Outcomes and safety of colonoscopy in elderly patients aged 80 years and older: a retrospective cohort study
Background The incidence of colorectal tumors increases with age. Colonoscopy is crucial for early detection, yet performing it on patients aged 80 and older poses challenges due to their complex health conditions. Methods This retrospective study included 447 elderly patients aged 80 years and older who underwent colorectal examinations at Peking University International Hospital from November 2015 to June 2024. Data on demographics, comorbidities, smoking and drinking history, and colonoscopy indications were collected. Risk factors for non-colorectal malignant tumors, colorectal malignant tumors, and colorectal advanced-stage tumors were compared. All patients received standard bowel preparation, and procedures were conducted by experienced endoscopists. Results A total of 364 patients (81.4%) completed the procedure successfully. The main reasons for failure were inadequate intestinal preparation and intestinal stenosis. A total of 37 (8.3%) had no significant abnormalities, 315 (70.5%) were diagnosed with colorectal polyps, and 110 (24.6%) had malignant tumors. The complication rate was 0.67%. Univariate analysis showed that patients with colorectal malignant tumors were older (P = 0.000) and had a higher prevalence of alcohol consumption history (P = 0.014). For advanced tumors, patients were also older (P = 0.000). Discussion Age is a significant risk factor for colorectal malignancies and advanced tumors. Although colonoscopy in elderly patients has acceptable safety, they face challenges in bowel preparation and examination techniques. The incidence of polyps and malignant tumors in this population is high. However, the study has limitations, such as its retrospective nature and reliance on incomplete electronic medical records. Conclusion Colonoscopy is effective and safe for elderly patients aged 80 and older. It is essential for detecting colorectal malignancies and polyps. Age-related risk factors highlight the importance of this procedure in this high-risk group.
Ding et al. (2025) Outcomes and safety of colonoscopy in elderly patients aged 80 years and older: a retrospective cohort study. PeerJ 13:e20404 https://doi.org/10.7717/peerj.20404
Risk factors and predictive model for intrapartum cesarean delivery in women with epidural analgesia: a retrospective cohort study
Background Labor epidural analgesia (LEA) is the gold standard for labor pain management, yet its association with intrapartum cesarean delivery (CD) remains controversial. This study aimed to identify risk factors and develop a predictive model for CD conversion in parturients receiving LEA. Methods A retrospective cohort study analyzed 1,896 parturients receiving LEA at Zhengzhou Central Hospital (2022–2023). Participants were categorized into vaginal delivery group (n = 1, 541) and cesarean delivery group (n = 355). The original dataset was randomly split into training/testing sets (7:3 ratio) for analytical purposes. Univariate analysis identified significant variables, followed by Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression to construct a predictive nomogram. Model performance was evaluated by area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). Results The CD conversion rate was 18.7%. Eight independent predictors were identified: height, pre-pregnancy body mass index (BMI), gestational age ≥ 40 weeks, hypertension, meperidine use, cervical dilation at analgesia initiation, intrapartum fever (≥ 38.0 °C), and estimated fetal weight. The nomogram demonstrated good discrimination (training set area under the curve (AUC) = 0.729, 95% confidence interval (CI) [0.695–0.763]; testing set AUC = 0.722, 95% CI [0.670–0.774]) and calibration (Hosmer-Lemeshow P > 0.05). DCA confirmed clinical utility. Conclusions This model provides a tool for individualized labor management that aims to reduce unnecessary cesarean deliveries.
Feng et al. (2025) Risk factors and predictive model for intrapartum cesarean delivery in women with epidural analgesia: a retrospective cohort study. PeerJ 13:e20358 https://doi.org/10.7717/peerj.20358
Effect of quality sleep on basketball three-point shooting outcomes: the mediating role of athletic mental energy in a cross-sectional study of collegiate athletes
Introduction Quality sleep is crucial for optimal sports performance, yet the psychological mechanisms underpinning the sleep-sports performance relationship require further examination. Methods This cross-sectional study explored the effects of athletic mental energy (AME) and sleep quality on basketball three-point shooting outcomes with a particular emphasis on the mediating role of AME. One hundred and forty-five collegiate basketball athletes (71 males and 74 females; Mage = 19.62 ± 1.35) with highly trained levels were recruited to evaluate sleep quality, AME, and basketball three-point shooting performance and percentage. Data were collected through validated questionnaires and a standardized three-point shooting test, and analyzed using structural equation modeling (SEM) with bootstrapping. Results Sleep quality was positively associated with basketball three-point shooting performance (r = 0.22, p = 0.007) and shooting percentage (r = 0.22, p = 0.009). AME partially and fully mediated these associations (indirect effect = 0.18, p = 0.031, 95% bias-corrected CI [0.02–0.42] for shooting performance; indirect effect = 0.27, p = 0.019, 95% bias-corrected CI [0.04–0.60] for shooting percentage). Conclusions The findings contribute to the literature on the relationship between sleep and competition-relevant sports performance and suggest AME as one of the potential psychological mechanisms underlying these associations. These results highlight the importance of considering athletes’ sleep quality and AME in performance contexts, while further research is needed to strengthen and generalize these conclusions.
Chan et al. (2025) Effect of quality sleep on basketball three-point shooting outcomes: the mediating role of athletic mental energy in a cross-sectional study of collegiate athletes. PeerJ 13:e20355 https://doi.org/10.7717/peerj.20355
Insights into antibiotic resistomes from metagenome-assembled genomes and gene catalogs of soil microbiota across environments
Antibiotic resistance poses a significant global health threat, and soil is recognized as a critical reservoir for antibiotic resistance genes (ARGs). To investigate soil microorganisms in the areas where both humans and common domestic animals (such as pigs and chickens) are present and active. In this study, we employed metagenomic sequencing to investigate the soil resistome across four Chinese provinces—Yunnan, Guizhou, Sichuan, and Jiangsu. From 111 soil samples, we generated metagenome-assembled genomes (MAGs) and gene catalogs to analyze microbial community composition, ARG distribution, and mobile genetic elements (MGEs). Our results revealed notable regional differences in microbial communities and ARG profiles. Pseudomonadota and Actinomycetota were the dominant phyla across samples, and ARG abundance was significantly higher in Sichuan, Yunnan, and Jiangsu compared to Guizhou. We also identified microbial taxa likely serving as ARG vectors, suggesting potential for horizontal gene transfer. Functional annotation indicated that metabolic functions, particularly carbohydrate and amino acid metabolism, were predominant, which may be associated with the composition of organic matter in the soil environment. Multidrug resistance genes are widespread in soil microbial communities and may spread through food chains or soil-water-plant systems, posing potential ecological and public health risks. MGEs showed significant regional variation and play a key role in the horizontal spread of ARGs. Together, these findings provide new insights into the soil antibiotic resistome and offer a foundation for developing targeted strategies to manage environmental antibiotic resistance.
Han et al. (2025) Insights into antibiotic resistomes from metagenome-assembled genomes and gene catalogs of soil microbiota across environments. PeerJ 13:e20348 https://doi.org/10.7717/peerj.20348
Cross-cultural adaptation and psychometric validation of the Chinese quality-of-life questionnaire for patients with systemic sclerosis
Background Patients with systemic sclerosis (SSc) frequently experience symptoms such as pain, fatigue, and functional impairments, leading to a significant decline in their quality of life (QoL). Accurately evaluating the QoL of SSc patients is crucial for developing personalized treatment plans and enhancing prognosis. The Systemic Sclerosis Quality of Life Questionnaire (SScQoL), an internationally recognized SSc-specific tool, is commonly used for QoL assessment. However, this questionnaire has not undergone cross-cultural adaptation in China, and its reliability and validity require further validation. Objectives To localize the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) into Chinese and assess its reliability and validity. Methods Following the principles of scale introduction, the Beaton model was employed to translate and back-translate the English version. The scale underwent cross-cultural adaptation through expert consultation, resulting in the Chinese version of the SScQoL test. From August 2023 to December 2024, a convenience sampling method was used to recruit 160 patients with systemic sclerosis from two hospitals for questionnaire surveys to evaluate questionnaire reliability and validity. Results SScQoL comprises five dimensions and 29 items. The content validity index (CVI) at the item level ranges from 0.83 to 1.00, and the CVI at the scale level is 0.97. Exploratory factor analysis identified five common factors, with a cumulative variance contribution rate of 65.761%. The Cronbach’s α coefficient for the total scale is 0.922, and the Cronbach’s α coefficients for the five dimensions range from 0.756 to 0.942. The test-retest reliability for the total scale is 0.969; for the five dimensions, it ranges from 0.710 to 0.961. Conclusions SScQoL is a reliable and effective tool for evaluating patients’ quality of life with systemic sclerosis. This tool can support nurses and researchers and help them formulate targeted strategies, thereby significantly improving patients’ quality of life with systemic sclerosis.
Hu et al. (2025) Cross-cultural adaptation and psychometric validation of the Chinese quality-of-life questionnaire for patients with systemic sclerosis. PeerJ 13:e20331 https://doi.org/10.7717/peerj.20331
Dissecting antibody-dependent enhancement modulation by Fc-modified cross-neutralizing human monoclonal antibody
Background Dengue is a mosquito-borne disease caused by four dengue virus serotypes (DENV1 to DENV4). Secondary infections can generate flavivirus cross-reactive antibodies at sub-neutralizing levels. This phenomenon can significantly increase the severity of secondary infections through antibody-dependent enhancement (ADE). ADE is associated with a high risk of viral infection in immune effector cells, triggering cytokine cascades and activating the complement system, which can lead to severe symptoms. Despite extensive studies, therapeutic antibodies, particularly fully human monoclonal antibodies, which could serve as candidates for immune passive therapy, have not yet been discovered. Methodology This study generated LALA-mutated human monoclonal antibody clone B3B9 (LALA-B3B9 HuMAb) which can neutralize all four DENV serotypes without enhancing viral activity. The number of infected cells in the ADE assay was compared among the wild-type antibody (B3B9), LALA-B3B9 HuMAb, and an Fc modified variant at position N297Q (N297Q-B3B9), with or without complement proteins. Moreover, the therapeutic efficacy of these HuMAbs against ADE infection by competing with natural antibodies in patients with acute dengue was evaluated using the in vitro suppression-of-enhancement assay in K562 cells. Result Our novel Fc-modified antibody LALA-B3B9 (Leu234Ala/Leu235Ala mutations), exhibited neutralizing activity against all dengue virus serotypes without triggering ADE activity at any antibody concentration. This outcome was similar to that observed with the previously developed Fc-modified N297Q-B3B9 antibody (N297Q mutation). We further evaluated the effect of complement protein on the enhancing and neutralizing activities of our Fc-modified antibodies. The results showed that LALA-B3B9 and N297Q-B3B9 HuMAbs were complement-independent, meaning that the reduced binding between complement protein (C1q) and the Fc portion of the antibody left the neutralizing and enhancing activities unchanged. Additionally, both LALA-B3B9 and N297Q-B3B9 HuMAbs demonstrated the suppression-of-enhancement activity in K562 cells induced by human anti-DENV serum antibodies. Overall, this study highlights the main advantages of our EDII-specific HuMAbs in inhibiting in vitro ADE, indicating that they are promising candidates for future dengue treatment.
Injampa et al. (2025) Dissecting antibody-dependent enhancement modulation by Fc-modified cross-neutralizing human monoclonal antibody. PeerJ 13:e20329 https://doi.org/10.7717/peerj.20329
Comparison of anti-PD-1/PD-L1-based regimens in relapsed/refractory diffuse large B-cell lymphoma: a meta-analysis
Aim To evaluate the therapeutic value and find out potential combination agents of programmed death 1/programmed death-ligand 1 (PD-1/PD-L1) monoclonal antibody (mAb) in relapsed/refractory (r/r) diffuse large B-cell lymphoma (DLBCL). Methods We conducted a meta-analysis to assess the efficacy and safety of PD-1/PD-L1 mAb in r/r DLBCL, potential qualified studies were searched in PubMed, Embase, Web of Science, and ClinicalTrials.gov. This meta-analysis had been registered on the PROSPERO platform (CRD42023340031). Results After systematic screening, a total of 32 records involving 29 studies were included, pooled survival curves indicated better progression-free survival (PFS) (p < 0.0001; HR = 0.51, 95% CI [0.42–0.62]) and overall survival (OS) (p = 0.013; HR = 0.71, 95% CI [0.57–0.88]) for combination therapy compared with monotherapy. Combination therapy group also achieved a better pooled complete response rate (CRR) (14.6% vs. 3.0%; p < 0.001) and overall response rate (ORR) (30.5% vs. 10.3%; p < 0.001). Analysis of the incidence of adverse events (AEs) did not demonstrate additional toxicities of combination therapy. The limitation was the predominance of single-arm trials, precluding the direct comparison of combination versus partner agents alone. Conclusions These findings support further exploration of PD-1/PD-L1-mAb-based combination therapy to identify long-term survival benefits, while application of monotherapy in unselected DLBCL patients is not recommended.
Jiang et al. (2025) Comparison of anti-PD-1/PD-L1-based regimens in relapsed/refractory diffuse large B-cell lymphoma: a meta-analysis. PeerJ 13:e20314 https://doi.org/10.7717/peerj.20314
Deciphering the role of Hat1 in spermatogenesis: Chromatin organization and beyond
Spermatogenesis, a core process for male fertility, relies heavily on chromatin organization regulated by histone acetyltransferases (HATs). However, the spatiotemporal expression pattern of histone acetyltransferase 1 (Hat1) in mouse testes and its specific role in spermatogenesis via chromatin organization remain unclear. This study employed RT-qPCR, Western blot, immunofluorescence localization, and bioinformatics to explore Hat1’s dynamic expression and regulatory mechanisms during mouse spermatogenesis. Results showed that both Hat1 mRNA and protein were significantly upregulated in the testes of 8-week-old (mature) mice compared to 3-week-old (immature) mice. Immunofluorescence revealed Hat1 was predominantly localized in the nuclei of male germ cells, with stage-specific expression: highest in spermatogonia and sperm, intermediate in primary spermatocytes, and lowest in secondary spermatocytes. Bioinformatics analysis (based on single-cell sequencing data GSE214315) identified 246 differentially expressed genes (DEGs) related to chromatin organization—these DEGs were screened between adjacent stages of male germ cell development during spermatogenesis, including comparisons of leptotene-zygotene vs. pachytene-diplotene cells, pachytene-diplotene vs. round spermatids, round spermatids vs. early elongating spermatids, and early elongating vs. late elongating spermatids (screening criteria: FDR < 0.05, |log2(FC)| ≥ 1). Additionally, 41 Hat1-interacting proteins encoded by these DEGs were identified. Functional enrichment indicated stage-specific roles of Hat1: in the leptotene-zygotene phase, it participated in transcription regulation to initiate meiosis; in round spermatids, it shifted to refined epigenetic regulation and chromatin assembly for subsequent spermiogenesis; in late spermiogenesis and sperm, it was involved in DNA repair and ATP-dependent chromatin remodeling to protect sperm genetic material. In summary, the stage-specific expression patterns of Hat1 and its interactors highlighted the importance of precise control of gene expression and chromatin remodeling, as well as DNA repair in protection of sperm genetic material, in the development of male germ cells. However, future research should conduct functional assays. Overall, this research provides valuable insights into the epigenetic regulatory mechanisms of spermatogenesis and a foundation for male fertility research.
Peng et al. (2025) Deciphering the role of Hat1 in spermatogenesis: Chromatin organization and beyond. PeerJ 13:e20240 https://doi.org/10.7717/peerj.20240
A Bayesian model for assessing organic matter supply in complex marine food webs using amino acid stable isotope analysis
While several software packages have been developed to solve stable isotope mixing models, none are currently equipped to trace the flow of organic matter through the lower trophic levels of planktonic food webs. To address this gap, we have developed a new Bayesian mixing model tailored for use with δ15N values of individual amino acids. This model simultaneously estimates trophic relationships between consumers and organic matter sources at the base of the food web, determines the relative contributions of these basal organic matter sources to consumers, and accounts for trophic discrimination affecting amino acid δ15N values during protozoan and metazoan trophic steps. This “Organic Matter Supply Model” is uniquely suited for applications where food web structure is unknown and trophic intermediaries, such as protozoan and metazoan grazers with distinct amino acid trophic discrimination factors, play a critical role in nutrient transfer. In this paper, we describe the model’s basic structure, outline key considerations for adapting it to specific applications, evaluate its performance using simulated zooplankton data, discuss its strengths and limitations, and offer recommendations for its further development. By testing the model on simulated zooplankton amino acid δ15N data, we demonstrate that the Organic Matter Supply Model can enhance our understanding of the roles of small particles and diel vertical migration in deep-sea organic matter supply pathways. Furthermore, it provides a new framework for exploring the foundational role of heterotrophic protists in marine ecosystems. We find specific subsets of amino acids to be most useful as markers of trophic ecology (in this case including glutamic acid and proline) and to identify supply from basal organic matter sources (phenylalanine, lysine, and threonine). Other amino acids may be more ideal source tracers in other settings, although amino acids with inconsistent or poorly constrained isotope fractionation behavior (e.g., isoleucine, valine) should be excluded to optimize model reliability.
Shea et al. (2025) A Bayesian model for assessing organic matter supply in complex marine food webs using amino acid stable isotope analysis. PeerJ 13:e20220 https://doi.org/10.7717/peerj.20220
Effect of rainfall on metagenomics in a sewage environment in Hongta District, Yuxi city, Yunnan Province
Background Hongta District of Yuxi city is located in the central region of Yunnan Province, Southwest China. Previous studies have shown a high prevalence of enteric infectious diseases in the area, which may be related to sewage discharge. However, there has been no systematic analysis of the microbiome in sewage in this area. In this study, we investigated environmental sewage in Hongta District, Yuxi city, Yunnan Province. Methods Surveillance was conducted in Hongta District, Yuxi city, for a period of one year. At both its urban and rural sites, sewage samples were collected for metagenomic sequencing. Results The results revealed that in the sewage samples, bacteria accounted for 98.31% of the total microbiome, followed by Archaea (1.05%), Viruses (0.30%) and Eukaryota (0.34%). At the phylum level, Proteobacteria was the taxon with the highest relative abundance, accounting for 57.57% of all samples, followed by Firmicutes (17.17%), Bacteroidetes (12.23%), Actinobacteria (7.10%), and Synergistetes (1.45%). At the genus level, the taxa with the highest relative abundances of all the microbiomes were Acidovorax (6.63%), Pseudomonas (4.98%), Acinetobacter (4.23%), Comamonas (3.85%), and Aliarcobacter (2.78%). The diversity of the samples grouped by site and rainfall formed their own clusters, but only the compositions of different taxa grouped by rainfall significantly differed (P = 0.038 at the family, P = 0.019 at the genus and P = 0.005 at the species level). In general, the abundance of several taxa at the family, genus and species levels in the dry season group was higher (P < 0.05) than that in the rainy season group according to the Kruskal–Wallis test. The relative abundance s of most virulence genes were higher at urban sites than at rural sites, while those in the rainy season was higher than those in the dry season. The distribution of antibiotic resistance genes (ARGs) in urban and rural sewage was significantly different (P = 0.018). The relative abundance of multidrug resistance genes in urban sewage was higher than that in rural sewage, and the relative abundance of most resistance genes in the dry season group was higher than that in the rainy season group. Conclusions In general, the abundance and distribution features of the sewage microbial communities in the Hongta District of Yuxi city were affected by site and rainfall factors, with significant regional and temporal specificity. Strengthening the surveillance of environmental sewage and improving discharge methods are highly important for ensuring public health security.
Environmental Contamination and Remediation
Jia et al. (2025) Effect of rainfall on metagenomics in a sewage environment in Hongta District, Yuxi city, Yunnan Province. PeerJ 13:e20199 https://doi.org/10.7717/peerj.20199