Clinical intelligence & editorial.

PLOS

Perceived facilitators and barriers influencing lifestyle modification among adults with cardiovascular disease attending a cardiac clinic at a referral hospital in northern Tanzania: An exploratory qualitative study

Cardiovascular diseases (CVDs) are a significant cause of morbidity and mortality worldwide, with lifestyle modification being a cornerstone in their management. However, qualitative evidence on the influences that facilitate or hinder lifestyle modification practices among patients attending cardiac clinics in Tanzania remains limited. Understanding these influences is important for designing feasible, context-appropriate cardiovascular risk-reduction interventions. This study aimed to explore...

Cardiovascular

Gladness N. Mkawe, Benedicto Mgala, Neema Mawi, Salome E. Buluba, Menti Ndile, Khadija Malima, Edith Tarimo, Fatina B. Ramadhani• October 27, 2026

PLOS

Cost-effectiveness of recommended interventions for managing low back pain: A systematic review

Background: Low back pain is the leading cause of disability worldwide. Although numerous treatment approaches are recommended by international clinical guidelines, there is still limited understanding of which interventions provide the best value for money. We aimed to critically appraise and summarise the evidence on the cost-effectiveness and costs of interventions endorsed in recent guidelines to manage low back pain (LBP), compared to usual care. Methods and findings: We searched 10 electro...

Back Pain

Stephanie Mathieson, Martin Underwood, Muhammad Ibrahim, Zhilin Hua, Zhaohua Zhu, Paulo H. Ferreira, Hema Mistry, Emily R. Atkins, Jocelyn L. Bowden, Jillian P. Eyles, Andrew M. Briggs, David J. Hunter, Manuela L. Ferreira• October 27, 2026

PLOS

Linking academic stress to loneliness, anxiety, and depression: The association of problematic micro-drama use among Chinese university students

Objective: Problematic micro-drama use (PMDU) has received increasing attention as micro-dramas have become widely consumed among young adults in China. This study examined the associations between academic stress and PMDU among Chinese university students, explored which dimensions of academic stress were uniquely associated with PMDU, and examined the associations between PMDU and loneliness, anxiety symptoms, and depressive symptoms. Methods: A cross-sectional online survey was conducted amon...

Anxiety

Haoyuan Yu, Zhibiao Yang• October 27, 2026

PLOS

A One Health approach to antibiotic resistance profiles in backyard (hobby) poultry settings in Central North Carolina

An increasing number of households in the United States keep backyard poultry, including small hobby flocks, or purchase eggs from backyard poultry farmers. Concerns about rising grocery prices and a growing interest in homesteading have driven a surge in poultry-related sales. Some research has been conducted to understand the prevalence of zoonotic bacteria and antimicrobial resistance of the backyard environment; however, with the expansion of backyard hobby flocks and increasing availability...

Antibiotic

Sarah Tong, Grace Faulkner, Sarah Rhea, Annette Greer, Emily S. Bailey• October 27, 2026

PLOS

Is resistance training effective to increase BDNF in multiple sclerosis? An updated systematic review and meta-analysis of isolated interventions

Background: Brain-derived neurotrophic factor (BDNF) is a key mediator of neuroplasticity and has been associated with disease progression in multiple sclerosis (MS). While aerobic exercise is consistently linked to BDNF modulation, the specific contribution of isolated resistance training (RT) remains unclear, as previous reviews have largely combined multimodal exercise interventions. Objective: To systematically review and meta-analyze the effects of isolated RT on peripheral BDNF levels in i...

Multiple Sclerosis

William Riciere Pedon, Gustavo De Conti Teixeira Costa, Lorenzo de Ávila Rodrigues Cortizo Vidal, Pedro Augusto Inacio, Marcelo Magalhães Sales, Ivanéria Mendonça Martins, James Oluwagbamigbe Fajemiroye, Sergio Machado, Vicente Aprigliano, Gabriela Ribeiro Inacio, Adolfo Mundombe Cameia, Gaspar R. Chiappa, Eduardo da Matta Mello Portugal, Alberto Souza Sá Filho• October 27, 2026

PLOS

Integrating MaxEnt and copula models to assess plague-associated ecological suitability under climate change in Northern Tianshan, China

Background: Plague, a paradigmatic zoonotic disease, depends on the intricate interplay among ecological environments, climatic conditions, and host-vector-pathogen interactions for its transmission. Climate change is reshaping the ecological distribution and transmission risks of plague. However, a systematic understanding of the future epidemiological trends for the Northern Tianshan Natural Plague Focus in Xinjiang remains limited. Methods: By employing an optimized maximum entropy model (Max...

Plague

Fang Li, Guoyu Zhao, Abulimiti Moming, Xiaobo Liu, Ping Ma, Shang Zhan, Huiqian Wang, Jianhui Chen, Wuliken Tuerdali, Qiguo Wang, Tao Luo, Haiyan Wu, Yujiang Zhang• October 26, 2026

PLOS

Exploratory baseline mucosal transcriptomics and vedolizumab response in ulcerative colitis

Currently, there are still no reliable pre-treatment biomarkers for vedolizumab in ulcerative colitis. To investigate baseline mucosal signals, we reconstructed the discovery cohort from GSE73661 and evaluated the derived panel in the blood samples from GSE191328 and the independent mucosal RNA-seq cohorts from E-MTAB-7845. The reconstructed cohort comprised 24 baseline samples, including 14 composite responders and 10 non-responders. Through repeated LASSO variable selection, the study identifi...

Ulcerative Colitis

Liang Zhang, Jian Liu, Chenfei Liang, Qiang Han, Da Li, Yali Wang• October 26, 2026

PLOS

Defining clinically meaningful pain reduction after spinal injections using an 11-point numerical rating scale and patient-reported relative reduction of pain

Background: We aimed to establish thresholds for assessing clinically meaningful pain improvement after spinal injections using numerical rating scale (NRS) and patient-reported relative reduction (PRR) of pain. Methods: This single-center retrospective study included 1,828 patients who received spinal injections at our spinal intervention center and completed a 2-week follow-up telephone interview in 2017. NRS absolute and relative reductions were calculated using the NRS scores before injectio...

Pain

Yoonah Do, Wookon Son, Youngjune Kim, Choong Guen Chee, Yusuhn Kang, Eugene Lee, Yeo Ju Kim, Joon Woo Lee• October 26, 2026

PLOS

Cost-effectiveness of capivasertib plus abiraterone for PTEN-deficient metastatic hormone-sensitive prostate cancer in the United States

Background: On June 12, 2026, the US Food and Drug Administration (FDA) approved capivasertib (Truqap; AstraZeneca) in combination with abiraterone and prednisone for adult patients with metastatic androgen pathway modulation-naive or -sensitive (mAPMN/S) prostate cancer, corresponding clinically to metastatic hormone-sensitive prostate cancer (mHSPC), that is PTEN-deficient as detected by an FDA-authorized test. The pivotal CAPItello-281 trial demonstrated a statistically significant radiograph...

Hormone

Glen J. Weiss• October 26, 2026

PLOS

Single-cell analysis of COPD: Microenvironmental interactions driven by immune-fibrotic imbalance

Chronic obstructive pulmonary disease (COPD) is a respiratory disease with a high degree of cellular heterogeneity and molecular complexity, characterized pathologically by persistent airflow limitation and an inflammatory-tissue remodeling cascade involving multiple cell types. Traditional transcriptomics lack the resolution to precisely define cell subpopulation roles in COPD. Single-cell RNA sequencing (scRNA-seq) overcomes this limitation by enabling high-resolution analysis of cell-type-spe...

Copd

Hong Jiang, Wenxing Wang, Lu Wang, Jiaojian Wu, Jianjiang Luo, Qi Yan, Xueli Gong, Jing Liang• October 26, 2026

PLOS

Burden of bacterial antimicrobial resistance associated with modifiable human antibiotic consumption: An observational study

Background: Human antibiotic use is widely believed to contribute to the evolution and maintenance of antimicrobial resistance (AMR) in bacterial pathogens. While antibiotic stewardship should thus discourage use in situations where AMR-related harms outweigh clinical benefit, evidence to inform this assessment of tradeoffs is lacking, most notably in low-resource settings where gaps in antibiotic access persist. Quantitative understanding of use-resistance relationships is thus necessary as cou...

Antibiotic

Benjamin J. Singer, Alec Gleason, Isabella Impalli, Mikkel D. Nagorsen, Chungman Chae, Lauren C. Granskog, Philip C. Lee, Ramanan Laxminarayan, Joseph A. Lewnard• October 26, 2026

PLOS

Handwriting-based Alzheimer’s disease classification on the DARWIN dataset: Repeated nested validation, task-level reduction, and cross-validated explainability

Online handwriting provides a low-burden source of cognitive–motor measurements, but small datasets can yield optimistic results when preprocessing, task selection, or explanation is not separated from evaluation. We evaluated eight classifiers on the DARWIN dataset (174 participants; 25 tasks; 450 predictors) using ten repetitions of 5-outer/3-inner-fold nested stratified cross-validation. All preprocessing, hyperparameter selection, and calibration were restricted to outer training data. We ad...

Alzheimer’S Disease

Tehreem Fatima, Tahira Anwar Lashari, Momina Moetesum, Sana Anwar Lashari• October 26, 2026