Primary care clinicians are ideally suited to provide comprehensive, whole-person survivorship care for cancer survivors that focuses on managing co-occurring chronic conditions and mitigating risks related to the cancer and long-term effects of the disease and its treatment. It is therefore critical to develop and test innovative strategies to support primary care practices in delivering high-quality survivorship care. The National Cancer Institute–funded Primary Care Engaged Research for Cancer Survivorship Care (PERCS) initiative encompasses 4 randomized controlled trials funded by…
In this essay, the author highlights her difficult journey to breastfeed her son, discussing the physical, mental, monetary, and temporal difficulties faced by those who desire to breastfeed and offering recommendations for clinicians and society to make breastfeeding more attainable. Despite knowing breastfeeding can improve outcomes, even the author, a privileged and highly informed obstetrician and gynecologist, nearly could not afford the multiple, varied costs to breastfeed. Breastfeeding should not be a privilege, but an option accessible to all our patients.
Working in a rural primary health center in India taught me lessons that medical training never covered. Patients arrived with ordinary complaints, but beneath them were unspoken burdens shaped by gender, belief, poverty, and hierarchy. Over time, I discovered that cultural humility, learning to listen, and reflecting on my own limits became my most reliable tools. Although these experiences unfolded in a remote setting, the lessons hold meaning for clinical practice anywhere. In medicine, healing often begins where diagnosis and treatment end. Sometimes the most radical act is presence…
Rural medicine is often viewed as a professional compromise, yet it offers some of the most formative clinical training available. It teaches physicians to thrive in discomfort—whether the discomfort is limited medical resources, broad responsibility, geographic isolation, or patients’ economic barriers. That discomfort is what shapes physicians into more resilient, resourceful, and empathetic clinicians. Experiences across rural and remote regions demonstrate how limited access to technology and subspecialists sharpens diagnostic reasoning, strengthens reliance on physical examination, and…
On a rare day off from my duties as an ophthalmology resident, I wandered into a neighborhood bookstore and was recognized by a woman I had treated for optic neuritis in the emergency department. I didn’t remember her, but she remembered everything. In that gap—between my routine and her life-altering night—I heard what the emergency department often muffles: how ordinary work for me can be extraordinary to the person living it. The piece follows our brief conversation to ask a simple question: how can I carry less and notice more, honoring meaning without slowing the work that must go on?
In Japan, death from old age— rousui —is officially recognized on death certificates and is now the third leading cause of death. Rousui describes a gradual decline in physiological function leading to death without a specific underlying disease. As a family physician, my first diagnosis of rousui occurred two decades ago, for a woman in her 90s whose decline was slow, multidimensional, and free of reversible causes. While culturally accepted, rousui remains undefined in clinical terms, creating uncertainty in diagnosis and care. This ambiguity influences end-of-life decision making, sometimes…
by Helen Lumbard, Lauren Cadwallader, Devin Soper, on behalf of the PLOS Medicine Staff Editors PLOS Medicine has always championed open science and data transparency. Now, recognizing that code is as essential a research artifact as the data it analyzes, we are strengthening our code sharing policy to further ensure reproducibility and trust in the scientific record. Recognizing that code is as essential a research artifact as the data it analyzes, this Editorial outlines how PLOS Medicine is strengthening its code sharing policy to further ensure reproducibility and trust in the scientific…
by Nicole A. Swartwood, Nanki Singh, Seyed Alireza Mortazavi, Melike Hazal Can, Hening Cui, Do Kyung Ryuk, Peter MacPherson, Katherine C. Horton, Nicolas A. Menzies Background Global and national initiatives to combat tuberculosis (TB) have expanded over recent years. Despite this, the TB burden remains high in some population groups, with men recognized as having elevated TB risks. Summary measures of sex differences in TB prevalence were last estimated in 2016. Since then, many additional prevalence surveys have been conducted, including in the highest TB burden countries. We conducted a…
by Alice Beardmore-Gray, Andrew Shennan Eclampsia is a life-threatening complication of pre-eclampsia, yet remains difficult to predict. In this Perspective, Alice Beardmore-Gray and Andrew Shennan highlight a recent study that identifies 10 novel prodromal symptoms of eclampsia, with potential to better predict which women are at risk and therefore reduce delays in intervention.
by Thiago S. Torres, Paula M. Luz Suppression of HIV with antiretrovirals eliminates HIV transmission risk, summarized as Undetectable = Untransmittable (U = U). However, U = U literacy remains unevenly understood and shared, and stigmas persist. Equitable and accurate awareness of U = U requires culturally tailored interventions, improved provider education, and supportive policy environments beyond biomedical evidence alone. Suppression of HIV with antiretrovirals eliminates HIV transmission risk, summarized as Undetectable = Untransmittable (U=U). However, U=U literacy remains unevenly…
by Jędrzej Chrzanowski, Magdalena Walicka, Jacek Burzyński, Małgorzata Zaraś, Arkadiusz Michalak, Wojciech Fendler Background Semaglutide, a glucagon-like peptide-1 receptor agonist, is widely used for the management of type 2 diabetes (T2DM). Recent case reports have raised concerns about a potential association between semaglutide use and the development of nonarteritic anterior ischemic optic neuropathy (NAION), a rare but vision-threatening condition. We aimed to evaluate whether semaglutide use is associated with an increased risk of NAION in patients with T2DM. Methods and findings We…
by Jelisaveta Džigurski, Märt Möls, Kristi Läll, Hannah Currant, Mall Eltermaa, Estonian Biobank Research Team , Reedik Mägi, Lili Milani, Triin Laisk Background Hormonal contraceptives (HCs) are widely used and have well-documented population-level statistics. Previous studies with short follow-ups have focussed on individual HC use and side effects. However, the same aspects over longer periods, HC formulation switching, and the impact of genetic factors on HC side effects remain understudied due to the limited availability of suitable datasets. We investigated whether the Estonian Biobank…
by Fabio Bernardoni, Dominic Arold, Luis Schoppik, Klaas Bahnsen, Ruiyang Ge, Clara Moreau, Lasse Bang, Federico D’Agata, Giovanni Abbate-Daga, Christian K. Tamnes, Iain Campbell, Owen O’Daly, Ulrike Schmidt, Guido Frank, Stefanie Horndasch, Andreas Hess, Arnd Dörfler, Hans-Christoph Friederich, Joe Simon, Angela Favaro, Luca Lavagnino, Christina E. Wierenga, Amanda Bischoff-Grethe, Amy E. Miles, Allan Kaplan, Aristotle Voineskos, Paul A. M. Smeets, Annemarie A. van Elburg, Unna Danner, Sophia I. Thomopoulos, Laura Berner, Neda Jahanshad, Sophia Frangou, Joseph A. King, Paul Thompson, Stefan…
by Veronica Tozzo, Rachel Petherbridge, Kaitlyn James, Sarah Hsu, Deepti Pant, Chloe Michalopoulos, Brody H. Foy, Tanayott Thaweethai, Christopher Mow, Jacqueline Maya, Carolina Batlle Camero, Lydia Shook, Kathryn J. Gray, Logan Mauney, John M. Higgins, Camille E. Powe Background Pregnancy alters hematologic state as measured by complete blood count (CBC), but the longitudinal changes in CBC indices that define healthy pregnancies are not well established. In a large cohort based at an academic health system in the United States, we aimed to define reference intervals and typical longitudinal…
by Zhi-Hui Luo, Na Wang, Jingwei Zhao, Fei Long, Si Wu, Wei Zhong, Wei-Ming Chen, Bicheng Wang, Kun Wang, Yufeng Yuan, Jingjiao Zhou, Chunhui Yuan, Fubing Wang Background Microvascular invasion (MVI) is closely related to the recurrence and metastasis of hepatocellular carcinoma (HCC), but the underlying cellular mechanism remains largely elusive. This study aims to elucidate the regional cellular discrepancy between MVI-positive (MVI + ) and MVI-negative (MVI − ) HCC by integrating Spatial transcriptomics (ST) and spatial metabolomics (SM). Methods and findings ST and SM were performed on six…
by Ariel Avraham Hasidim, Itamar Ben Shitrit, Daphna Idan, Tal Michael, Amalia Levy, Gali Pariente, Eitan Lunenfeld, Sharon Daniel Background Pain and fever are common in early pregnancy, yet their management poses a major clinical dilemma. Although not confirmed, recent studies have raised safety concerns regarding acetaminophen. Evidence on the use of nonsteroidal anti-inflammatory drugs (NSAID) in the first trimester remains inconclusive. This uncertainty has left clinicians with limited evidence to guide treatment decisions. This study evaluated the association between first-trimester…
by Alessia Hysa, D. Herbert Opi, Joshua Waterhouse, Sandra Chishimba, Jessica L. Horton, Natalie Kingston, Hans J. Netter, David Wetzel, Michael Piontek, Gaoqian Feng, Jahit Sacarlal, Carlota Dobaño, Liriye Kurtovic, James G. Beeson Background The RTS,S/AS01 malaria vaccine was recently approved for implementation in children, but only provides modest and short-lived efficacy against malaria. RTS,S targets a portion of the Plasmodium falciparum ( Pf ) circumsporozoite protein (CSP), comprising the central NANP-repeat region and C-terminal domain. Mechanisms of immunity and correlates of…
by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza…
by Silja Kosola Social media has evolved from connection to compulsion, disproportionately harming children and adolescents. Addictive designs together with developmental vulnerability fuel mental health risks and highlight the urgent need for stricter age limits and stronger protections. In this Perspective, Silja Kosola outlines how social media disproportionately harms child and adolescent mental health, and argues that while recent policy changes aimed at protecting youth from social media are welcome, stricter age limits and greater accountability of social media companies are needed.