PLoS Medicine最新文献

{"title":"Adolescent cardiorespiratory fitness and risk of cancer in late adulthood: A nationwide sibling-controlled cohort study in Sweden.","authors":"Marcel Ballin, Daniel Berglind, Pontus Henriksson, Martin Neovius, Anna Nordström, Francisco B Ortega, Elina Sillanpää, Peter Nordström, Viktor H Ahlqvist","doi":"10.1371/journal.pmed.1004597","DOIUrl":"https://doi.org/10.1371/journal.pmed.1004597","url":null,"abstract":"<p><strong>Background: </strong>Cardiorespiratory fitness has been linked to both lower and higher risks of cancer, but the evidence comes from observational analysis which may be influenced by unobserved confounders and bias processes. We aimed to examine the associations between adolescent cardiorespiratory fitness and risk of cancer in late adulthood while addressing the unknown influence of unobserved familial confounders and diagnostic bias processes.</p><p><strong>Methods and findings: </strong>We conducted a sibling-controlled cohort study with registry linkage based on all Swedish men who participated in mandatory military conscription examinations from 1972 to 1995 and who completed standardized cardiorespiratory fitness testing. The outcomes were overall cancer diagnosis and cancer mortality, and 14 site-specific cancers (diagnosis or death), ascertained using the National Patient Register and Cause of Death Register until 31 December 2023. A total of 1,124,049 men, including 477,453 full siblings, with a mean age of 18.3 years at baseline, were followed until a median (maximum) age of 55.9 (73.5) years, during which 98,410 were diagnosed with cancer and 16,789 died from cancer (41,293 and 6,908 among full siblings respectively). In cohort analysis, individuals in the highest quartile of fitness had a lower risk of overall cancer mortality (adjusted hazard ratio [HR]: 0.71, 95% confidence interval [CI] 0.67, 0.76; P < 0.001) compared to the lowest quartile, corresponding to a standardized cumulative incidence (1-Survival) difference of -0.85 (95% CI [-1.00, -0.71]) percentage points at 65 years of age. Individuals in the highest quartile of fitness also had lower risks (HRs ranging from 0.81 to 0.49, incidence differences ranging from -0.13 to -0.32 percentage points; P < 0.001 for all) of rectum, head and neck, bladder, stomach, pancreas, colon, kidney, liver, bile ducts, and gallbladder, esophagus, and lung cancer. Yet, individuals in the highest quartile of fitness had higher risks of prostate (HR: 1.10, 95% CI [1.05, 1.16]; P < 0.001, incidence difference: 0.48 percentage points, 95% CI [0.23, 0.73]) and skin cancer (e.g., non-melanoma HR: 1.44, 95% CI [1.38, 1.50]; P < 0.001, incidence difference: 1.84 percentage points, 95% CI [1.62, 2.05]). Individuals in the highest quartile of fitness had a higher risk of overall cancer diagnosis (HR: 1.08, 95% CI [1.06, 1.11]; P < 0.001, incidence difference: 1.32 percentage points, 95% CI [0.94, 1.70]), results driven by prostate and skin cancer being the most common types of cancer. When comparing full siblings, and thereby controlling for unobserved shared confounders, the lower risk of overall cancer mortality remained (HR: 0.78, 95% CI [0.68, 0.89]; P < 0.001, incidence difference: -0.61 percentage points, 95% CI [-0.93, -0.28]), while the excess risk of prostate (HR: 1.01, 95% CI [0.90, 1.13]; P = 0867, incidence difference: 0.05 percentage points, 95% CI [-0.50, 0.60]), skin (e.g., non-","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 5","pages":"e1004597"},"PeriodicalIF":15.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of screening with transcriptional signatures for incipient TB among U.S. migrants.","authors":"Yuli Lily Hsieh, C Robert Horsburgh, Ted Cohen, Jeffrey W Miller, Joshua A Salomon, Nicolas A Menzies","doi":"10.1371/journal.pmed.1004603","DOIUrl":"10.1371/journal.pmed.1004603","url":null,"abstract":"<p><strong>Background: </strong>Host-response-based transcriptional signatures (HrTS) have been developed to identify \"incipient tuberculosis (TB)\". No study has reported the cost-effectiveness of HrTS for post-arrival migrant screening programs in low-incidence countries. The aim of this study was to assess the potential health impact and cost-effectiveness of HrTS for post-arrival TB infection screening among new migrants in the United States.</p><p><strong>Methods and findings: </strong>We used a discrete-event simulation model to compare four strategies: (1) no screening for TB infection or incipient TB; (2) 'IGRA-only', screen all with interferon-gamma release assay (IGRA), provide TB preventive treatment for IGRA-positives; (3) 'IGRA-HrTS', screen all with IGRA followed by HrTS for IGRA-positives, provide incipient TB treatment for individuals testing positive with both tests; and (4) 'HrTS-only', screen all with HrTS, provide incipient TB treatment for HrTS-positives. We assessed outcomes over the lifetime of migrants entering the United Stataes (U.S.) in 2019, assuming HrTS met WHO Target Product Profile (TPP) optimal criteria. We conducted sensitivity analyses to evaluate the robustness of results. Our findings show that at a willingness-to-pay threshold of $150,000 per quality-adjusted life-year (QALY) gained, the IGRA-only strategy was the optimal strategy under both healthcare sector and societal perspectives, with an incremental cost-effectiveness ratio (ICER) of $104,138 and $143,103 per QALY gained, respectively. At a willingness-to-pay of $100,000 per QALY gained the IGRA-HrTS strategy appeared optimal. When the cohort was stratified by TB incidence in the country-of-origin, the IGRA-only strategy was optimal for country-of-origin incidence [Formula: see text]100 per 100,000, and the no-screening strategy was optimal for country-of-origin incidence <10 per 100,000. The IGRA-HrTS strategy was potentially cost-effective with country-of-origin incidence of 10-100 per 100,000, though this result had substantial uncertainty. Results were sensitive to time trends in TB progression risk after U.S. entry.</p><p><strong>Conclusions: </strong>An HrTS test meeting WHO TPP optimal criteria would be potentially cost-effective for post-arrival screening among a subset of U.S. migrants, but this result was sensitive to multiple factors.</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 5","pages":"e1004603"},"PeriodicalIF":15.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-disaggregated data along the gendered health pathways: A review and analysis of global data on hypertension, diabetes, HIV, and AIDS.","authors":"Alessandro Feraldi, Virginia Zarulli, Kent Buse, Sarah Hawkes, Angela Y Chang","doi":"10.1371/journal.pmed.1004592","DOIUrl":"10.1371/journal.pmed.1004592","url":null,"abstract":"<p><strong>Background: </strong>Health data disaggregated by sex is vital for identifying the distribution of illness, and assessing risk exposures, service access, and utilization. Disaggregating data along a health pathway, i.e., the measurable continuum from risk factor exposure to final health outcome (death), and including disease prevalence and a three-step care cascade (diagnosis, treatment, and control), has the potential to provide a holistic and systematic source of information on sex- and gender-based health inequities and identify opportunities for more tailored interventions to reduce those inequities.</p><p><strong>Methods and findings: </strong>We collected sex- and age-disaggregated data along the health pathway. We searched for papers using global datasets on the sex-disaggregated care cascade for eight major conditions and identified cascade data for only three conditions: hypertension, diabetes, and HIV and AIDS. For each condition, we collected risk factor prevalence, disease prevalence, cascade progression, and death rates. We assessed the sex difference for all steps along the pathway and interpreted inequities through a lens of gender analysis. Sex-disaggregated data on risk factors, disease prevalence, and mortality were found for all three conditions across 204 countries. Sex-disaggregated care cascades for hypertension, diabetes, and HIV and AIDS were found only for 200, 39, and 76 countries, respectively. Significant sex differences were found in each step along the pathways. In many countries, males exhibited higher disease prevalence and death rates than females, while in some countries, they also reported lower rates of healthcare seeking, diagnosis, and treatment adherence. Smoking prevalence was higher among males in most countries, whereas prevalence of obesity and unsafe sex were higher in females in most countries.</p><p><strong>Conclusions: </strong>Findings support the increasing need to develop strategies that encourage greater male participation in preventive and healthcare service and underscore the importance of sex-disaggregated data in understanding health inequities and guiding gender-responsive interventions at different points along the pathway. Despite limitations in data availability and completeness, this study elucidates the need for more comprehensive and harmonized datasets for these and other conditions to monitor sex differences and implement sex-/gender-responsive interventions along the health pathway.</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 5","pages":"e1004592"},"PeriodicalIF":15.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Contraception use and pregnancy in women receiving a 2-dose Ebola vaccine in Rwanda: A retrospective analysis of UMURINZI vaccination campaign data.","authors":"","doi":"10.1371/journal.pmed.1004605","DOIUrl":"https://doi.org/10.1371/journal.pmed.1004605","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pmed.1004508.].</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 4","pages":"e1004605"},"PeriodicalIF":15.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A deep-learning algorithm using real-time collected intraoperative vital sign signals for predicting acute kidney injury after major non-cardiac surgeries: A modelling study.","authors":"Sehoon Park, Soomin Chung, Yisak Kim, Sun-Ah Yang, Soie Kwon, Jeong Min Cho, Min Jae Lee, Eunbyeol Cho, Jiwon Ryu, Sejoong Kim, Jeonghwan Lee, Hyung Jin Yoon, Edward Choi, Kwangsoo Kim, Hajeong Lee","doi":"10.1371/journal.pmed.1004566","DOIUrl":"10.1371/journal.pmed.1004566","url":null,"abstract":"<p><strong>Background: </strong>Postoperative acute kidney injury (PO-AKI) prediction models for non-cardiac major surgeries typically rely solely on preoperative clinical characteristics.</p><p><strong>Methods and findings: </strong>In this study, we developed and externally validated a deep-learning-based model that integrates preoperative data with minute-scale intraoperative vital signs to predict PO-AKI. Using data from three hospitals, we constructed a convolutional neural network-based EfficientNet framework to analyze intraoperative data and created an ensemble model incorporating 103 baseline variables of demographics, medication use, comorbidities, and surgery-related characteristics. Model performance was compared with the conventional SPARK model from a previous study. Among 110,696 patients, 51,345 were included in the development cohort, and 59,351 in the external validation cohorts. The median age of the cohorts was 60, 61, and 66 years, respectively, with males comprising 54.9%, 50.8%, and 42.7% of each cohort. The intraoperative vital sign-based model demonstrated comparable predictive power (AUROC (Area Under the Receiver Operating Characteristic Curve): discovery cohort 0.707, validation cohort 0.637 and 0.607) to preoperative-only models (AUROC: discovery cohort 0.724, validation cohort 0.697 and 0.745). Adding 11 key clinical variables (e.g., age, sex, estimated glomerular filtration rate (eGFR), albuminuria, hyponatremia, hypoalbuminemia, anemia, diabetes, renin-angiotensin-aldosterone inhibitors, emergency surgery, and the estimated surgery time) improved the model's performance (AUROC: discovery cohort 0.765, validation cohort 0.716 and 0.761). The ensembled deep-learning model integrating both preoperative and intraoperative data achieved the highest predictive accuracy (AUROC: discovery cohort 0.795, validation cohort 0.762 and 0.786), outperforming the conventional SPARK model. The retrospective design in a single-nation cohort with non-inclusion of some potential AKI-associated variables is the main limitation of this study.</p><p><strong>Conclusions: </strong>This deep-learning-based PO-AKI risk prediction model provides a comprehensive approach to evaluating PO-AKI risk prediction by combining preoperative clinical data with real-time intraoperative vital sign information, offering enhanced predictive performance for better clinical decision-making.</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 4","pages":"e1004566"},"PeriodicalIF":15.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving transparency in clinical trial reporting.","authors":"Alison Farrell","doi":"10.1371/journal.pmed.1004588","DOIUrl":"https://doi.org/10.1371/journal.pmed.1004588","url":null,"abstract":"<p><p>The power to interpret the results of randomised clinical trial results relies on transparent reporting of the study design, protocol, methods and analyses. Without such clarity, the benefits of the findings, to both healthcare, policy and research, cannot be realized in full. The publication of the updated CONSORT 2025 and SPIRIT 2025 statements for reporting of randomised clinical trials and protocols, respectively, offers the opportunity to reflect on the power that transparent reporting of clinical trial design and data offers to improve the quality of trials and outcomes.</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 4","pages":"e1004588"},"PeriodicalIF":15.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPIRIT 2025 statement: Updated guideline for protocols of randomised trials.","authors":"An-Wen Chan, Isabelle Boutron, Sally Hopewell, David Moher, Kenneth F Schulz, Gary S Collins, Ruth Tunn, Rakesh Aggarwal, Michael Berkwits, Jesse A Berlin, Nita Bhandari, Nancy J Butcher, Marion K Campbell, Runcie C W Chidebe, Diana R Elbourne, Andrew J Farmer, Dean A Fergusson, Robert M Golub, Steven N Goodman, Tammy C Hoffmann, John P A Ioannidis, Brennan C Kahan, Rachel L Knowles, Sarah E Lamb, Steff Lewis, Elizabeth Loder, Martin Offringa, Philippe Ravaud, Dawn P Richards, Frank W Rockhold, David L Schriger, Nandi L Siegfried, Sophie Staniszewska, Rod S Taylor, Lehana Thabane, David J Torgerson, Sunita Vohra, Ian R White, Asbjørn Hróbjartsson","doi":"10.1371/journal.pmed.1004589","DOIUrl":"https://doi.org/10.1371/journal.pmed.1004589","url":null,"abstract":"<p><strong>Importance: </strong>The protocol of a randomised trial is the foundation for study planning, conduct, reporting, and external review. However, trial protocols vary in their completeness and often do not address key elements of design and conduct. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was first published in 2013 as guidance to improve the completeness of trial protocols. Periodic updates incorporating the latest evidence and best practices are needed to ensure that the guidance remains relevant to users.</p><p><strong>Objective: </strong>To systematically update the SPIRIT recommendations for minimum items to address in the protocol of a randomised trial.</p><p><strong>Design: </strong>We completed a scoping review and developed a project specific database of empirical and theoretical evidence to generate a list of potential changes to the SPIRIT 2013 checklist. The list was enriched with recommendations provided by lead authors of existing SPIRIT/CONSORT (Consolidated Standards of Reporting Trials) extensions (Harms, Outcomes, Non-pharmacological Treatment) and other reporting guidelines (TIDieR). The potential modifications were rated in a three-round Delphi survey followed by a consensus meeting.</p><p><strong>Findings: </strong>Overall, 317 individuals participated in the Delphi consensus process and 30 experts attended the consensus meeting. The process led to the addition of two new protocol items, revision to five items, deletion/merger of five items, and integration of key items from other relevant reporting guidelines. Notable changes include a new open science section, additional emphasis on the assessment of harms and description of interventions and comparators, and a new item on how patients and the public will be involved in trial design, conduct, and reporting. The updated SPIRIT 2025 statement consists of an evidence-based checklist of 34 minimum items to address in a trial protocol, along with a diagram illustrating the schedule of enrolment, interventions, and assessments for trial participants. To facilitate implementation, we also developed an expanded version of the SPIRIT 2025 checklist and an accompanying explanation and elaboration document.</p><p><strong>Conclusions and relevance: </strong>Widespread endorsement and adherence to the updated SPIRIT 2025 statement have the potential to enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, funders, research ethics committees, journals, trial registries, policymakers, regulators, and other reviewers.</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 4","pages":"e1004589"},"PeriodicalIF":15.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiology community begins to embrace obesity as an important target for cardiovascular health.","authors":"Naveed Sattar, Martin K Rutter","doi":"10.1371/journal.pmed.1004578","DOIUrl":"https://doi.org/10.1371/journal.pmed.1004578","url":null,"abstract":"<p><p>Naveed Sattar and Martin K Rutter discuss the contributory role of obesity in the development and progression of cardiovascular disease, and prospects for tackling the obesity epidemic.</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 4","pages":"e1004578"},"PeriodicalIF":15.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressing towards the 2030 health-related SDGs in ASEAN: A systematic analysis.","authors":"Yafei Si, Lei Guo, Shu Chen, Xinyu Zhang, Xiaochen Dai, Daniel Wang, Yunguo Liu, Bach Xuan Tran, Paul Michael Pronyk, Shenglan Tang","doi":"10.1371/journal.pmed.1004551","DOIUrl":"10.1371/journal.pmed.1004551","url":null,"abstract":"<p><strong>Background: </strong>The Sustainable Development Goals (SDGs) articulate an ambitious global agenda and set of targets to achieve by 2030. Among the health-related SDGs, many formidable challenges remain in settings like the Association of Southeast Asian Nations (ASEAN) which face wide-ranging social, economic and health inequalities. In advance of the 2030 horizon, charting the trajectory of the health SDGs is critical for informing policy and programmatic course corrections to advance health and well-being among ASEAN's 10 member countries with its 667 million people.</p><p><strong>Methods and findings: </strong>We used estimates from the Global Burden of Disease (GBD) Study 2021 and surveillance data to identify 27 health-related SDG indicators. The indicators were classified into 7 thematic areas: (i) nutrition, (ii) maternal, child and reproductive health (MCH), (iii) infectious diseases, (iv) non-communicable diseases (NCDs), (v) environmental health, (vi) universal health coverage (UHC), and (vii) road injuries. We developed an attainment index ranging from 0 to 100 for each SDG indicator by referencing the SDG targets and projected their progress to 2030. We find an overall positive progress towards the health-related SDG targets in ASEAN from 1990 to 2030. At the aggregate level by 2030, 2 member countries, Singapore and Brunei, are projected to achieve their targets (attainment score ≥ 90). At a wider regional level, ASEAN is projected to make substantial progress in nutrition, MCH, and UHC, with a majority of countries projected to come close to or achieve their targets. However, progress is projected to be slower in the areas of reducing the incidence of infectious disease (i.e., HIV and AIDs, hepatitis B, TB, and neglected tropical diseases), NCD-related mortality and its risk factors (i.e., harmful alcohol use and smoking), environment-related mortality and its risk factors (i.e., unsafe water and poor hygiene, and air pollution), and road injuries. Substantial disparities are identified in the region, with Singapore, Brunei, Malaysia and Thailand generally performing better than elsewhere. A limitation of our study was its reliance on historical trends which may not fully capture future political, social, or technological changes.</p><p><strong>Conclusions: </strong>As a regional bloc, ASEAN faces persistent challenges in achieving health-related SDG targets by 2030, with unequal progress between countries. Moreover, epidemiological transitions and worsening environmental threats further compound potential gains. At the country level, efforts to enhance health system financing, quality and equity will need to be coupled with wider approaches that address structural drivers of disease. Furthermore, coordinated regional efforts will be essential to effectively respond to emerging threats posed by pollution and environmental risks.</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 4","pages":"e1004551"},"PeriodicalIF":15.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Comparing cervical cerclage, pessary and vaginal progesterone for prevention of preterm birth in women with a short cervix (SuPPoRT): A multicentre randomised controlled trial.","authors":"Natasha L Hezelgrave, Natalie Suff, Paul Seed, Vicky Robinson, Jenny Carter, Helena Watson, Alexandra Ridout, Anna L David, Susana Pereira, Fatemeh Hoveyda, Joanna Girling, Latha Vinayakarao, Rachel M Tribe, Andrew H Shennan","doi":"10.1371/journal.pmed.1004594","DOIUrl":"https://doi.org/10.1371/journal.pmed.1004594","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1371/journal.pmed.1004427.].</p>","PeriodicalId":49008,"journal":{"name":"PLoS Medicine","volume":"22 4","pages":"e1004594"},"PeriodicalIF":15.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}