Clinical intelligence & editorial.

PLOS

Antibiotic stewardship challenges in Madagascar’s poultry sector: informality, knowledge gaps, and market constraints

Antibiotic resistance (ABR) is a major global public health threat, largely driven by the overuse and misuse of antibiotics. Tackling its animal health component is particularly difficult in low- and middle-income countries, where data and resources are limited. This qualitative study aims to explore antibiotic use (ABU) and its underlying drivers in poultry farms in Analamanga, Madagascar’s region with the highest poultry density. In April 2023, we conducted semi-structured interviews with 79 p...

Antibiotic

Sophie Molia, Ilo Tsimok’Haja Ramahatafandry, Michel Rakotoharinome, Christian Lienhardt, Muriel Figuié, Alexandre Hobeika, Daouda Kassié• November 6, 2026

PLOS

Efficacy of diadynamic currents versus transcutaneous electrical nerve stimulation for transcutaneous tibial nerve stimulation in subjects with overactive bladder syndrome: A double-blind randomized controlled trial

Background: In the traditional treatment of overactive bladder (OAB) with transcutaneous posterior tibial nerve stimulation (TTNS), physical therapists currently use only transcutaneous electrical nerve stimulation (TENS). However, the literature has commonly replaced TENS with diadynamic currents for various musculoskeletal pain syndromes. Moreover, no literature describes the use of diadynamic currents in the TTNS procedure. Therefore, our study aimed to determine the efficacy of diadynamic cu...

Overactive Bladder

Jaya Shanker Tedla, Sneha Latha Lalaji, Ajaya Kumar Midde, Nirmala A. Papalkar, N. Bindhu Priya, Devika Rani Sangadala, Ravi Shankar Reddy, Debjani Mukherjee, Ahlam Mohammed Alamri, Abdullah Suwayyid Alzahrani, Najla Awn Alhadi• November 6, 2026

PLOS

Introduction of contraceptive implants as a family planning strategy in Honduras and Chiapas: Results from the Salud Mesoamerica Initiative (SMI)

Expanding access to a broad range of contraceptive methods is critical for reducing unintended pregnancies and improving reproductive health. This study evaluates the introduction of subdermal contraceptive implants in the selected areas of Honduras and Chiapas, Mexico, in the context of the Salud Mesoamérica Initiative, a results-based financing program focused on disadvantaged populations. Data were obtained from household surveys conducted between 2012 and 2022 among women aged 15–49 years in...

Contraception And Family Planning

Adrián Santoro, Natalia Basualdo, Federico Rolón, Lucía Bartolomeu, Camila Volij, Matt Simon, Brittany Hagedorn, Diego Ríos-Zertuche, Santiago Esteban, Adolfo Rubinstein• November 6, 2026

PubMed

Pregnancy-Induced Hypertension Complicated by Posterior Reversible Encephalopathy Syndrome: A Case Series of Two Patients.

ABSTRACT Posterior reversible encephalopathy syndrome (PRES) is a rare but potentially life‐threatening neurological complication associated with hypertensive disorders of pregnancy. This report presents two cases of pregnancy‐induced hypertension complicated by PRES, both clinically characterized by headache and visual disturbances, with characteristic neuroimaging findings. The clinical manifestations, laboratory findings, and magnetic resonance imaging (MRI) characteristics of two patients a...

Pregnancy

Zhao X, Yan M, Long F, Mumdzjans A, Song R• November 6, 2026

PubMed

Unexplained Optic Neuritis and New Heart Block: A Diagnostically Challenging Case of Probable Sarcoidosis.

ABSTRACT Sarcoidosis is a systemic inflammatory disease of unknown etiology and manifests in multiple forms. It can affect several organs within the body; however, the lungs and intra‐thoracic lymph nodes are involved in the majority of cases. Diagnosis can be challenging due to the diversity of presentation and similarities to other systemic diseases. Although biopsy is often used to confirm the diagnosis, areas of disease involvement can be difficult to access. This case involves a patient wi...

Sarcoidosis

Kamath C, Al-Qaysi G, Paudel H, Saado J, Nwaonu J• November 6, 2026

PubMed

Bone marrow sarcoidosis in Takayasu arteritis: Case report and literature review.

Rationale: Takayasu arteritis (TA) is a systemic granulomatous large-vessel vasculitis predominantly involving the aorta and its primary branches. Sarcoidosis is a systemic granulomatous disorder characterized histologically by non-necrotizing epithelioid granulomas, most commonly affecting the lungs. Although the coexistence of TA and sarcoidosis has been documented, bone marrow involvement by sarcoidosis in a patient with concomitant TA has not, to our knowledge, been previously reported. Pa...

Sarcoidosis

Fakih O, Hachem S, Chamas R, Abi Dargham S, Aitisha Tabesh O, Fayad F• November 6, 2026

PubMed

Toward Immersive Diabetes Education: Understanding User Needs for Virtual Reality-Assisted Self-Management Support in Adults With Type 2 Diabetes Mellitus.

Effective self‐management in Type 2 diabetes mellitus (T2DM) requires sustained adherence to diet, physical activity, medication, and lifestyle modification. However, conventional diabetes education often remains generic, one‐directional, and insufficiently responsive to the psychological, behavioral, and contextual challenges patients face in daily life. Immersive technologies such as virtual reality (VR) may offer a more engaging approach to diabetes education, yet evidence on the user needs t...

Type 2 Diabetes Mellitus

Jafar N, Setyawati A, Ibeneme SC, Akbar A, Ahmad HH, Suriani S• November 6, 2026

PubMed

Pathological Ossification of Spinal Ligament-Derived Fibroblasts in an Inflammatory Micro-Environment via Activation of the ECM/ITGA5/FAK/AKT Pathway in Ankylosing Spondylitis.

ABSTRACT Chronic inflammation and heterotopic ossification (HO) were typical hallmarks of ankylosing spondylitis (AS). Although existing target inflammation inhibitors could reduce inflammation but failed to halt HO progression, highlighting the need for osteogenesis‐specific treatments. However, the role of fibroblasts (Fbs) responsible for extracellular matrix (ECM) remodelling in AS‐associated pathological ossification remained unclear. In this study, osteogenic capacity, pathological condit...

Ankylosing Spondylitis

Qiao M, Wang KY, Song CY, Lu JS, Li JK, Qiu Y, Qian BP, Zhu ZZ• November 6, 2026

PubMed

Evaluation of the efficacy of Si-based agent in Rheumatoid Arthritis with complicating vestibular impairment.

Background Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent joint inflammation and progressive disability. Although current therapies have improved clinical outcomes, safer and more effective therapeutic approaches remain needed. Silicon (Si)-based agents have antioxidant and anti-inflammatory properties and have shown beneficial effects in several inflammatory disease models. Methods We evaluated the effects of oral administration of a Si-based agent in a...

Rheumatoid Arthritis

Harada S, Koyama Y, Kobayashi Y, Imai T, Yoshioka Y, Kobayashi H, Inohara H, Shimada S• November 6, 2026

PubMed

Deep learning optimisation for cardiology: Neural Architecture Search-driven arrhythmia classification with electrocardiograms.

Cardiovascular disease is the leading cause of death worldwide. Sudden cardiac death (SCD) accounts for roughly 50% of all cardiac deaths. The electrocardiogram (ECG) is widely used for diagnosing cardiac disease. However, the complexity of interpretation limits the ECG’s efficacy. Modern deep learning methods can assist clinicians in diagnosis. We applied Neural Architecture Search (NAS) to identify optimal deep learning architectures for classifying cardiac arrhythmias with ECGs. We applied th...

Cardiology

Vanegas Müller E, Joe-Oshodi A, Banerjee A, Villarroel M• November 6, 2026

PubMed

Artificial intelligence in cardiology for non-experts: decoding key terms and understanding machine learning methodologies. A Scientific Statement of the ESC Working Group on e-Cardiology, the European Heart Rhythm Association (EHRA), the Association for Acute CardioVascular Care (ACVC), the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI), the European Association of Preventive Cardiology (EAPC), and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC, the ESC Regulatory Affairs Committee, and the ESC Digital Cardiology and Artificial Intelligence Committee.

Abstract Evidence-based medicine represents the systematic approach through which physicians today use the best available scientific evidence from clinical research to guide their clinical decision-making process. However, the emergence of artificial intelligence (AI), with its diverse models and potential applications in medicine, is leading to a new form of research driven by ‘big data’ and heterogeneous datasets, extending beyond conventional statistical analysis and thereby making AI litera...

Cardiology

De Lucia R, Cluitmans M, Ramírez J, Kolossváry M, Climent AM, Millet J, Parollo M, Tubaro M, Volterrani M, Dendale P, D'Ascenzo F, Szymański P, Jensen MT, Dilaveris P, Bernardino G, Duncker D, Rienstra M, Vidal-Perez R, Locati ET, Treskes R, Schuuring M, Vitale C, Aung N, Leeson P, Busnatu S, Koltowski L, Casado-Arroyo R• November 6, 2026

PubMed

Transvaginal ultrasound with color doppler in the diagnosis of polycystic ovary syndrome: A single-center case-control study.

This study aimed to investigate the diagnostic value of transvaginal color Doppler ultrasonography and imaging indicators in polycystic ovary syndrome (PCOS). In this case-control study, 100 PCOS patients (PCOS group) and 100 healthy subjects (control group) were selected. The total ovarian area, ovarian medullary area, peak systolic velocity (PSV), end-diastolic blood flow velocity (EDV), and resistance index (RI) were compared. The total ovarian area, ovarian medullary area, PSV, and EDV of PC...

Ultrasound

Bu Y, Yu W, Zhao W, Liang X, Na F, Wu J• November 6, 2026