eastern Ethiopia: A Cross-sectional study.","authors":"Jemal Yousuf, Kedir Teji Roba, Nesredin Ahmed, Tefera Belsty, Fenta Wondimneh, Lema Daba, Tilahun Teshager, Indeshaw Ketema","doi":"10.1371/journal.pone.0322655","DOIUrl":"https://doi.org/10.1371/journal.pone.0322655","url":null,"abstract":"<p><strong>Background: </strong>Blood pressure regulation depends heavily on adherence to antihypertensive medication. Additionally, poor adherence to antihypertensive drugs leads to the development of hypertensive complications. However, little is knowen about the factors affecting antihypertensive medication adherance in Ethiopia, and no study has been conducted in the study settings. Therefore, this study aimed to assess antihypertensive medication adherence and associated factors among adult hypertensive patients in selected public hospitals in East Hararghe Zone, Eastern Ethiopia.</p><p><strong>Methods: </strong>A facility-based quantitative cross-sectional study was conducted from August 20 to September 20, 2023, among 364 adult hypertensive patients on follow-up in selected public hospitals of eastern Ethiopia. A simple random sampling method was used to select the study participants. Data were collected through face-to-face interviews using a pretested structured questionnaire. Drug adherence status was assessed using Morisky Medication Adherence Scale-8. Data was analyzed using Epi-Data 3.1 and STATA 17.0, applying bivariate and multivariate logistic regression techniques. The association was declared using p < 0.05.</p><p><strong>Results: </strong>The overall level of adherence to antihypertensive medications was 59.94% (95% CI: 54.65-65.06). Urban residence (AOR = 1.96; 95% CI: 1.21-3.18), college and higher education level (AOR = 3.41; 95% CI: 1.69-6.87), health insurance coverage user (AOR = 2.00; 95% CI: 1.11-3.59), having knowledge about hypertension (AOR = 1.75; 95% CI: 1.03-2.97), distance to health care facility less than 10 kilometers (AOR = 4.6; 95% CI: 1.97-10.73), having social support (AOR = 1.86; 95% CI: 1.13-3.08), and taking three and above medications (AOR = 0.28; 95% CI: 0.12-0.64) showed a statistically significant association with medication adherence.</p><p><strong>Conclusion: </strong>Adherence to antihypertensive medication was found to be low. This study identified place of residence, educational status, health insurance coverage, social support, knowledge of hypertension, distance from a health care facility, and number of medications as independent predictors of medication adherence. Therefore, improving accessibility of health care facilities, strengthening health insurance coverage, and providing health education about hypertension will improve antihypertensive medication adherence.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0322655"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174542","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 high-sensitivity C-reactive protein to albumin ratio with all-cause and cardiac death in coronary heart disease individuals: A retrospective NHANES study.","authors":"Shangxun Zhou, Miaohan Qiu, Kexin Wang, Yixuan Duan, Daoshen Liu, Ying Xu, Xuefei Mu, Jing Li, Yi Li, Yaling Han","doi":"10.1371/journal.pone.0322281","DOIUrl":"https://doi.org/10.1371/journal.pone.0322281","url":null,"abstract":"<p><strong>Background: </strong>This research aimed to explore the association of high-sensitivity C-reactive protein to albumin ratio (CAR) with death events in community-based patients with coronary heart disease (CHD).</p><p><strong>Methods: </strong>624 CHD participants were followed for 36 months using data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES). The CAR was dichotomized at 0.075 mg/g to stratify inflammation levels. Relationships between CAR, high-sensitivity C-reactive protein (hsCRP), albumin (ALB) and all-cause and cardiac death in all participants and subgroups were analyzed using restricted cubic spline (RCS), Kaplan-Meier survival curves and Cox proportional hazards models.</p><p><strong>Results: </strong>Both CAR and hsCRP showed positive correlations with all-cause and cardiac death risk while ALB exhibited a U-shaped correlation with all-cause death risk but a negative correlation with cardiac death risk. The high-CAR group had higher risks of all-cause (P = 0.04) and cardiac death (P = 0.02). The hazard ratios (HR) (95% confidence intervals (CI)) for all-cause death was 1.77 (1.15-2.74) (P = 0.010), while it was 2.99 (1.44-6.22) (P = 0.003) for cardiac death. No significant interaction was observed in subgroup analyses.</p><p><strong>Conclusions: </strong>A CAR threshold of 0.075 mg/g effectively distinguished between high and low inflammation risks. Elevated CAR significantly increased the risk of all-cause and cardiac death in community CHD patients.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0322281"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174547","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":"Blockchain assisted signature and certificate based protocol for efficient data protection and transaction management in smart grids.","authors":"Keyan Abdul-Aziz Mutlaq, Vincent Omollo Nyangaresi, Mohd Adib Omar, Zaid Ameen Abduljabbar, Junchao Ma, Mustafa A Al Sibahee, Abdulla J Y Aldarwish, Ali Hasan Ali","doi":"10.1371/journal.pone.0318182","DOIUrl":"https://doi.org/10.1371/journal.pone.0318182","url":null,"abstract":"<p><p>Smart grids collect real-time power consumption reports that are then forwarded to the utility service providers over the public communication channels. Compared with the traditional power grids, smart grids integrate information and communication technologies, cyber physical systems, power generation and distribution domains to enhance flexibility, efficiency, transparency and reliability of the electric power systems. However, this integration of numerous heterogeneous technologies and devices increases the attack surface. Therefore, a myriad of security techniques have been introduced based on technologies such as public key cryptosystems, blockchain, bilinear pairing and elliptic curve cryptography. However, majority of these protocols have security challenges while the others incur high complexities. Therefore, they are not ideal for some of the smart grid components such as smart meters which are resource-constrained. In this paper, a protocol that leverages on digital certificates, signatures, elliptic curve cryptography and blockchain is developed. The formal verification using Real-Or-Random (ROR) model shows that the derived session keys are secure. In addition, semantic security analysis shows that it is robust against typical smart grid attacks such as replays, forgery, privileged insider, side-channeling and impersonations. Moreover, the performance evaluation shows that our protocol achieves a 17.19% reduction in the computation complexity and a 46.15% improvement in the supported security and privacy features.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0318182"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174567","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":"Estimation of finite population mean in a complex survey sampling.","authors":"Mohsin Abbas, Muhammad Ahmed Shehzad, Mahwish Rabia, Haris Khurram, Muhammad Ijaz","doi":"10.1371/journal.pone.0324559","DOIUrl":"https://doi.org/10.1371/journal.pone.0324559","url":null,"abstract":"<p><p>Accurate estimation of the finite population mean is a fundamental challenge in survey sampling, especially when dealing with large or complex populations. Traditional methods like simple random sampling may not always provide reliable or efficient estimates in such cases. Motivated by this, the current study explores complex sampling techniques to improve the precision and accuracy of mean estimators. Specifically, we employ two-stage and three-stage cluster sampling methods to develop unbiased estimators for the finite population mean. Building upon these, the next phase of the study formulates unbiased mean estimators using stratified two- and three-stage cluster sampling. To further enhance the precision of these estimators, a ranked-set sampling strategy is applied to the secondary and tertiary sampling stages. Additionally, unbiased variance estimators corresponding to the proposed mean estimators are derived. Real-world datasets are utilized to demonstrate the application of these complex survey sampling methodologies, with results showing that the mean estimates derived using ranked set sampling are more accurate than those obtained via simple random sampling.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0324559"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174575","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":"The impact of mergers and acquisitions on technological innovation in state-owned enterprises: The moderating role of mixed-ownership.","authors":"Niannian Wu, Furong Guo, Bingxia Wang","doi":"10.1371/journal.pone.0324025","DOIUrl":"https://doi.org/10.1371/journal.pone.0324025","url":null,"abstract":"<p><p>Using data from Chinese A-share listed state-owned enterprises (SOEs) between 2007 and 2019, we examine how mergers and acquisitions (M&As) affect SOE innovation through patent outputs, with a focus on mixed-ownership M&As where SOEs acquire private firms. Our results show that while M&As generally enhance SOE innovation through increased patent applications, mixed-ownership M&As demonstrate significantly stronger positive effects compared to SOE-to-SOE M&As. This enhancement is most notable when control rights are transferred, when acquiring SOEs possess high R&D investment but lower production efficiency, and in regions with less developed markets. The primary mechanism appears to be improved corporate governance through increased private shareholder involvement in strategic decision-making. These findings advance our understanding of how ownership differences influence innovation in M&As while providing practical guidance for SOE reform policies in China and similar emerging economies.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0324025"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174601","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":"Numerical solutions of a fractional order SEIR epidemic model of measles under Caputo fractional derivative.","authors":"Nawa A Alshammari, N S Alharthi, Abdulkafi Mohammed Saeed, Adnan Khan, Abdul Hamid Ganie","doi":"10.1371/journal.pone.0321089","DOIUrl":"https://doi.org/10.1371/journal.pone.0321089","url":null,"abstract":"<p><p>Measles is a highly contagious illness that can spread throughout a population based on the number of susceptible or infected individuals as well as their social dynamics within the society. The measles epidemic is thought to be controlled for the suffering population using the susceptible-exposed-infectious-recovered (SEIR) epidemic model, which depicts the direct transmission of infectious diseases. To better explain the measles epidemics, we provided a nonlinear time fractional model of the disease. The solution of SEIR is obtained by using the Caputo fractional derivative operator of order [Formula: see text]. The Homotopy perturbation transform method (HPTM) and Yang transform decomposition methodology (YTDM) have been employed to obtain the numerical solution of the time fractional model. Obtaining numerical findings in the form of a fast-convergent series significantly improves the proposed techniques accuracy. The behaviour of the approximate series solution for several fractional orders is shown graphically which are derived through Maple. A graphic representation of the behaviours of susceptible, exposed, infected, and recovered individuals are shown at different fractional order values. Figures that depict the behaviour of the projected model are used to illustrate the developed results. Finally, the present work may help you predict the behaviour of the real-world models in the wild class with respect to the model parameters. It was found that the majority of patients who receive therapy join the recovered class when various epidemiological classes were simulated at the effect of fractional parameter [Formula: see text]. These approaches shows to be one of the most efficient methods to solve epidemic models and control infectious diseases.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0321089"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174383","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":"Deep learning-based classification of speech disorder in stroke and hearing impairment.","authors":"Joo Kyung Park, Sae Byeol Mun, Young Jae Kim, Kwang Gi Kim","doi":"10.1371/journal.pone.0315286","DOIUrl":"https://doi.org/10.1371/journal.pone.0315286","url":null,"abstract":"<p><strong>Background and objective: </strong>Speech disorders can arise from various causes, including congenital conditions, neurological damage, diseases, and other disorders. Traditionally, medical professionals have used changes in voice to diagnose the underlying causes of these disorders. With the advancement of artificial intelligence (AI), new possibilities have emerged in this field. However, most existing studies primarily focus on comparing voice data between normal individuals and those with speech disorders. Research that classifies the causes of these disorders within the abnormal voice data, attributing them to specific etiologies, remains limited. Therefore, our objective was to classify the specific causes of speech disorders from voice data resulting from various conditions, such as stroke and hearing impairments (HI).</p><p><strong>Methods: </strong>We experimentally developed a deep learning model to analyze Korean speech disorder voice data caused by stroke and HI. Our goal was to classify the disorders caused by these specific conditions. To achieve effective classification, we employed the ResNet-18, Inception V3, and SEResNeXt-18 models for feature extraction and training processes.</p><p><strong>Results: </strong>The models demonstrated promising results, with area under the curve (AUC) values of 0.839 for ResNet-18, 0.913 for Inception V3, and 0.906 for SEResNeXt-18, respectively.</p><p><strong>Conclusions: </strong>These outcomes suggest the feasibility of using AI to efficiently classify the origins of speech disorders through the analysis of voice data.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0315286"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174410","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":"Knowledge, attitude, and practice of vasoactive agents infusions: Development and psychometric properties of a questionnaire with chinese clinical nurses.","authors":"Yanfang Huang, Yi Chen, Yaping Fang, Junjie Mou, Shiqin Li, Xianying Lei, Yuxin Li, Zhongping Ai","doi":"10.1371/journal.pone.0312068","DOIUrl":"https://doi.org/10.1371/journal.pone.0312068","url":null,"abstract":"<p><strong>Background: </strong>Inconsistencies with guidelines or standards regarding nurses' practice of vasoactive agent infusion have been documented. Adequate knowledge and positive attitudes are critical for compliance. However, there are currently no validated tools specifically designed to measure the knowledge and attitudes related to vasoactive agent infusions among nurses.</p><p><strong>Objective: </strong>The aim of this study was to develop and test the validity and reliability of the Chinese mainland version of Knowledge, Attitude, and Practice of Vasoactive Agents Infusions Questionnaire among nurses.</p><p><strong>Methods: </strong>The initial questionnaire items were developed through a comprehensive literature review, expert consultation, and pilot study. From February to June 2024, cross-sectional data were collected using convenience sampling from 538 nurses across 9 hospitals in Sichuan Province, China. The reliability and validity of the scale were evaluated through internal consistency reliability, inter-rater reliability, exploratory factor analysis, and confirmatory factor analysis.</p><p><strong>Results: </strong>The final version of the questionnaire included 33 items across 3 dimensions, explaining 78.04% of the variance, with item loadings ranging from 0.56 to 0.89. The content validity index ranged from 0.91 to 1.00, and the scale-level content validity index was 0.98.The overall Cronbach's α for the questionnaire was 0.96, with Cronbach's α for each dimension ranging from 0.96 to 0.98. The test-retest reliability for the entire questionnaire was 0.90, and for each dimension, it ranged from 0.90 to 0.94 (p < 0.05). The confirmatory factor analysis demonstrated acceptable fit indices for the three-dimensional model: χ²/(df) = 1.135, p = 0.200, RMSEA = 0.024, CFI = 0.986, TLI = 0.985, GFI = 0.884, and NFI = 0.895.</p><p><strong>Conclusion: </strong>The Knowledge, Attitude, and Practice of Vasoactive Agents Infusions Questionnaire demonstrates good reliability and validity, making it a reliable measurement tool for assessing nurses' attitudes and knowledge related to vasoactive agents' infusions. This version will facilitate further research and advancements in this specific field of study.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0312068"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174424","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: Fruit fly infestation of cucurbitaceous vegetables in Morogoro-Eastern Central Tanzania.","authors":"","doi":"10.1371/journal.pone.0325451","DOIUrl":"https://doi.org/10.1371/journal.pone.0325451","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pone.0322277.].</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0325451"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174438","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":"Effect of orally administered cannabidiol oil on daily tonometric curve in healthy Italian Saddle horses.","authors":"Marilena Bazzano, Fulvio Laus, Matteo Cerquetella, Andrea Spaterna, Andrea Marchegiani","doi":"10.1371/journal.pone.0325191","DOIUrl":"https://doi.org/10.1371/journal.pone.0325191","url":null,"abstract":"<p><strong>Background: </strong>Phytocannabinoids have the potential to lower intraocular pressure in both normal and glaucomatous eyes and they have been tested in different animal species, but not in the horse. The present paper describes the tonometric curve of healthy adult Italian Saddle horses after oral administration of cannabidiol oil (CBD).</p><p><strong>Methods: </strong>CBD 20% was administered orally (oily solution) at the dose of 1 mg/kg to 8 adult horses and intraocular pressure (IOP) was evaluated by tonometric curve. Data were then compared to those of the same horses obtained the day before (blank) CBD administration.</p><p><strong>Results: </strong>15 minutes after CBD administration, IOP (time zero 27.3 ± 2.1 mmHg right eye; 24.6 ± 2.3 mmHg left eye) started to decrease (19.5 ± 5.2 mmHg right eye; 20.8 ± 2.4 mmHg left eye) and 1 hour later CBD it reached the minimum level in all horses (11.4 ± 7.5 mmHg right eye; 9.5 ± 5.8 mmHg left eye), remaining statistically significantly lower than normal values for the entire observation period (8 hours; 12.0 ± 7.9 mmHg right eye; 11.9 ± 7.8 mmHg left eye).</p><p><strong>Conclusions: </strong>CBD 20% was effective to significantly reduce IOP in healthy adult Italian Saddle horses and may be an effective hypotensive agent to be implemented in case of primary or secondary glaucoma.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0325191"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174450","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}