PLoS ONEPub Date : 2025-05-16eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0322516
Gideon Post Hospers, Mirjam Laging, Wesley J Visser, Pedro Miranda Afonso, Jeroen Ghp Verhoeven, Ingrid Ram Mertens Zur Borg, Dennis A Hesselink, Anneke M E de Mik-van Egmond, Michiel G H Betjes, Madelon van Agteren, David Severs, Jacqueline van de Wetering, Robert Zietse, Michel J Vos, Ido P Kema, Marcia M L Kho, Marlies E J Reinders, Joke I Roodnat
{"title":"Pre-transplant residual diuresis and oxalic acid concentration influence kidney graft survival.","authors":"Gideon Post Hospers, Mirjam Laging, Wesley J Visser, Pedro Miranda Afonso, Jeroen Ghp Verhoeven, Ingrid Ram Mertens Zur Borg, Dennis A Hesselink, Anneke M E de Mik-van Egmond, Michiel G H Betjes, Madelon van Agteren, David Severs, Jacqueline van de Wetering, Robert Zietse, Michel J Vos, Ido P Kema, Marcia M L Kho, Marlies E J Reinders, Joke I Roodnat","doi":"10.1371/journal.pone.0322516","DOIUrl":"10.1371/journal.pone.0322516","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Oxalic acid, a toxic metabolic end product, accumulates when kidney function deteriorates. Apart from its direct tubulotoxicity, it crystallizes at concentrations above 30-40 µmol/L. High oxalic acid concentrations at transplantation might negatively influence kidney transplant function. The influence of the concentrations of oxalic acid and its precursors and residual diuresis on kidney transplant outcomes was studied.</p><p><strong>Methods: </strong>In this prospective cohort study, patients who received a kidney transplant between September 2018 and January 2022 participated. Concentrations of oxalic acid and precursors were determined in pre-transplant blood samples. Data on residual diuresis and other recipient, donor or transplant related variables were collected. Follow-up lasted until July 1st 2023.</p><p><strong>Results: </strong>496 patients were included, 154 were not on dialysis. Median residual diuresis was 1000 mL/day (IQR 200; 2000 mL/day). There were 230 living donor transplantations. Oxalic acid concentrations exceeded the upper normal concentration in 99% of patients, glyoxylic acid in all patients. There were 52 (10%) graft failures. As the influence of oxalic acid on the risk of graft failure censored for death was non-linear, it was categorized into two groups: ≤ 60 and > 60 μmol/L. In multivariable Cox analysis the graft failure censored for death risk was significantly influenced by residual diuresis, donor type (living versus deceased), donor age and oxalic acid. In 180 patients oxalic acid concentration shortly after transplantation was significantly lower than pre-transplant concentrations, suggesting excretion by the new graft. A better eGFR at day 7 was associated with lower oxalic acid concentration. Oxalic acid and residual diuresis did not influence patient survival.</p><p><strong>Conclusion: </strong>Residual diuresis and oxalic acid concentration are important and independent predictors of graft survival censored for death. These results underline the importance of pre-emptive transplantation, or optimizing the pre-transplant patients' condition regarding waste product concentrations.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0322516"},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079653","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}
PLoS ONEPub Date : 2025-05-16eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0323615
Sarthak Mishra, Ute Ipe, Astrid F Nottebaum, Kevin G Peters, Dietmar Vestweber
{"title":"Inhibition of VE-PTP rejuvenates Schlemm's canal in aged mice and acts via Tie2.","authors":"Sarthak Mishra, Ute Ipe, Astrid F Nottebaum, Kevin G Peters, Dietmar Vestweber","doi":"10.1371/journal.pone.0323615","DOIUrl":"10.1371/journal.pone.0323615","url":null,"abstract":"<p><strong>Purpose: </strong>Glaucoma is the leading cause of irreversible blindness worldwide and is associated with high intraocular pressure (IOP). Schlemm's canal (SC), a hybrid vessel present in the anterior part of the eye, is known to control IOP by draining aqueous humor into the systemic circulation. Formation and function of SC is supported by the tyrosine kinase receptor Tie2. Likewise, inhibition of the vascular endothelial protein tyrosine phosphatase (VE-PTP), which associates with Tie2 has similar effects. However, VE-PTP also targets VE-cadherin and several other substrates. Here, we analyzed whether Tie2 is indeed the major substrate which is responsible for the role of VE-PTP in SC function. In addition, we analyzed the function of VE-PTP in SC of the aged eye in mice.</p><p><strong>Methodology: </strong>We tested the effects of the VE-PTP inhibitor AKB9778 and of VE-PTP gene inactivation on SC area and IOP in WT and in Tie2iLEC/SC-KO and VE-cadherin-Y685F mutant mice.</p><p><strong>Results: </strong>Pharmacologic inhibition of VE-PTP with AKB9778 increased SC area only in mice expressing Tie2. The VE-cadherin-Y685F mutation had neither an effect on SC area nor on the effects of AKB9778 on SC formation. Induced VE-PTP gene inactivation in adult mice had similar effects as AKB9778. Furthermore, we could show that AKB9778 improved SC function in aged mice as judged by increasing SC area and lowering of IOP.</p><p><strong>Conclusion: </strong>Interference with VE-PTP function improves SC function in a strictly Tie2 dependent way and pharmacologic inhibition of VE-PTP with AKB9778 is a promising approach for improving SC function in the aged eye.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0323615"},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079676","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}
PLoS ONEPub Date : 2025-05-16eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0323834
Andrew Putman, Adam Cole, Shilpa Dogra
{"title":"Initial validity and reliability testing of the SGBA-5.","authors":"Andrew Putman, Adam Cole, Shilpa Dogra","doi":"10.1371/journal.pone.0323834","DOIUrl":"10.1371/journal.pone.0323834","url":null,"abstract":"<p><strong>Background: </strong>A growing body of research indicates that sex (biological) and gender (sociocultural) influence health through a variety of distinct mechanisms. Sex- and Gender-Based Analysis (SGBA) techniques could examine these influences, however, there is a lack of nuanced and easily implementable measurement tools for health research. To address this gap, we created the Sex- and Gender-Based Analysis Tool - 5 item (SGBA-5).</p><p><strong>Objectives: </strong>This research aims to assess the validity and reliability of the SGBA-5 for use in health sciences research where sex or gender are not primary variables of interest.</p><p><strong>Methods: </strong>A Delphi consensus study was conducted with Canadian researchers (n = 14). The Delphi experts rated the validity of each SGBA-5 item on a 5-point Likert scale each round, receiving summary statistics of other experts' responses after the first round. A conservative threshold for consensus agreement (75% rating an item 4+ of 5) was used given the novelty of this scale's items. Reliability was assessed through a two-armed test-retest study. The university student arm (n = 89) was conducted in-person (on paper), and the older adult arm (n = 71) was conducted online (digitally).</p><p><strong>Results: </strong>The Delphi study ended after three rounds; experts reached consensus agreement on the validity of the biological sex item of the SGBA-5 (93%) and consensus non-agreement on each of the gendered aspect of health items (identity: 64%, expression: 64%, roles: 50%, relations: 57%). Both the student arm (sex item: [Formula: see text], gendered items: [Formula: see text]) and the older adult arm (sex item: [Formula: see text], gendered items: [Formula: see text]) of the test-retest study indicated that all items were reliable.</p><p><strong>Conclusions: </strong>The novel SGBA-5 tool demonstrated reliability across all scale items and validity of the biological sex item. The gendered aspects of health items may be valid. Future research can further develop the SGBA-5 as a tool for use in health research.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0323834"},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079678","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}
PLoS ONEPub Date : 2025-05-16eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0301404
Eline M van den Broek-Altenburg, Jamie S Benson, Adam J Atherly, Kristen K DeStigter
{"title":"Patient preferences for diagnostic imaging services: Decentralize or not?","authors":"Eline M van den Broek-Altenburg, Jamie S Benson, Adam J Atherly, Kristen K DeStigter","doi":"10.1371/journal.pone.0301404","DOIUrl":"10.1371/journal.pone.0301404","url":null,"abstract":"<p><p>The objective of this study was to identify patient preferences for outpatient diagnostic imaging services and analyze how patients make trade-offs between attributes of these services using a discrete choice experiment (DCE). We used a DCE with 14 choice questions asking which imaging locations patients would prefer. We used latent class analysis to analyze preference heterogeneity between different patient groups and to estimate the relative value they assign to different attributes of imaging services. Our analysis showed that the \"Experienced Patients\" subgroup generally value diagnostic imaging services in both acute and chronic situations and had a strong preference for hospital outpatient radiology departments (HORD) that would provide services at lower costs, where their images would be interpreted by a specialty radiologist, the clinic would be recommended by their PCP, online scheduling would be available, service rating were higher, and travel and wait times would be shorter. New Patients significantly valued the service rating of the (HORD and online scheduling. HORDs can be more competitive by providing services that live up to expectations better than available retail radiology clinics (RRCs). Most RRCs do not currently offer online scheduling so ease of use may also steer patients towards HORDs. HORDs have the advantage of being linked to the main medical center which has the reputation of having clinical expertise and more sophisticated technology. We conclude that there is room for medical centers to build HORDs that provide an appealing and competitive alternative to current RRC.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0301404"},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079711","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}
PLoS ONEPub Date : 2025-05-15eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0320014
Kathryn M Yount, Robert Durr, Suniti Neogy, Yuk Fai Cheong
{"title":"Engaging boys as \"Structured Allies\" to prevent gender-based violence against girls: Results from the CARE Tipping Point Initiative in Nepal.","authors":"Kathryn M Yount, Robert Durr, Suniti Neogy, Yuk Fai Cheong","doi":"10.1371/journal.pone.0320014","DOIUrl":"https://doi.org/10.1371/journal.pone.0320014","url":null,"abstract":"<p><p>Global efforts to end violence against women and girls (VAWG) include engaging men and boys. The CARE Tipping Point Initiative in Nepal engaged men and boys as structured allies in girl-centered movement building to prevent VAWG, including sexual bullying and gender harassment (SBGH). We assessed whether this initiative in Kapilvastu and Rupandehi districts in Western Nepal affected adolescent boys' reports of ever witnessing SBGH of a girl by another boy. Eligible boys were unmarried, 12-16 years, and not intending to migrate over the next 24 months. 1,154 (93% of) eligible, consenting boys across 54 randomly selected clusters participated at baseline, and 1,143 (99.0% of) baseline participants were followed. Outcomes were ever witnessed acts of non-contact (0-7; 0/1) and contact (0-7; 0/1) SBGH of a girl by another boy or male peer. Difference-in-difference (DID) regressions were estimated to assess the unadjusted and adjusted average treatment effects on these outcomes for participants assigned to the Tipping Point Program (TPP), Tipping Point Plus Program (TPP+), or control. Reports of ever witnessing acts of non-contact SBGH increased from 64% at baseline to 77% at follow-up due to increased reporting of ever witnessing \"writing sexual messages…about a girl.\" In adjusted models, boys in the TPP+ group ever witnessed 0.42 fewer acts of non-contact SBGH than did boys in the control group. Reports of ever witnessing acts of contact SBGH implausibly declined from 42% at baseline to 38% at follow-up, and this trend did not differ across study arm in adjusted models. Thus, compared to the control group, the TPP+ group may have reported smaller increases in ever witnessing acts of non-contact SBGH and more often concealed previously reported acts of non-contact SBGH ever witnessed. Future intervention studies should assess bystander motivation, self-efficacy, and behavior as direct measures of boys' allyship to prevent SBGH and VAWG.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0320014"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078749","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}
PLoS ONEPub Date : 2025-05-15eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0319468
Zerong Wang, Jiaxin Fei, Jie Han
{"title":"How does occupational prestige of migrant workers affect farmland transfer in China?","authors":"Zerong Wang, Jiaxin Fei, Jie Han","doi":"10.1371/journal.pone.0319468","DOIUrl":"https://doi.org/10.1371/journal.pone.0319468","url":null,"abstract":"<p><p>Occupational prestige, a socioeconomic status metric, has received limited attention in prior studies regarding its influence on farmland transfer. Based on data from the China Family Panel Studies (CFPS) conducted in 2018 and 2020, we analyze the impact of occupational prestige on farmland transfer. The findings reveal that farmers with higher occupational prestige are more likely to transfer their farmland, and the results using the instrumental variable (IV)-Probit model remained significant. Occupational prestige facilitates farmland transfer by enhancing farmers' awareness of land ownership rights and policies, concurrently diminishing their expectations of land security. Credit-constrained farmers, those with lower income levels, and farmers in the central-western regions of China are more willing to transfer their land. These research insights underscore the significance of fostering inclusive urban employment initiatives and providing upward mobility opportunities for rural migrant workers. Such endeavors are deemed critical for nurturing the development and advancement of China's rural land rental market.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0319468"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078875","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}
PLoS ONEPub Date : 2025-05-15eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0323704
Li Zhang, Xufeng Gao, Meifang He, Wenyan Wang, Yuebin Zhao
{"title":"Nonlinear association between C-reactive protein and severity of diabetic foot infection in patients with diabetes: A retrospective cohort study with clinical implications.","authors":"Li Zhang, Xufeng Gao, Meifang He, Wenyan Wang, Yuebin Zhao","doi":"10.1371/journal.pone.0323704","DOIUrl":"https://doi.org/10.1371/journal.pone.0323704","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic foot infection(DFI) is a frequent complication of diabetes and can lead to significant morbidity and mortality. These are huge economic health burdens for patients, countries, and the world. Timely diagnosis and accurate assessment of the severity of DFI based on sensitive inflammatory biomarkers is critical, with considerable benefits for debridement procedures and antibiotic use. This study aimed to examine the association between C-reactive protein (CRP) levels and the severity of DFI in patients with diabetes.</p><p><strong>Methods: </strong>In this retrospective cohort study, we investigate the association between CRP levels and the severity of DFI in patients with diabetes. Multivariable logistic regression modeling, a generalized additive model, and a two-piecewise linear regression model were conducted to explore the relationship between CRP levels and DFI severity.</p><p><strong>Results: </strong>Based on inclusion exclusion criteria, A total of 301 patients with Wagner stage 3 or higher diabetic foot ulcers combined with moderate to severe infections were included in the study at last. CRP levels were independently associated with the severity of DFIs after accounting for potential confounding factors. A nonlinear relationship was observed between CRP level and DFI severity, with a threshold of approximately 105 mg/L. The odds ratio for severe diabetic foot infection was 1.039 (95% confidence interval: 1.019-1.06, P < 0.001) in patients with DFI and CRP < 105 mg/L.</p><p><strong>Conclusion: </strong>The relationship between CRP and the severity of DFI was nonlinear; as CRP levels remained below 105 mg/L, the severity of DFI increased with an increase in CRP.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0323704"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079317","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}
PLoS ONEPub Date : 2025-05-15eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0323297
Wim Naudé
{"title":"Business and entrepreneurship is declining as scholarly field: Empirical evidence.","authors":"Wim Naudé","doi":"10.1371/journal.pone.0323297","DOIUrl":"https://doi.org/10.1371/journal.pone.0323297","url":null,"abstract":"<p><p>This paper presents evidence from 68,792 papers published between 1961 and 2020 that progress in the scholarly field of business and entrepreneurship is declining. It is found that the annual number of papers published in the field has increased exponentially since the Second World War, growing on average by 17% annually since 1961; the average disruption score of papers have declined by a factor of 36 between the 1960s and the 2010s; and that the average team size per paper has increased from 1,6 between 1960-1980-2,4 between 2000 and 2020. Estimates from an ideas production function suggest that the field is getting fished out and that researchers may be stepping on one another's toes. A Wald-test indicates that a structural break in the disruptiveness of business and entrepreneurship and papers occurred around 1999. These results could reflect pathologies in how research in the field is organized and/or that the field has matured.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0323297"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079436","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}
PLoS ONEPub Date : 2025-05-15eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0322357
Marck Jickel Kemegne Tagne, Thomas Kanaa, Paul Etouke Owoundi, Arnaud Obono Biyobo
{"title":"Customizing egg incubators for Cameroon: A design and construction guide.","authors":"Marck Jickel Kemegne Tagne, Thomas Kanaa, Paul Etouke Owoundi, Arnaud Obono Biyobo","doi":"10.1371/journal.pone.0322357","DOIUrl":"https://doi.org/10.1371/journal.pone.0322357","url":null,"abstract":"<p><p>In Cameroon, poultry farming represents an important source of income for many families and is a key sector for economic development and food security. However, there is a deficiency in suitable infrastructure, especially high-performance and affordable incubators, leading many poultry farmers to resort to manual incubation techniques, which are often inefficient and labor-intensive. This paper aims to build an automatic incubator using locally accessible materials, optimized techniques, and modern, simple technologies. This paper also serves as a construction guide. Its initiative offers a significant opportunity to improve poultry farming practices, increase local productivity, and contribute to sustainable development. The incubator is built using the prototyping method, and the optimization of energy efficiency for the system was achieved through the mathematical modeling of heat transfer. The study's findings indicate that the incubator is a dependable and effective solution for hatching poultry eggs. Its user-friendly design, ease of maintenance, and affordability make it an excellent choice for local poultry farmers.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0322357"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079442","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}
PLoS ONEPub Date : 2025-05-15eCollection Date: 2025-01-01DOI: 10.1371/journal.pone.0324083
S Hidad, S C de Greeff, F de Haan, R Schilperoort, G L Leusink, A Timen, H Schmitt
{"title":"An observational study protocol on wastewater measurements and diaper culture to estimate antimicrobial resistance in long-term care facilities for people with intellectual disabilities: The GIRAF-MIC study protocol.","authors":"S Hidad, S C de Greeff, F de Haan, R Schilperoort, G L Leusink, A Timen, H Schmitt","doi":"10.1371/journal.pone.0324083","DOIUrl":"https://doi.org/10.1371/journal.pone.0324083","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance (AMR) has become one of the leading global health threats. It is critical to understand the burden of AMR, particularly among vulnerable populations such as people with intellectual disabilities residing in long-term care facilities (ID-LTCFs). Traditional study methods to estimate the burden of AMR in these settings, such as rectal swabs to measure the prevalence of MDRO carriage, are considered burdensome for this population. This underscores the importance of a non-invasive method to assess the burden of AMR among people living in ID-LTCFs. This publication describes a study protocol for an alternative approach to estimate AMR, specifically Extended Spectrum Beta-Lactamase (ESBL) and carbapenemase-producing Enterobacterales (CPE), in ID-LTCFs in the Netherlands, through wastewater measurements combined with analysis of stool collected from diaper material. The protocol provides detailed information about the study design and methodologies proposed for a pilot study.</p><p><strong>Methods and analysis: </strong>Wastewater samples will be obtained from the sewers of ID-LCTFs using passive samplers. Additionally, as a considerable part of ID-LTCF residents are incontinent, stool samples will be collected from diaper material which will be obtained from incontinent residents living in participating ID-LTCFs. The wastewater and stool samples will be cultured on selective media to detect ESBL-producing Enterobacterales and carbapenem producing Enterobacterales (CPE) strains. Determination of strains will be carried out using MALDI-TOF and phenotypical tests will be carried out to confirm ESBL and CPE producing strains. In wastewater samples, bacterial concentrations will be determined, expressed in colony forming unit (CFU) per passive sampler, while in stool from diaper material the presence or absence of ESBL and CPE will be reported in proportions.</p><p><strong>Ethics and dissemination: </strong>The procedures described in this study protocol will be conducted in line with principles outlined in the Declaration of Helsinki, Code of Conduct for Health research, as well as the General Data Protection Regulation. Approval in advance by an ethical research committee or institutional review board is deemed unnecessary by current national and European legislation.</p>","PeriodicalId":20189,"journal":{"name":"PLoS ONE","volume":"20 5","pages":"e0324083"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079444","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}