Clinical intelligence & editorial.

PLOS

PCR bias impacts microbiome ecological analyses

Polymerase Chain Reaction (PCR) is a critical step in amplicon-based microbial community profiling, allowing the selective amplification of marker genes such as 16S rRNA from environmental or host-associated samples. Despite its widespread use, PCR is known to introduce amplification bias, where some DNA sequences are preferentially amplified over others due to factors such as primer-template mismatches, sequence GC content, and secondary structures. Although these biases are known to affect tra...

Pcr

Dharmik R. Rathod, Justin D. Silverman• January 27, 2026

PLOS

CoSMIC: A hybrid approach for large-scale, high-resolution microbial profiling of novel niches

Standard microbial profiling based on 16S rRNA (16S) sequencing suffers from a lack of primer universality, primer biases, and often yields low resolution. We introduce ‘Comprehensive Small Ribosomal Subunit Mapping and Identification of Communities’ (CoSMIC), addressing these challenges, especially in unexplored niches. CoSMIC begins with long-read sequencing of the full-length 16S gene, amplified by generic Locked Nucleic Acid primers over pooled samples, thus augmenting reference databases wi...

Scales

Maor Knafo, Shahar Rezenman, Tal Idan, Michael Elgart, Shlomi Dagan, Vered Zavaro, Ziv Reich, Ruti Kapon, Dagan Sade, Noam Shental• January 27, 2026

PLOS

Relationship between postural and kinesthetic awareness, static balance, and weight-bearing asymmetry in individuals with chronic stroke: A cross-sectional study

Postural and kinesthetic awareness are essential sensory-perceptual components contributing to balance control and symmetrical weight distribution. In individuals with chronic stroke, deficits in body awareness can impair postural stability and increase asymmetry, yet their precise relationships with balance parameters remain insufficiently explored. This cross-sectional study investigated the associations between postural and kinesthetic awareness and both static balance performance and weight-...

Stroke

Mohammad A. ALMohiza, Ravi Shankar Reddy• January 27, 2026

PLOS

Correction: Trends and disparities in ischemic stroke mortality and location of death in the United States: A comprehensive analysis from 1999–2020

The Data Availability statement for this article is incorrect. The correct Data Availability statement is as follows: The data underlying the results from this study are publicly available from the CDC WONDER database ( https://wonder.cdc.gov/ucd-icd10.html ). Researchers can access the data by utilizing the search parameters provided in the Supporting Information (S1 File). In the Place of death by race subsection of the Results, there is an error in the fourth sentence of the first paragraph....

Stroke

Jason K. Lim, Jenlu Pagnotta, Richard Lee, Do H. Lim, Jeffrey M. Breton, Zachary A. Abecassis, Raymond M. Meyer, Jeffrey C. Mai, Michael R. Levitt• January 27, 2026

PLOS

Association between acute respiratory acidosis and hyperkalemia during esophageal cancer surgery in the prone position: A multicenter retrospective observational study protocol

Introduction: Esophagectomy in the prone position can induce acute respiratory acidosis. While it is known that metabolic acidosis can significantly elevate serum potassium, the effect of respiratory acidosis is conventionally considered to cause minimal or no elevation. However, clinical practice in this surgical setting sometimes reveals a greater-than-expected degree of hyperkalemia. The objective of this study is to investigate the association between this acute respiratory acidosis and hype...

Respiratory

Sakura Okamoto, Tokiko Tochii, Jyunya Nakada, Hideaki Note• January 27, 2026

PLOS

Development and evaluation of machine learning algorithms for the prediction of opioid-related deaths among UK patients with non-cancer pain

The global rise in prescription opioid use has contributed to an opioid epidemic, associated harms, and unintentional deaths in several western countries. Opioids however continue to be regularly prescribed for acute pain and in the chronic pain context due to limited treatment options. Currently there are no accurate tools that help predict which patients prescribed opioids may be at risk of death, which depends on the cultural context and varies across countries. Existing models do not account...

Pain

Jose Benitez-Aurioles, Carlos Raul Ramirez Medina, David Jenkins, Niels Peek, Meghna Jani• January 27, 2026

PLOS

Effectiveness of immersive virtual reality and exercise on clinical, clinimetric and biomarker variables in rotator cuff-related shoulder pain patients: A study protocol for a multicentre randomized clinical trial (IVR- RCRSP-Rehab)

Introduction: Shoulder pain is a common reason for physiotherapy consultations, and the high prevalence of rotator cuff-related shoulder pain (RCRSP) calls for novel approaches. Immersive virtual reality (IVR) offers an innovative treatment option to reduce pain, improve mobility and function in RCRSP. This study aims to compare the effectiveness of combining IVR with standard treatment versus standard treatment alone on clinical variables, clinimetric measures, and biomarkers in individuals wit...

Pain

Alberto Roldán-Ruiz, Claudio Villagrán-Soto, Gabriele Bertotti, Miguel López-Moreno, Sandra Sánchez-Jorge, Vicente Fernández-Ruiz, Manuel Rodríguez-Aragón, Javier Guerra-Armas• January 27, 2026

PLOS

Effect of esketamine-based patient-controlled intravenous analgesia on postoperative pain and quality of recovery after video-assisted thoracoscopic lobectomy: A prospective, double-blind, randomized controlled trial

Objective: This double-blinded randomized study aimed to investigate the effects of esketamine-based patient-controlled intravenous analgesia (PCIA) on postoperative analgesia and quality of recovery in patients undergoing video-assisted thoracoscopic (VATS) lobectomy. Methods: Patients undergoing selective VATS lobectomy were enrolled and randomly assigned (1:1) to receive PICA with 1.5 mg/kg esketamine (group K) or 1.5 mg/kg sufentanil (group S). Pain intensity was evaluated using the short-fo...

Pain

Ruirui Bi, Jiqiang Zhang, Ruijuan Liu, Lijuan Li, Yuxi Su, Mengjun Xu, Wenjun Yan• January 27, 2026

PLOS

Invisible scars and trauma: The psychological cost of youth-led protests in Nepal and the global imperative for trauma‑responsive mental-health systems

Nepal’s 2025 Gen‑Z movement In September 2025, Nepal witnessed an unprecedented youth-led movement driven largely by Generation Z (aged 13–28 years), with even schoolchildren joining the protests, reflecting the frustrations of a generation. What began as peaceful demonstrations against a governance system that is perceived to lack accountability, widespread corruption, nepotism, high youth unemployment, and a temporary social-media ban (viewed as a threat to civic freedom) quickly escalated in...

Mental Health

Shishir Paudel, Anisha Chalise, Uday Narayan Yadav• January 27, 2026

PLOS

Correction: From mental health detention to health systems reform: Co-producing policy and practice recommendations with Black men, their communities, and health and social care professionals

The affiliation for the fourth and sixth author is incorrect. Anna Bergqvist and Debbie Best are not affiliated with #4 but with #1: School of Nursing and Public Health, Manchester Metropolitan University, United Kingdom.

Mental Health

Elaine Craig, Caroline Leah, Jeremy Dixon, Anna Bergqvist, Isaiah Brodrick, Debbie Best, Kim Heyes, Joy Duxbury, Alina Haines-Delmont• January 27, 2026

PLOS

Benznidazole therapy improves pressure overload and cardiac electrical profile in an experimental model of Angiotensin II infusion-induced hypertension: Mechanistic insights

High blood pressure is one of the leading global causes of cardiovascular diseases. The chronic action of high concentrations of angiotensin II (Ang II) promotes arterial hypertension. Ang II acts via AT1 and AT2 receptors. Acting via AT1R, Ang II can induce the production of inflammatory cytokines and reactive oxygen species, promoting oxidative stress, which may influence cardiac electrical traits. In hypertensive patients, a dispersed QTc interval may predict cardiovascular events and mortali...

Hypertension

Ana Paula da Silva Pinheiro, Glaucia Vilar-Pereira, Leda Castaño-Barrios, Isalira Peroba Rezende Ramos, Yasmin Pedra-Rezende, Luiza Dantas-Pereira, Rubem Figueiredo Sadok Menna-Barreto, Daniel Gibaldi, Hilton Antônio Mata-Santos, Joseli Lannes-Vieira• January 27, 2026

PLOS

Correction: Association and progression of multi-morbidity with Chronic Kidney Disease stage 3a secondary to Type 2 Diabetes Mellitus, grouped by albuminuria status in the multi-ethnic population of Northwest London: A real-world study

The Competing Interests statement for this article is incorrect. The correct Competing Interests statement is as follows: RD is supported by Imperial College Institute of Global Health Innovation, Clinical Research Fellowship. FWKT is supported by the Ken and Mary Minton Chair of Renal Medicine. This project is supported by funding from NIH Imperial Biomedical Research Centre and Imperial Health Charity (Diamond fund) and award to FWKT. https://imperialbrc.nihr.ac.uk ; https://www.imperialcharit...

Diabetes

Rakesh Dattani, Zia Ul-Haq, Moulesh Shah, Gabrielle Goldet, Lord Ara Darzi, Hutan Ashrafian, Tahereh Kamalati, Andrew H. Frankel, Frederick W. K. Tam• January 27, 2026