2026-04-01
Ngozika Jane Hemuka, Laura Kudrna, Lina Martino, Jason Copp, Samina Saudagar, Kimberley Maynard
by Ngozika Jane Hemuka, Laura Kudrna, Lina Martino, Jason Copp, Samina Saudagar, Kimberley Maynard Background Perinatal mental health problems, such as depression and anxiety, are major global public health concerns. Screening for mental health problems in pregnancy supports early detection and treatment, improving outcomes for women and their families. However, mental ill health is not consistently identified in routine maternal practice, particularly among women from ethnic minority communities in high income countries like the United Kingdom. Although research has explored mental health screening tools among majority ethnic populations, there remains a notable lack of evidence regarding the experiences of women from ethnic minority communities. To address this, this study investigated these women’s perceptions of perinatal mental health screening tools used by United Kingdom maternity services. Methods A qualitative study of women’s experiences and perceptions of perinatal mental health screening tools. Purposive sampling strategy was employed to recruit women from ethnic minority communities from a local charity to participate in online and face-to-face semi-structured interviews and a focus group discussion. Participants were asked about their understanding of and experience with the Generalized Anxiety Disorder scale (GAD), Edinburgh Postnatal Depression Scale (EPDS) and Whooley questions. Data were collected on perceptions of what made it easy or hard to be screened using these tools. Analyses were conducted using a framework analysis approach. Results Fifteen women took part in the study (12 in interviews; 3 in a focus group), representing Asian, Black African, Bangladeshi, Black Caribbean, Pakistani, and Afghan ethnic backgrounds. Four organising themes were identified after coding. These were: Mixed experiences and perceptions of perinatal mental health screening tools; Factors shaping women’s perceptions and engagement with perinatal mental health screening tools: barriers and facilitators; Lack of continuity, early support, and clear pathways hinders women’s engagement with mental health screening tools; and Recommendations for improvement. Conclusions The detection of mental health problems among women from under-represented communities can be improved by considering the identified themes. Key opportunities include being more explicit and culturally sensitive about mental health, explaining the purpose and benefits of screening tools, its process, and potential outcomes and consequences. It is important to allocate sufficient time, ensure privacy during mental health screening appointments, incorporate open-ended questions and avoid ambiguous words in screening tools. The use of mental health screening tools in the perinatal period needs to be delivered in a supportive context in order to address health and health inequalities.
DOI: 10.1371/journal.pone.03458822026-04-01
Afsana Sultana, Fatema Tuz Johora, Palash Chandra Banik
by Afsana Sultana, Fatema Tuz Johora, Palash Chandra Banik In Bangladesh, a low-resource setting country, the range of hospital-acquired infections (HAIs) is as high as 30% in some hospitals. Several studies have been conducted to determine the prevalence of HAIs and gaps in Infection Prevention and Control (IPC) measures. However, understanding the underlying causes and the barriers in the healthcare system that prevent the implementation of IPC measures and the control of HAIs has been the least explored. The study's primary aim was to comprehend the system-level factors influencing the high prevalence of hospital-acquired infections and the barriers to implementing strict, effective IPC measures in hospitals in Bangladesh. In this qualitative study, grounded theory with an inductive approach was adopted to understand the perspective of healthcare workers and key stakeholders regarding HAIs and IPC measures. Using a non-random, purposive sampling technique, we recruited participants from four major tertiary-care hospitals in Bangladesh. 10 KIIs (Directors, Deputy Directors, Nurse Supervisors and Superintendents) and one focus group discussion (six nurses). A semi-structured interview was conducted face-to-face with the participants. To ensure data reliability, methodological triangulation was conducted. For data analysis, the constant comparative method was adopted, which involved conceptualising and categorising through open coding. The study identified multiple factors, such as gaps in IPC knowledge and practice, a lack of HAI surveillance, resource constraints, hospital infrastructure, and overcrowding, as key barriers in implementing IPC measures effectively. To prevent HAIs, besides healthcare workers and hospital management, community awareness and adherence to IPC measures also play a key role. The findings show that, to prevent HAIs, besides the healthcare workers and hospital management, community awareness also plays a key role in implementing IPC measures successfully and preventing HAIs. This is why it is pertinent to develop IPC strategies that will engage both healthcare workers and the general population.
DOI: 10.1371/journal.pone.03460132026-04-01
Wagdy R. ElAshmawy, Noha M. Bakry, Samah M. El-Sayed, Karima M. Fahim, Samira H. Aljuaydi, Huda O. AbuBakr, Adel A. Fayed, Rehab Elhelw, Sharif S. Aly, Heba S. Farag
by Wagdy R. ElAshmawy, Noha M. Bakry, Samah M. El-Sayed, Karima M. Fahim, Samira H. Aljuaydi, Huda O. AbuBakr, Adel A. Fayed, Rehab Elhelw, Sharif S. Aly, Heba S. Farag Blanket dry cow therapy is a common practice on dairies to control mastitis, and when adopted, constitutes the majority of antimicrobial use on a dairy. The current study aimed to investigate the effect of dry cow therapy on the bacteriological cure and new infections after calving, and the association between dry cow therapy and antimicrobial resistance of Staphylococcus aureus isolated from milk samples of dairy cows after calving on Egyptian dairy farms. A randomized clinical trial was implemented on two Egyptian dairy farms. A total of 400 cows were randomized to one of four intramammary treatments at dry-off (Antibiotic, AB; Internal teat sealant, ITS; AB&ITS, or no treatment; Control). Composite milk samples were collected from enrolled cows at dry-off before receiving treatments and after calving. Bacterial culture and species identification were performed based on colony morphology, biochemical identification, and PCR using 16S rRNA. The Minimum Inhibitory Concentration (MIC) for each of the study Staphylococcus aureus ( S. aureus ) isolates was estimated using a commercial plate (CMV1AMAF Sensititre plate). Logistic regression models were used to estimate the effect of the different dry cow treatments on bacteriological cure and new infections. Parametric survival interval regression models were used to model the association between dry cow treatment and antimicrobial resistance after calving. Cows with a history of mastitis at the dry-off lactation had significantly higher odds (Odds Ratio, OR = 2.2, SE = 0.005, P S. aureus isolated from cows that received AB and AB&ITS at dry-off in both study seasons. The current study revealed that more than 30% of subclinical mastitis cows were infected with S. aureus at dry-off and after calving, which requires future studies to evaluate the control measures of contagious mastitis implemented on Egyptian dairies before implementing the selective dry cow therapy algorithm.
DOI: 10.1371/journal.pone.03456462026-04-01
Jiaxin Tian, Jingwen An, Linchun Song, Wang Zhang, Die Chen, Tianya Zhang, Ying Ben
by Jiaxin Tian, Jingwen An, Linchun Song, Wang Zhang, Die Chen, Tianya Zhang, Ying Ben Purpose To explore the mechanism by which alpha-lipoic acid (ALA) regulates mitochondrial axonal transport to protect the sciatic nerve in diabetic rats. Methods Among 55 healthy male Sprague‒Dawley rats, 40 were randomly selected, fed a high-carbohydrate/high-fat diet and intraperitoneally injected with streptozotocin (STZ) to induce diabetes. Diabetic rats were randomly divided into diabetic peripheral neuropathy (DPN) and alpha lipoic acid (ALA) groups, with 15 rats in each group, excluding the rats in which diabetes failed to be induced and the dead rats. The other 15 rats were used as the control group. The rats in the ALA group were administered an ALA suspension (60 mg/kg/day) by gavage for 12 weeks. The rats in the control group and DPN group were gavaged with an equal volume of distilled water every day for 12 weeks. After the intervention was complete, the motor nerve conduction velocity (MNCV) and paw withdrawal threshold (PWT) were measured. Morphological changes in the sciatic nerve were observed by HE staining. Immunofluorescence staining and Western blotting were performed to measure protein expression levels. In vitro, a model of NSC34 cell injury was established by treating cells with high concentrations of glucose and palmitic acid sodium. NSC34 cells were randomly divided into the control group, DPN group and ALA group. The ALA group was treated with ALA for 24 hours. Changes in the axons of NSC34 cells were assessed by measuring the length of the axons. Immunofluorescence staining was performed to determine the fluorescence intensity of the cells, and Western blotting was performed to determine the grayscale value of each band. Results ALA increased the MNCV and PWT in DPN rats and increased the levels of phosphorylated AMP-activated protein kinase (p-AMPK) and phosphorylated cAMP-response element-binding protein (p-CREB). The expression of a motor protein involved in anterograde axonal mitochondrial transport, kinesin family member 5A (KIF5A), was upregulated, whereas the expression of a dynein protein involved in mitochondrial retrograde transport, Dynein cytoplasmic 1 intermediate chain 2 (DYNC1I2), was downregulated by ALA. Conclusion The results of this study suggest that ALA alleviates peripheral nerve injury in diabetic rats by promoting the anterograde axonal transport of mitochondria, which may be related to AMPK/CREB signaling.
DOI: 10.1371/journal.pone.03462972026-04-01
Soo Yun Kim, Gyeongmin Kim, Seongoh Park, Cheonsoo Kim, Deok Hyun Jang, Dong-Hee Joe, Won Mo Jang
by Soo Yun Kim, Gyeongmin Kim, Seongoh Park, Cheonsoo Kim, Deok Hyun Jang, Dong-Hee Joe, Won Mo Jang In this study, we examine voting intentions during the later stage of the COVID-19 pandemic in relation to risk perceptions and performance evaluations. Although prior research has documented rally-around-the-flag effects during the early phase of the pandemic, less is known about how vote choice is structured once acute crisis conditions have waned. This study draws on a nationally representative survey conducted in South Korea around the March 2022 presidential election. The analysis examines associations between affective and cognitive risk perceptions, evaluations of the government’s COVID-19 countermeasures, overall government approval, economic evaluations and expectations, and voting intention. The results show that cognitive risk perception was associated with voting intention to a limited degree, whereas affective risk perception was not. More importantly, voting intentions were associated with conventional performance evaluations—overall government approval and economic evaluations and expectations—alongside pandemic-response approval, rather than being explained solely by the latter. This study addresses the need to better understand electoral behavior during the later phase of a prolonged crisis, a period that has received far less scholarly attention than the acute onset of the pandemic.
DOI: 10.1371/journal.pone.03456212026-04-01
Montakarn Chuemchit, Nyan Linn, Chit Pyae Pyae Han, Zayar Lynn, Suttharuethai Chernkwanma, Nutta Taneepanichskul, Wandee Sirichokchatchawan, Ratana Somrongthong
by Montakarn Chuemchit, Nyan Linn, Chit Pyae Pyae Han, Zayar Lynn, Suttharuethai Chernkwanma, Nutta Taneepanichskul, Wandee Sirichokchatchawan, Ratana Somrongthong Background Violence against women migrant workers is an alarming public health problem. This study aims to investigate the experiences and impact of violence on women migrant workers in Thailand, including their help-seeking patterns, knowledge, future plans for seeking help, ways of help received, and the factors associated with violence. Methods This cross-sectional study included 494 women migrant workers across seven key provinces in Thailand – Bangkok, Chiang Rai, Chonburi, Samut Prakan, Rayong, Samut Sakhon, and Tak. Data was collected by well-trained enumerators using the validated standardized structured questionnaire. We analysed multiple logistic regressions to investigate the factors associated with experiences of violence and adjusted odds ratios (AOR) with a 95% CI were presented. Results The study identified the lifetime prevalence of violence to be 54.45%, 42.47% for intimate partner violence (IPV), and 46.15% for non-intimate partner violence (N-IPV). Women experienced psychological, physical, and occupational impacts from violence. A significant proportion of women sought informal support from friends (59.1%) and family (52.6%), while formal support was most commonly sought from employers (15.3%) and the police (6.6%). Factors associated with IPV and/or N-IPV among women migrant workers included area of residence, duration of stay, monthly income, perceived safety, Thai language proficiency, and job or income loss during the COVID-19 pandemic. Conclusion The findings highlight widespread violence against migrant women workers in Thailand, urging the need for tailored support services. Key strategies include strengthening workplace-based protections, multilingual reporting mechanisms, peer networks, culturally relevant education, and individual- and community-level interventions within labour, health, and social protection systems. Collaborative efforts among policymakers and stakeholders are vital for the prevention of and response to violence and for ensuring the safety of women migrant workers.
DOI: 10.1371/journal.pone.03457902026-04-01
Sadia Tina, Oussama Khibech, Samy Iskandar, Mohamed Bouhrim, Mohammed Al-zharani, Fahd A. Nasr, Ashraf Ahmed Qurtam, Allal Challioui, Balouch Lhousaine, Meryem El Jemli
by Sadia Tina, Oussama Khibech, Samy Iskandar, Mohamed Bouhrim, Mohammed Al-zharani, Fahd A. Nasr, Ashraf Ahmed Qurtam, Allal Challioui, Balouch Lhousaine, Meryem El Jemli Wood tar obtained from Juniperus phoenicea L. is traditionally used in Morocco, yet its chemical profile and biological activities remain insufficiently documented. In this work, Juniperus phoenicea wood tar ( JPWT ) was chemically characterized by GC-MS, qualitatively screened for major phytochemical classes, and evaluated for total polyphenols, tannins and flavonoids contents. Antioxidant activity was assessed using DPPH and FRAP assays, and antibacterial activity was screened by the disc diffusion method. GC-MS identified 17 compounds, with hydroxychavicol (46.3%), 2,3-dehydroferruginol (18.5%) and eugenol (7.3%) as major constituents. JPWT showed high levels of polyphenols (242.91 ± 68.93 µg GAE/mg), tannins (110.59 ± 11.31 µg TAE/mg) and flavonoids (26.74 ± 0.52 µg QE/mg). JPWT exhibited antioxidant activity with an IC50 of 17.05 ± 0.67 µg/mL in the DPPH assay and an EC50 of 75.81 ± 2.02 µg/mL in the FRAP assay, confirming its antioxidant activity. Antibacterial screening revealed dose-dependent inhibition, with stronger effects against Gram-positive strains. Molecular docking suggested that hydroxychavicol and 2,3-dehydroferruginol may contribute to antibacterial activity through favorable binding to MRSA PBP2a and ESBL CTX‑M‑15. Overall, these findings support JPWT as a promising natural source of antimicrobial and antioxidant agents and warrant further isolation and in vivo investigations.
DOI: 10.1371/journal.pone.03459232026-04-01
Linda Sande, Mariet Benade, Timothy Tchereni, Aniset Kamanga, Vinolia Ntjikelane, Allison Morgan, Taurai Makwalu, Wyness Phiri, Priscilla Lumano-Mulenga, Prudence Haimbe, Hilda Shakwelele, Amy Huber, Sophie Pascoe, Mhairi Maskew, Nancy Scott, Sydney Rosen
by Linda Sande, Mariet Benade, Timothy Tchereni, Aniset Kamanga, Vinolia Ntjikelane, Allison Morgan, Taurai Makwalu, Wyness Phiri, Priscilla Lumano-Mulenga, Prudence Haimbe, Hilda Shakwelele, Amy Huber, Sophie Pascoe, Mhairi Maskew, Nancy Scott, Sydney Rosen Background A growing number of people living with HIV (PLHIV) also have non-communicable diseases (NCDs). Shifting to an integrated delivery model may facilitate care-seeking and improve outcomes for people with a dual burden of HIV and NCDs. We describe the current state of integration of hypertension and diabetes care into HIV treatment in Malawi, South Africa and Zambia. Methods We administered structured interviews to HIV treatment providers in 41 primary healthcare facilities to evaluate how NCD care is provided to PLHIV accessing antiretroviral therapy (ART). We defined integration as provision of NCD services within the HIV clinic. The potential degree of integration in HIV clinics ranged from not integrated at all (no NCD services) to fully integrated (all NCD services). We also surveyed a sample of ART clients about their access to integrated care. Results The degree of integration varied across the facilities and countries. All facilities in South Africa reported being fully integrated for HIV care and hypertension and diabetes, and most providers in South Africa identified no barriers to integration. Integration was much less complete in Malawi and Zambia, with most facilities offering hypertension and diabetes screening/diagnosis and support but limited treatment or disease monitoring services. Frequently cited barriers to integration in Malawi and Zambia were limited staff knowledge of integrated care provision and facility space constraints. ART clients’ experience with integrated services mirrored provider responses. Over 90% of survey participants in South Africa reported HIV and non-HIV visit and medication collection alignment, compared to less than half in Malawi and Zambia. Conclusions The level of integration of hypertension and diabetes care with HIV treatment varies widely across facilities in Malawi, South Africa, and Zambia, despite each country having national guidelines that promote integration. Interventions to increase integration must consider differences among facilities at baseline.
DOI: 10.1371/journal.pone.03460292026-04-01
The PLOS One Editors
by The PLOS One Editors
DOI: 10.1371/journal.pone.03461182026-04-01
Xiaoming Guo, Fengbao Yang, Linna Ji
by Xiaoming Guo, Fengbao Yang, Linna Ji Infrared-visible object detection in complex dynamic environments often suffers from weak feature representation and underutilized cross-modal complementarity, leading to missed and false detections. To address these issues, we propose a Dual-modal Enhanced Feature Enhancement and Fusion Network (DEF-Net). To enhance the model’s focus on informative features within both infrared and visible modalities, a feature interaction enhancement module is designed to effectively highlight and reinforce salient information. Furthermore, to better exploit the complementary characteristics of the two modalities, a transformer-based fusion architecture incorporating a cross-attention mechanism is introduced, enabling deep inter-modal feature integration. Experiments on SYUGV and LLVIP datasets show that DEF-Net outperforms existing methods in accuracy while maintaining real-time processing speed.
DOI: 10.1371/journal.pone.03458152026-04-01
Anselm P. Moshi, Ladislaus Kasankala, Analice Kamala, Nyabasi Makori, Dyness Kejo, Hoyce Mshida, Beatrice Bachwenkizi, Malimi Kitunda, Francis Millinga, Ai Zhao, Germana H. Leyna
by Anselm P. Moshi, Ladislaus Kasankala, Analice Kamala, Nyabasi Makori, Dyness Kejo, Hoyce Mshida, Beatrice Bachwenkizi, Malimi Kitunda, Francis Millinga, Ai Zhao, Germana H. Leyna Recent national surveys show that anaemia affects approximately 30–40% of school-aged children and up to 50% of adolescents in Tanzania, with prevalence exceeding 50% in some regions, underscoring the urgent need for nutrient-dense, school-appropriate food solutions. This study developed snack bars from biofortified crops and compared partially germinated and non-germinated formulations to improve the diets of school-aged children and adolescents. Germination significantly (P ≤ 0.05) increased carbohydrate, fat, fibre, and provitamin A content. Zinc content was slightly higher in the germinated bars, whereas iron content was slightly lower compared to the non-germinated formulation. Both formulations supplied 50–70% of the Recommended Dietary Allowances for carbohydrate, protein, fibre, iron and zinc iron aligning with Tanzania’s School Feeding Policy targets. Sensory testing showed higher acceptance of germinated ingredient’s snack bars for texture, colour, aroma and overall acceptability, while non-germinated bars were preferred for appearance and taste. These results demonstrate that both germinated and non-germinated biofortified snack bars can provide substantial amounts of essential nutrients in a child-friendly form. To our knowledge, this is the first study in Tanzania to develop germinated biofortified crop–based snack bars, offering a scalable, culturally acceptable approach to reducing micronutrient deficiencies among school-aged children.
DOI: 10.1371/journal.pone.0346034