Effects of creatine supplementation on muscle strength gains—a meta-analysis and systematic review
Creatine (Cr) is a widely utilized nutritional supplement. Empirical evidence indicates that Cr supplementation significantly elevates intramuscular Cr content, thereby providing an energy substrate reservoir for exercise performance and facilitating improvements in muscle strength. Although numerous studies have examined the relationship between Cr and muscle strength, comprehensive investigations into population-specific ergogenic responses, optimal Cr dosage, and concomitant training intensity remain limited. These parameters are critical determinants for maximizing the efficacy of Cr supplementation. Against this backdrop, this study adopts meta-analysis, integrating conventional and Robust Variance Estimation (RVE) models, to comprehensively evaluate the intervention effects of Cr supplementation across three dimensions: population applicability, dosage optimization, and training intensity (PROSPERO registration number: CRD42024547697). It aims to provide evidence-based support for precise clinical application and subsequent research directions. Results Results showed no statistical difference in baseline muscle strength between the Cr intervention group and the control group; after intervention, the Cr group exhibited significant strength gains. Further subgroup analysis revealed: untrained individuals had greater muscle strength improvements than trained ones; the low-to-moderate dose group showed better effects than the high-dose group; high-intensity training had more significant effect sizes than low-intensity training; and no definitive conclusion was reached on muscle strength improvements between middle-aged/elderly and young populations. Conclusion Cr supplementation significantly improves muscle strength in the general population. Specifically: untrained individuals show greater muscle strength improvements; low-dose supplementation combined with high-intensity exercise yields better effects; no definitive conclusion was reached on effect differences between middle-aged/elderly and young populations, requiring larger-sample studies for more precise effect size analysis.
Zhang et al. (2025) Effects of creatine supplementation on muscle strength gains—a meta-analysis and systematic review. PeerJ 13:e20380 https://doi.org/10.7717/peerj.20380
Application analysis of two nucleic acid detection systems in blood detection of hepatitis B virus, hepatitis C virus and human immunodeficiency virus
Objective This study aimed to compare the diagnostic efficacy between the Kehua and Roche nucleic acid testing (NAT) systems for detecting hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in blood donation screening. Methods We analyzed retrospective data from 670,775 transient blood donation samples collected between 2016 and 2024. Key performance indicators (KPIs) included the types of reactive samples, effective split rate, effective reaction rate, single pool invalid number, batch invalid number, and pooling missing samples. Annual trends in cycle threshold (CT) value distributions and overall system performance were also evaluated. Results Among 419 reactive samples (Kehua: 202; Roche: 217), no significant differences were observed in the effective split rates (P > 0.05) or overall specimen reaction rates (P > 0.05) between the two systems. The HCV detection rate was significantly lower for the Kehua system (P < 0.05), while the detection rates for HBV and HIV showed no significant inter-system differences (P > 0.05). The separation efficiency of reactive pools varied significantly across different CT value ranges (P < 0.05). The Kehua system demonstrated stable annual effective split and reaction rates (P > 0.05), whereas the Roche system exhibited significant annual fluctuations in these metrics (P < 0.05). The Kehua system had significantly fewer single pool invalid numbers and pooling omissions than the Roche system (P < 0.05). Conclusion The Kehua and Roche NAT systems demonstrated comparable overall performance in blood screening, with Kehua proving non-inferior to Roche. Kehua’s advantages included fewer invalid tests and fewer pooling errors, which could reduce economic and time costs. The Roche system exhibited higher automation, supporting continuous batch processing. The observed CT value-dependent separation efficiency suggests potential for protocol optimization in detecting low viral load samples.
Wang et al. (2025) Application analysis of two nucleic acid detection systems in blood detection of hepatitis B virus, hepatitis C virus and human immunodeficiency virus. PeerJ 13:e20365 https://doi.org/10.7717/peerj.20365
Validity, reliability and minimal detectable change in the sit-to-stand test for synchronous and asynchronous tele-assessment in post-COVID-19 condition
Background Individuals with symptoms of long-term COVID-19 (coronavirus disease 2019) who presented mild infection without needing invasive ventilatory support require rehabilitation and performance and monitoring evaluations. The 1-minute sit-to-stand test (STS) is used to assess individuals with COVID-19 and might be an alternative for remote use in this population. Objective The current study aimed to validate the synchronous and asynchronous STS tele-assessment in individuals with post-COVID-19 condition to analyze the inter-evaluator reliability of the asynchronous STS, and identify the relationship between the participants’ self-reported asynchronous STS results and those of the evaluator. Methods Thirty-eight men and women with post-COVID syndrome who did not require invasive ventilator support were included in this study. The participants were assessed using STS in-person (STS-IP), synchronous (STS-S), and asynchronous (STS-A) tele-assessments. The participants also self-reported the total executed repetitions (STS-SR). The main outcomes were the number of repetitions performed in the STS-IP, STS-S, STS-A, and STS-SR. To verify STS-A reliability, the total repetitions registered between evaluators were compared. Results STS-IP showed significant correlations and lower total repetitions compared to STS-S and STS-A. STS-A repetitions were significantly lower compared to STS-SR; however, a significant correlation was observed. The STS-S and STS-A showed minimal detectable change values of 6.6 and 10.5, respectively. In terms of reliability, there were no significant differences in total repetitions or errors found between evaluators’ assessments of STS-A. Conclusion The study demonstrated good and moderate evidence of validity for synchronous and asynchronous remote STS assessments, respectively, highlighting the impact of the assessment protocol on STS performance interpretation. Asynchronous STS presented high reliability.
Machado Marques et al. (2025) Validity, reliability and minimal detectable change in the sit-to-stand test for synchronous and asynchronous tele-assessment in post-COVID-19 condition. PeerJ 13:e20211 https://doi.org/10.7717/peerj.20211
Insights into the interactions between Deverra tortuosa and Schizomyia buboniae: phytochemicals, antioxidant capacity, and enzyme inhibitory effects
Schizomyia buboniae (Diptera: Cecidomyiidae) induces berry-like galls on the stems of Deverra tortuosa (Desf.) DC. It is also known as “Shabat El-Gabal” and is one of the most important aromatic medicinal plants in Egypt. Many researchers have reported the relationship between galling insects and plant secondary metabolites, but this relationship is not quantitative. This study investigated the impact of S. buboniae-induced galls on physiological traits, phytochemical profiles, antioxidant capacity, and antinutrient levels in D. tortuosa stems. Our results reported that photosynthetic pigment levels, including chlorophyll a, chlorophyll b, total chlorophyll, and carotenoids significantly decreased in galled stems by 63%, 14%, 44%, and 53%, respectively (p < 0.05). Antioxidant enzyme activities such as polyphenol oxidase (PPO), peroxidase (POX), catalase (CAT) and superoxide dismutase (SOD) significantly increased in galled stems by 173%, 88%, 125% and 25%, respectively, indicating elevated oxidative stress response. The analysis of phytochemical compositions revealed that the galled stems of D. tortuosa contained significantly higher levels of total flavonoids, flavonols, saponins, steroids, tannins, alkaloids, cardiac glycosides, and total phenolic compounds compared to non-galled stems, suggesting enhanced production of secondary metabolites. Additionally, galled stems exhibited higher levels of phytates, oxalates, and cyanogenic glycosides than non-galled stems. Proximate contents, including lipids, carbohydrates and proteins, were also elevated in galled stems. Furthermore, galled stems exhibited significantly (p < 0.05) stronger antioxidant activity than non-galled stems. S. buboniae appears to modify the phenotype of D. tortuosa, inducing tissue differentiation and activating defense-related responses. These results reveal that gall composition alters key physiological and biochemical traits in D. tortuosa, possibly as a defense response or as a result of insect interference. The study provides novel insights into the complex plant-insect interaction and highlights the potential implications for the plant medicinal value and suggests that gall-induced tissues of D. tortuosa may be valuable sources of bioactive compounds for pharmaceutical applications.
Mahmoud et al. (2025) Insights into the interactions between Deverra tortuosa and Schizomyia buboniae: phytochemicals, antioxidant capacity, and enzyme inhibitory effects. PeerJ 13:e20052 https://doi.org/10.7717/peerj.20052
Patterns of pre-sleep music use and sleep quality: exploratory survey findings on state anxiety
Music listening is a widely used self-help approach that may influence psychological and physiological processes associated with sleep. This cross-sectional study explored patterns of pre-sleep music use in relation to psychological distress (state anxiety, mood disturbance, stress) and subjective sleep quality. Adults (N = 269, 52.6% female; Mage = 27.7, SD = 9.0) completed validated self-report measures of sleep quality (the Pittsburgh Sleep Quality Index (PSQI)) and psychological distress. Pre-sleep music use was modestly associated with poorer sleep quality (r = 0.23, p < 0.01). A borderline interaction between state anxiety and music use (β = −0.170, p = 0.050) suggested, but did not confirm, a possible buffering pattern in which the anxiety-sleep association appeared weaker among more frequent music users. No moderation effects were observed for mood or stress. These preliminary findings suggest that pre-sleep music use may reflect a coping-oriented effort among individuals experiencing anxiety. However, given the cross-sectional design, self-report measures, and borderline statistical support, the results should be viewed as descriptive and hypothesis-generating.
Danso et al. (2025) Patterns of pre-sleep music use and sleep quality: exploratory survey findings on state anxiety. PeerJ 13:e20444 https://doi.org/10.7717/peerj.20444
Biological maturation, anthropometric, and physical fitness variables of youth breaking athletes with different competition levels
Purpose This study aimed to analyze differences in anthropometric characteristics and physical fitness performance based on chronological age, maturation status, and competition level among youth breaking athletes. Methods Morphological characteristics and selected physical fitness performances were assessed in 23 male youth breaking athletes (mean age: 14.47 ± 1.99 years). Biological maturity was estimated from anthropometric measures and expressed as age at peak height velocity (APHV) and maturity offset. All athletes were classified into two age groups (U14 and U18), three maturity groups (pre-peak height velocity (PHV), circum-PHV, and post-PHV) and two competition level groups (elite and sub-elite). Independent samples t-tests and analysis of variance (ANOVAs) were employed to examine group differences, and Pearson correlation analysis was conducted to investigate intragroup relationships between morphological and physical fitness variables. Results There was no difference in body fat percentage (P > 0.05) between U14 and U18 in terms of anthropometric measurement indicators. In contrast, significant differences (P < 0.05) were observed in most physical fitness indicators (T-test, standing long jump, 30-m sprint, p ull up and 400-m run), with the U18 athletes showing superior performance. No significant differences were observed between elite and sub-elite youth breaking athletes, except in the one-minute sit-up test (P = 0.028). Significant differences among different maturity groups were found in age (P < 0.01), maturity offset (P < 0.001), height (P < 0.001), body mass (P < 0.001), body mass index (BMI) (P < 0.001), sitting height (P < 0.001), leg length (P = 0.016), T-test (P = 0.029), standing long jump (P = 0.019), 30-m sprint (P = 0.006), 30s bodyweight squat (P = 0.030), and 400-m (P = 0.021). While chronological age and maturity status correlated with multiple physical performance indicators, body fat percentage (P > 0.05) showed no such association. Conclusions Chronological age and maturity status play a crucial role in the physical performance of breaking athletes. However, the current physical fitness tests may not effectively distinguish the competitive levels of breaking athletes. Future studies are recommended to further develop and refine sport-specific test batteries.
Zhao et al. (2025) Biological maturation, anthropometric, and physical fitness variables of youth breaking athletes with different competition levels. PeerJ 13:e20383 https://doi.org/10.7717/peerj.20383
Efflux systems driving resistance and virulence across biological domains
Background Efflux pumps (EPs) are key contributors to multidrug resistance (MDR) in bacteria, fungi, and cancer cells. These membrane proteins actively extrude a variety of therapeutic agents, reducing their intracellular concentration and thus compromising the efficacy of treatment. Beyond resistance, EPs are also involved in virulence, biofilm formation, immune evasion, and environmental persistence. Aim This review aimed to provide a comprehensive and critical synthesis of the role of efflux pumps in antimicrobial and antitumoral resistance, as well as their contribution to virulence and persistence across biological domains. Methodology A narrative review was conducted following a structured search strategy in PubMed, Scopus, and Web of Science using combinations of terms related to efflux systems, efflux pumps, resistance mechanisms, virulence factors, detection methods, and inhibitors. The review integrates data from in vitro, in silico, and clinical studies, including both classical detection strategies and emerging technologies such as clustered regularly interspaced short palindromic repeats (CRISPR)-based modulation, biosensors, and microfluidics. Results Efflux pumps from different families (e.g., resistance-nodulation-division (RND), ATP-binding cassette (ABC), major facilitator superfamily (MFS)) are implicated in the active extrusion of antimicrobial agents, facilitating MDR and treatment failure in pathogens such as E. coli, P. aeruginosa, M. tuberculosis, Candida albicans, and cancer cells. EPs also regulate biofilm formation, virulence factor secretion, and metabolic adaptation. Classical methods for detecting efflux (e.g., minimum inhibitory concentration (MIC) shifts with inhibitors, fluorometric assays) have technical limitations, while novel technologies offer improved precision. Several natural and synthetic efflux pump inhibitors (EPIs) have demonstrated efficacy in preclinical studies, yet few have progressed to clinical use due to toxicity and pharmacokinetic barriers. CRISPR interference systems and combinatory therapies represent promising advances in overcoming EP-mediated resistance. Conclusion Efflux systems are central players in both drug resistance and pathogenicity. Although the development of effective EIs remains challenging, advances in molecular detection, gene editing, and drug design hold potential for translational breakthroughs. A deeper understanding of efflux dynamics across organisms is essential to develop adjuvant therapies and reduce the clinical impact of MDR.
Almeida da Silva et al. (2025) Efflux systems driving resistance and virulence across biological domains. PeerJ 13:e20360 https://doi.org/10.7717/peerj.20360
Pelvis-Trunk coordination strategies differ a cross preparatory court movement distances during the tennis forehand
Objectives To examine the effects of on-court movement distances on pelvis-trunk coordination during forehand strokes. Methods Eighteen male college tennis athletes participated in this study. They performed forehand stroke task at three different preparatory court movement distances (minimum, medium and maximum movement distances). A one-way repeated-measures ANOVA with Statistical Parametric Mapping was used to determine differences in pelvis-trunk coordination in the transverse plane across the three movement distances, and Pearson’s correlation analysis was used to determine the relationships between each of the four pelvis-trunk coordination features on the dominant and non-dominant side and racket speed. Results Significant differences were observed for different movement distances in the non-dominant pelvis-trunk continuous relative phase (CRP) during 23–41% of the acceleration phase (p = 0.016, F2,34 = 5.901) and in the dominant pelvis-trunk CRP during 76–100% of the acceleration phase (p = 0.016, F2,34 = 5.946). For the minimum distance, significant correlations with racket speed were found in the mean CRP (r = − 0.889, p = 0.001) and peak CRP (r = − 0.488, p = 0.04) for the non-dominant side, and the mean CRP (r = − 0.478, p = 0.045) for the dominant side. Regarding medium distances, significant correlations with racket speed were observed for the non-dominant side in the mean CRP (r = − 0.493, p = 0.037), peak CRP (r = − 0.628, p = 0.005), and maximum positive CRP slope (r = 0.477, p = 0.046). For the dominant side, significant correlations with racket speed were noted for peak CRP (r = 0.551, p = 0.018) and maximum positive CRP slope (r = 0.514, p = 0.029). At the maximum distance, significant correlations with racket speed were identified for the dominant side in the maximum positive CRP slope (r = 0.580, p = 0.012) and maximum negative CRP slope (r = 0.566, p = 0.014); however, there was no significant difference in racket speed at impact when approaching from different distances. Conclusion These findings underscore the role of pelvis-trunk coordination in enhancing racket speed, particularly under varying task constraints. Coaches and players should focus on developing adaptable coordination strategies for optimizing performance across different movement distances.
Meng et al. (2025) Pelvis-Trunk coordination strategies differ a cross preparatory court movement distances during the tennis forehand. PeerJ 13:e20321 https://doi.org/10.7717/peerj.20321
Mandibular form and function is more disparate in amniotes than in non-amniote tetrapods from the late Palaeozoic
Terrestrial tetrapods originated during the Middle Devonian, and the group rapidly diversified throughout the subsequent Carboniferous and Permian periods. Feeding in air rather than water is expected to require changes to tetrapod mandibular form and function. Previous biomechanical studies on jaw evolution, however, found that the increase in functional disparity lagged behind terrestrialisation by approximately 70 Myr, coinciding with the origin of amniotes and herbivory. We expand on a previous dataset composed primarily of non-amniote tetrapods to identify the drivers of this diversification, including representatives of all major amniote clades from the Permo-Carboniferous. First, we measured nine biomechanical traits from 111 tetrapod jaws in medial view. Second, we performed an Elliptical Fourier Analysis on 198 jaws in lateral view and 73 jaws in occlusal view. The first peak in jaw disparity, during the Pennsylvanian, occurs in carnivorous non-amniote tetrapods. However, the jaws of amniotes, particularly those inferred as herbivorous, are consistently more disparate than non-amniote tetrapods from the early Permian, especially in terms of jaw depth, symphysial length and force transmission. Functional and shape disparity of Palaeozoic tetrapod jaws follow a similar pattern that is explained by large-scale faunal turnovers and ecosystem structures.
Ponstein et al. (2025) Mandibular form and function is more disparate in amniotes than in non-amniote tetrapods from the late Palaeozoic. PeerJ 13:e20243 https://doi.org/10.7717/peerj.20243
Overexpression of ORAOV1 and its association with immunotherapy resistance in hepatocellular carcinoma
Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality globally. Previous studies have reported that oral cancer overexpression 1 (ORAOV1) is overexpressed in HCC and correlated with poor prognosis, yet its molecular mechanisms remain incompletely understood. In this study, ORAOV1 overexpression was confirmed in HCC tissues via tissue microarray analysis and functionally linked to tumor cell proliferation through a positive correlation with Ki-67 expression in the human HCC cell line MHCC-97L. Bioinformatics analyses using The Cancer Genome Atlas (TCGA) and three Gene Expression Omnibus (GEO) HCC datasets further supported these findings. Multiple mechanisms appear to drive ORAOV1 upregulation, including promoter hypomethylation, amplification of the 11q13 region, and a putative ceRNA network involving AC005332.1, AC012615.1, and hsa-miR-100-5p. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses implicated ORAOV1 in various cellular processes, such as abnormal membrane channel function, extracellular matrix–receptor interactions, IL-17 signaling, and peroxisome proliferator-activated receptor (PPAR) signaling. Co-expression analysis identified significant associations between ORAOV1 and the oncogenes TPCN2 and CCND1. Additionally, ORAOV1 expression correlated with enhanced infiltration of immunosuppressive cells, including regulatory T cells, myeloid-derived suppressor cells, and cancer-associated fibroblasts, as well as upregulation of immune checkpoint markers (PD-1, PD-L1, and CTLA-4). These results indicate that ORAOV1 may modulate the immunosuppressive tumor microenvironment and contribute to resistance against immunotherapy, highlighting its potential as a therapeutic target in HCC.
Huang et al. (2025) Overexpression of ORAOV1 and its association with immunotherapy resistance in hepatocellular carcinoma. PeerJ 13:e20390 https://doi.org/10.7717/peerj.20390