Clinical intelligence & editorial.

PLOS

Exploratory cluster analysis of noninvasive vascular measures reveals heterogeneous vascular profiles after stroke

Vascular dysfunction is prevalent after stroke and contributes to elevated cardiovascular risk; however, the extent to which vascular heterogeneity exists in this population remains unclear. This study examined whether distinct multi-domain cluster-derived vascular profiles are present in individuals with chronic stroke and whether these profiles are associated with functional performance. Vascular structure and function were assessed using flow-mediated dilation, carotid intima-media thickness,...

Stroke

Bria L. Bartsch, Amanda N. Engler, Sandra A. Billinger• November 6, 2026

PLOS

Effectiveness of dose-matched immersive virtual reality-stationary cycling combined with neurological physiotherapy versus neurological physiotherapy alone in individuals with chronic stroke (CIVIS): A single-blind, randomized crossover trial protocol

Background: Stroke is a leading cause of long-term disability worldwide and frequently results in persistent motor and functional impairments, particularly affecting gait and balance. Given the high prevalence and impact of these limitations on independence and quality of life, innovative rehabilitation strategies are needed. Immersive virtual reality combined with stationary cycling (IVR-SC) has emerged as an innovative rehabilitation approach with the potential to improve mobility and function...

Stroke

Daniel Asensio-Perez, David Lucena-Anton, Jose A. Moral-Munoz• November 6, 2026

PLOS

Stroke disability burden and rehabilitation service-capacity proxies in China, 1990–2023: A population-based analysis using GBD 2023 and national service statistics

China’s stroke burden is increasingly shaped by survival with disability, population ageing, and demand for rehabilitation and long-term support. Yet the extent to which stroke disability burden has shifted towards older-old and oldest-old adults, and how this burden relates to community and elder-care service capacity, remains insufficiently quantified. We conducted a population-based secondary analysis of Global Burden of Disease Study 2023 estimates for China from 1990 to 2023, focusing on is...

Stroke

Yumin Zhou, Wenke Fan, Dandan Lv, Qian Li, Yu Cao, Hao Tian, Weiwei Guo, Xia Bi• November 6, 2026

PLOS

Association of unmet discharge needs on readmission or mortality among acute respiratory failure survivors during the COVID-19 pandemic: The Addressing Post-Intensive Care Syndrome (APICS-COVID) multicenter prospective cohort study

Background: Survivors of acute respiratory failure (ARF) often face long-term impairments known as Post-Intensive Care Syndrome. These impairments, coupled with fragmented healthcare, contribute to high rates of readmission and mortality. The COVID-19 pandemic challenged healthcare systems, providing an important opportunity to evaluate healthcare fragmentation before and during the pandemic. Methods: From December 2020 to July 2022, this prospective multicenter study (APICS-COVID) enrolled ARF...

Respiratory

Harris L. Carmichael, Danielle Groat, Victor D. Dinglas, Somnath Bose, Mustafa Mir Kasimov, James C. Jackson, Naga Preethi Kadiri, Maria Isabel Trejo-Zambrano, Carla M. Sevin, Tom Greene, Dale M. Needham, Samuel M. Brown, for the APICS-COVID Study Team• November 6, 2026

PLOS

Visual outcomes and headache in intracranial hypertension following cerebral venous sinus thrombosis: A retrospective cohort study

Intracranial hypertension is a frequent complication of cerebral venous sinus thrombosis (CVT), posing a risk for permanent visual impairment. However, long-term visual outcomes have not been systematically assessed using objective neuro-ophthalmic measures. We retrospectively evaluated consecutive adults presenting to a single-center tertiary intracranial hypertension clinic between 2019 and 2025 with intracranial hypertension following CVT. Visual outcomes were assessed using best-corrected vi...

Hypertension

Theresia Knoche, Ivo Grueninger, Charlotte Pietrock, Zohreh Jami, Leon Alexander Danyel• November 6, 2026

PLOS

Protocol for investigating the association between Helicobacter pylori exposure, antigen-specific serological responses, and resistant versus non-resistant hypertension in a South African cohort

Background: Hypertension is a leading contributor to cardiovascular morbidity and mortality, with poor control in low- and middle-income countries. Helicobacter pylori (H. pylori) has been associated with hypertension through inflammatory, endothelial, metabolic and immune pathways, but data from sub-Saharan Africa, particularly in resistant hypertension, are limited. Methods: This cross-sectional observational study will enrol 200 adults aged ≥18 at a tertiary academic hospital in Cape Town, So...

H. Pylori

Mathilda C. Mennen, Michael Z. Zulu, Koketso C. Mabatha, Richard Baguma, Sango Skelem, Nandipha N. Mbundwini, Olukayode O. Aremu, Marguerite Adriaanse, Daphne van Dijk, Preyanka Pillay, Sam Africa, Erika Jones, Mashiko Setshedi, Adrian Brink, Wendy A. Burgers, Ntobeko A. B. Ntusi• November 6, 2026

PLOS

HIF-1α/PPAR-γ/SIRT1 axis drives astrocyte senescence and regulates endothelial function via GDNF/NRTN in diabetic retinopathy

Background: Diabetic retinopathy (DR) is a leading cause of blindness in working-age populations. Astrocyte senescence is highly prevalent in DR, but the underlying regulatory mechanism remains unclear. This study aims to investigate the role of the HIF-1α/PPAR-γ/SIRT1 axis in regulating retinal astrocyte senescence and endothelial function in DR. Methods: Mouse retinal astrocytes were exposed to high glucose (30 mM) to mimic diabetic conditions. Senescence was evaluated by β-galactosidase stain...

Diabetes

Jing Wang, Shufen Fang, Ming Sun, Jue Wang, Yongqing Liu, Xuan Wang, Weiwei Liu, Lei Gao• November 6, 2026

PLOS

Cardiovascular disease risk prediction models for people living with HIV in Sub-Saharan Africa: A scoping review protocol

Background: The landscape of Human Immunodeficiency Virus (HIV) care has dramatically shifted with the advent of effective antiretroviral therapy (ART), transforming HIV from a rapidly fatal illness into a chronic, manageable disease. This success, however, has unveiled new challenges, primarily the increased prevalence of non-AIDS-related comorbidities, with non-communicable diseases (NCDs) such as cardiovascular disease (CVD) emerging as a critical concern for people living with HIV (PLWH). CV...

Cardiovascular

Nchidzi Ntiyani, Gobopamang Letamo, Mpho Keetile, Mpho Disang• November 6, 2026

PLOS

Development of a village health worker care model to reduce cardiovascular risk in areas of armed conflict: Qualitative results from a participatory planning process in Myanmar

Cardiovascular disease (CVD) is the leading cause of death in Myanmar, but care models are lacking to deliver evidence-based treatments to reduce CVD risks in areas of armed conflict. Village health workers (VHWs) play a key role in bridging communities and clinics, but their role in CVD prevention and management in conflict-affected settings has not been clearly defined. This study aimed to describe the system for CVD care and to elicit perspectives on how VHWs might contribute to a village-bas...

Cardiovascular

Eindra Htoo, Parveen Parmar, Adam Richards, Tara Russell, Catherine Lee, Saw Sha Kler Law, Saw Kyaw Myint, Zay Yar Phyo Aung, Tom Traill• November 6, 2026

PLOS

Calibration of a fully closed-loop lumped-parameter cardiovascular model with baroreflex in response to induced central hypovolemia

Calibration of cardiovascular models is essential to their clinical utility. We provide a full description of the calibration of a non-linear, dynamic model using global optimisation methods. Specifically, we consider an experimental cohort response in a closed-loop, baro-regulated cardiovascular model, in the setting of induced central hypovolemia.We propose a framework for simplifying calibration of dynamic, regulated models. We perform global sensitivity analysis and orthogonality analysis of...

Cardiovascular

Karolina Tlałka, Harry Saxton, Ian Halliday, Xu Xu, Andrew Narracott, Daniel James Taylor, Lars Øivind Høiseth, Jonny Hisdal, David Rodney Hose, Maciej Malawski• November 6, 2026

PLOS

Commonly expressed key driver genes in the pathogenesis of viral and non-viral liver cancer

Background: Hepatocellular carcinoma (HCC) is a common and lethal liver cancer primarily associated with viral infections like hepatitis B virus (HBV) and hepatitis C virus (HCV), as well as non-viral causes. Understanding the molecular mechanisms of these subtypes is essential for identifying potential biomarkers and therapeutic targets. Methods: In this study, an integrated bioinformatics approach was used to analyze publicly available datasets related to HBV-associated, HCV-associated, and no...

Cancer

Melika Zamanian, Niloofar Bajool, Yasamin Haghir-Sharif-Zamini, Seyedeh-Sanaz Araban, Farbod Nassiri, Seyedeh-Nasim Mirbahari, Rayhaneh Ahangar-Parvin, Roshanak Shams, Massoud Vosough, Sara Taleahmad• November 6, 2026

PLOS

Male breast cancer in Northern Tanzania: Clinicopathology and predictors of two-year survival (2016–2022)

Background: Male breast cancer (BC) is rare, accounting to approximately 1% of all breast cancers worldwide. Patients often present with advanced disease, contributing to poor outcomes. This study aimed to estimate two-year overall survival (OS) and identify clinicopathological and health-system–related predictors of survival among men with breast cancer treated at Kilimanjaro Christian Medical Centre (KCMC). Methods: A retrospective cohort study was conducted among 55 histologically confirmed m...

Cancer

Timon Stephen Emaely, Alex Mremi, Elizabeth F. Msoka, Rebeca Mutashobya, Blandina T. Mmbaga, Kondo Chilonga• November 6, 2026