PeerJ
type: channel
link: https://peerj.com/articles/
description: Articles published in PeerJ
publisher: PeerJ Inc.
publication name: PeerJ
issn: 2167-8359
items: Human-mediated dispersal of Geniotrigona thoracica (Apidae: Meliponini) colonies promotes high genetic diversity and reduces population structuring in managed populations
items: High abundance of Early Miocene sea cows from Qatar shows repeated evolution of seagrass ecosystem engineers in Eastern Tethys
items: Differential effects of physical activity on cognitive and motor performance in obese young adults
items: Effects of core stability exercises on balance among Chinese children and youth with intellectual disabilities
items: Single-cell RNA-seq reveals breast cancer heterogeneity and identifies TCP1 as a therapeutic target in breast cancer
items: Knowledge, attitude, and practice toward perioperative neurocognitive disorders among healthcare workers in Shandong, China: a cross-sectional study
items: Application of an interpretable machine learning model based on optimal feature selection for predicting triple-vessel coronary disease: a multicenter retrospective study
items: Sex ratios in flux: seasonal dynamics and methodological insights in Rumex species
items: Development and content validity of the evaluation of multidimensional functioning and risks in aging scale
items: Chronic cervical instability in mice and rats: a reproducible model to simulate human intervertebral disc degeneration

Human-mediated dispersal of Geniotrigona thoracica (Apidae: Meliponini) colonies promotes high genetic diversity and reduces population structuring in managed populations
type: item
type: AcademicArticle
description: The stingless bee Geniotrigona thoracica is a key managed pollinator in Southeast Asia, valued for its honey, propolis, and colony trade. In Thailand, frequent human-mediated movement of colonies raises concerns about its effects on genetic diversity and population structure. We analysed variation in mitochondrial (COI and 16S rRNA) and nuclear (five microsatellite loci) markers from 70 colonies sampled across 17 meliponaries in seven southern provinces. Microsatellite data revealed high genetic diversity and low nuclear differentiation (K = 1; Fst = 0.0024–0.1219; all P > 0.05), with extensive gene flow (Nm = 3.60–207.83) among provinces. In contrast, mitochondrial markers indicated moderate-to-high differentiation (Fst = 0.619), consistent with mito-nuclear discordance arising from sex-biased. Managed colonies exhibited elevated heterozygosity and allelic richness, likely reflecting admixture from colony exchange, while unique haplotypes in certain provinces suggest introductions from external sources. Significant inbreeding was detected only in Yala, possibly linked to habitat loss and reduced effective population size. Our findings indicate that current meliponicultural practices maintain high genetic diversity in G. thoracica despite mitochondrial structuring, but increasing colony movement between genetically distinct populations may risk erosion of local adaptations, underscoring the need for genetic screening prior to translocation.
format: application/pdf
format: text/html
creator: Orawan Duangphakdee
creator: Ekgachai Jeratthitikul
creator: Pisit Poolprasert
creator: Rujira Pongkitsittiporn
creator: Chama Inson
creator: Atsalek Rattanawannee
subject: Agricultural Science
subject: Biodiversity
subject: Conservation Biology
subject: Entomology
subject: Genetics
description: doi:10.7717/peerj.20460
publisher: PeerJ Inc.
rights: © 2025 Duangphakdee et al.
abstract: The stingless bee Geniotrigona thoracica is a key managed pollinator in Southeast Asia, valued for its honey, propolis, and colony trade. In Thailand, frequent human-mediated movement of colonies raises concerns about its effects on genetic diversity and population structure. We analysed variation in mitochondrial (COI and 16S rRNA) and nuclear (five microsatellite loci) markers from 70 colonies sampled across 17 meliponaries in seven southern provinces. Microsatellite data revealed high genetic diversity and low nuclear differentiation (K = 1; Fst = 0.0024–0.1219; all P > 0.05), with extensive gene flow (Nm = 3.60–207.83) among provinces. In contrast, mitochondrial markers indicated moderate-to-high differentiation (Fst = 0.619), consistent with mito-nuclear discordance arising from sex-biased. Managed colonies exhibited elevated heterozygosity and allelic richness, likely reflecting admixture from colony exchange, while unique haplotypes in certain provinces suggest introductions from external sources. Significant inbreeding was detected only in Yala, possibly linked to habitat loss and reduced effective population size. Our findings indicate that current meliponicultural practices maintain high genetic diversity in G. thoracica despite mitochondrial structuring, but increasing colony movement between genetically distinct populations may risk erosion of local adaptations, underscoring the need for genetic screening prior to translocation.
bibliographic citation: Duangphakdee et al. (2025) Human-mediated dispersal of Geniotrigona thoracica (Apidae: Meliponini) colonies promotes high genetic diversity and reduces population structuring in managed populations. PeerJ 13:e20460 https://doi.org/10.7717/peerj.20460
date submitted: 2025-09-02
date accepted: 2025-11-03
issued: 2025-12-10
is part of: PeerJ
license: https://creativecommons.org/licenses/by/4.0/
author list: Agent
  family name: Duangphakdee
  given name: Orawan
author list: Agent
  family name: Jeratthitikul
  given name: Ekgachai
author list: Agent
  family name: Poolprasert
  given name: Pisit
author list: Agent
  family name: Pongkitsittiporn
  given name: Rujira
author list: Agent
  family name: Inson
  given name: Chama
author list: Agent
  family name: Rattanawannee
  given name: Atsalek
doi: 10.7717/peerj.20460
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-10
copyright: ©2025 Duangphakdee et al.
attribution name: Duangphakdee et al.

High abundance of Early Miocene sea cows from Qatar shows repeated evolution of seagrass ecosystem engineers in Eastern Tethys
type: item
type: AcademicArticle
description: Coastal ecosystems that include seagrasses are potential carbon sinks that require strategic conservation of top trophic consumers, such as dugongs, to maintain their function. It is unclear, however, how long seagrass ecosystems have persisted in geologic time because their fossil record is poor, although the record of their associated vertebrate consumers offers useful proxies. Here we describe an area of dense Early Miocene dugongid remains from Qatar. We documented over 172 sites in <1 km2 from one stratigraphic level, including material representing a new species of fossil dugongine dugongid. This taxon is unrelated to coeval Early Miocene dugongids from India and the Eastern Tethys and it is distantly related to extant dugongs, which occupy seagrass habitats of the Persian or Arabian Gulf (hereafter ‘Gulf’) today. The monodominant assemblage in this area likely reflects a single fossil dugongid taxon and matches the ecological diversity and geospatial distribution of modern-day live-dead assemblages in the Gulf. This fossil site from Qatar shows that the Gulf has repeatedly evolved sea cow communities with different taxa over the past 20 million years and coincides with an Early Miocene marine biodiversity hotspot in Arabia, prior to its eastward shift to the Indo-Australian Archipelago where dugongs continue to thrive today.
format: application/pdf
format: text/html
creator: Nicholas D. Pyenson
creator: Ferhan Sakal
creator: Jacques LeBlanc
creator: Jon Blundell
creator: Katherine D. Klim
creator: Christopher D. Marshall
creator: Jorge Velez-Juarbe
creator: Katherine Wolfe
creator: Faisal Al-Naimi
subject: Ecology
subject: Evolutionary Studies
subject: Marine Biology
subject: Paleontology
subject: Zoology
description: doi:10.7717/peerj.20030
publisher: PeerJ Inc.
rights: © 2025
abstract: Coastal ecosystems that include seagrasses are potential carbon sinks that require strategic conservation of top trophic consumers, such as dugongs, to maintain their function. It is unclear, however, how long seagrass ecosystems have persisted in geologic time because their fossil record is poor, although the record of their associated vertebrate consumers offers useful proxies. Here we describe an area of dense Early Miocene dugongid remains from Qatar. We documented over 172 sites in <1 km2 from one stratigraphic level, including material representing a new species of fossil dugongine dugongid. This taxon is unrelated to coeval Early Miocene dugongids from India and the Eastern Tethys and it is distantly related to extant dugongs, which occupy seagrass habitats of the Persian or Arabian Gulf (hereafter ‘Gulf’) today. The monodominant assemblage in this area likely reflects a single fossil dugongid taxon and matches the ecological diversity and geospatial distribution of modern-day live-dead assemblages in the Gulf. This fossil site from Qatar shows that the Gulf has repeatedly evolved sea cow communities with different taxa over the past 20 million years and coincides with an Early Miocene marine biodiversity hotspot in Arabia, prior to its eastward shift to the Indo-Australian Archipelago where dugongs continue to thrive today.
bibliographic citation: Pyenson et al. (2025) High abundance of Early Miocene sea cows from Qatar shows repeated evolution of seagrass ecosystem engineers in Eastern Tethys. PeerJ 13:e20030 https://doi.org/10.7717/peerj.20030
date submitted: 2025-05-30
date accepted: 2025-08-13
issued: 2025-12-10
is part of: PeerJ
license: https://creativecommons.org/publicdomain/zero/1.0/
author list: Agent
  family name: Pyenson
  given name: Nicholas D.
author list: Agent
  family name: Sakal
  given name: Ferhan
author list: Agent
  family name: LeBlanc
  given name: Jacques
author list: Agent
  family name: Blundell
  given name: Jon
author list: Agent
  family name: Klim
  given name: Katherine D.
author list: Agent
  family name: Marshall
  given name: Christopher D.
author list: Agent
  family name: Velez-Juarbe
  given name: Jorge
author list: Agent
  family name: Wolfe
  given name: Katherine
author list: Agent
  family name: Al-Naimi
  given name: Faisal
doi: 10.7717/peerj.20030
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-10
copyright: ©2025 Pyenson et al.

Differential effects of physical activity on cognitive and motor performance in obese young adults
type: item
type: AcademicArticle
description: The rising prevalence of obesity among young adults presents significant health challenges, particularly due to its adverse effects on cognitive function and physical mobility. This cross-sectional study examined the effects of physical activity on cognitive performance and gait speed in obese individuals aged 18 to 25 years. Seventy-six participants were categorized as either physically active or sedentary based on the Global Physical Activity Questionnaire. All enrolled participants completed the study, and no data were missing. Anthropometric data, including body mass, height, waist circumference, and hip circumference, were collected using standardized procedures. Cognitive assessments included the Trail Making Test, Stroop Color and Word Test, Hand Reaction Time Test, and Logical Memory Test. Gait speed was evaluated using the 10-meter walk test. The physically active group showed significantly better results in logical memory, executive function, and all Stroop test conditions (p < 0.05). No group differences were found in reaction time, Stroop interference score, or gait speed (p > 0.05). These findings suggest that higher physical activity levels are linked to better cognitive performance, highlighting the value of promoting physical activity in young adults with obesity. The lack of observed differences in gait speed and reaction time may indicate that these functions are less sensitive to early changes or require longer periods of inactivity to decline in this population.
format: application/pdf
format: text/html
creator: Piangkwan Sa-nguanmoo
creator: Busaba Chuatrakoon
creator: Puntarik Keawtep
creator: Savitree Thummasorn
creator: Tanawat Thongsukdee
creator: Patimakorn Homjan
creator: Phumiphat Phetcharat
subject: Cognitive Disorders
subject: Kinesiology
subject: Obesity
subject: Mental Health
subject: Rehabilitation
description: doi:10.7717/peerj.20481
publisher: PeerJ Inc.
rights: © 2025 Sa-nguanmoo et al.
abstract: The rising prevalence of obesity among young adults presents significant health challenges, particularly due to its adverse effects on cognitive function and physical mobility. This cross-sectional study examined the effects of physical activity on cognitive performance and gait speed in obese individuals aged 18 to 25 years. Seventy-six participants were categorized as either physically active or sedentary based on the Global Physical Activity Questionnaire. All enrolled participants completed the study, and no data were missing. Anthropometric data, including body mass, height, waist circumference, and hip circumference, were collected using standardized procedures. Cognitive assessments included the Trail Making Test, Stroop Color and Word Test, Hand Reaction Time Test, and Logical Memory Test. Gait speed was evaluated using the 10-meter walk test. The physically active group showed significantly better results in logical memory, executive function, and all Stroop test conditions (p < 0.05). No group differences were found in reaction time, Stroop interference score, or gait speed (p > 0.05). These findings suggest that higher physical activity levels are linked to better cognitive performance, highlighting the value of promoting physical activity in young adults with obesity. The lack of observed differences in gait speed and reaction time may indicate that these functions are less sensitive to early changes or require longer periods of inactivity to decline in this population.
bibliographic citation: Sa-nguanmoo et al. (2025) Differential effects of physical activity on cognitive and motor performance in obese young adults. PeerJ 13:e20481 https://doi.org/10.7717/peerj.20481
date submitted: 2025-07-25
date accepted: 2025-11-05
issued: 2025-12-09
is part of: PeerJ
license: https://creativecommons.org/licenses/by/4.0/
author list: Agent
  family name: Sa-nguanmoo
  given name: Piangkwan
author list: Agent
  family name: Chuatrakoon
  given name: Busaba
author list: Agent
  family name: Keawtep
  given name: Puntarik
author list: Agent
  family name: Thummasorn
  given name: Savitree
author list: Agent
  family name: Thongsukdee
  given name: Tanawat
author list: Agent
  family name: Homjan
  given name: Patimakorn
author list: Agent
  family name: Phetcharat
  given name: Phumiphat
doi: 10.7717/peerj.20481
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-09
copyright: ©2025 Sa-nguanmoo et al.
attribution name: Sa-nguanmoo et al.

Effects of core stability exercises on balance among Chinese children and youth with intellectual disabilities
type: item
type: AcademicArticle
description: Background Children and youth with intellectual disabilities (IDs) are at risk of falls due to balance problems. Objective This study was conducted to assess the effects of six weeks of core stability exercises on balance in this population. Methods Thirty-five participants with IDs from a special school were selected. Static and dynamic balance were assessed by the one-legged stance test (OLS) and lower quarter Y balance test (YBT-LQ), respectively. Results Core stability exercises significantly improved static balance with eyes opened (EO) on firm (FI) ground (t = −5.269, P < 0.001) and dynamic balance in all three directions (left leg: anterior: t = −3.197, P = 0.005; posteromedial: t = − 4.608, P < 0.001; posterolateral: t = −4.706, P < 0.001; right leg: anterior: t = −3.324, P = 0.004; posteromedial: t = −5.614, P < 0.001; posterolateral: t = −5.905, P < 0.001). Conclusions Six weeks of core stability exercises significantly improved the static balance of children and youth with IDs under EO and FI conditions, as well as all three directions of dynamic balance. Future studies with multiple measurement points are warranted to examine the long-term effectiveness of this training on balance in this population.
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creator: Jing Qi
creator: Yecheng Zhong
creator: Junjie Zhou
creator: Niuniu Li
creator: Yuhang Han
creator: Zehua Dong
creator: Yan Li
creator: Wenhong Xu
subject: Pediatrics
subject: Psychiatry and Psychology
subject: Sports Medicine
description: doi:10.7717/peerj.20454
publisher: PeerJ Inc.
rights: © 2025 Qi et al.
abstract: Background Children and youth with intellectual disabilities (IDs) are at risk of falls due to balance problems. Objective This study was conducted to assess the effects of six weeks of core stability exercises on balance in this population. Methods Thirty-five participants with IDs from a special school were selected. Static and dynamic balance were assessed by the one-legged stance test (OLS) and lower quarter Y balance test (YBT-LQ), respectively. Results Core stability exercises significantly improved static balance with eyes opened (EO) on firm (FI) ground (t = −5.269, P < 0.001) and dynamic balance in all three directions (left leg: anterior: t = −3.197, P = 0.005; posteromedial: t = − 4.608, P < 0.001; posterolateral: t = −4.706, P < 0.001; right leg: anterior: t = −3.324, P = 0.004; posteromedial: t = −5.614, P < 0.001; posterolateral: t = −5.905, P < 0.001). Conclusions Six weeks of core stability exercises significantly improved the static balance of children and youth with IDs under EO and FI conditions, as well as all three directions of dynamic balance. Future studies with multiple measurement points are warranted to examine the long-term effectiveness of this training on balance in this population.
bibliographic citation: Qi et al. (2025) Effects of core stability exercises on balance among Chinese children and youth with intellectual disabilities. PeerJ 13:e20454 https://doi.org/10.7717/peerj.20454
date submitted: 2025-03-21
date accepted: 2025-10-31
issued: 2025-12-09
is part of: PeerJ
license: https://creativecommons.org/licenses/by/4.0/
author list: Agent
  family name: Qi
  given name: Jing
author list: Agent
  family name: Zhong
  given name: Yecheng
author list: Agent
  family name: Zhou
  given name: Junjie
author list: Agent
  family name: Li
  given name: Niuniu
author list: Agent
  family name: Han
  given name: Yuhang
author list: Agent
  family name: Dong
  given name: Zehua
author list: Agent
  family name: Li
  given name: Yan
author list: Agent
  family name: Xu
  given name: Wenhong
doi: 10.7717/peerj.20454
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-09
copyright: ©2025 Qi et al.
attribution name: Qi et al.

Single-cell RNA-seq reveals breast cancer heterogeneity and identifies TCP1 as a therapeutic target in breast cancer
type: item
type: AcademicArticle
description: Breast cancer is composed of diverse cell populations, and this intratumoral heterogeneity profoundly affects clinical behavior. Here, we leveraged single cell RNA sequencing (scRNA-seq) of 68 breast cancer specimens to dissect tumor heterogeneity at high resolution. Unsupervised clustering identified all major cell types of the tumor microenvironment (TME)—including malignant epithelial cells, fibroblasts, T cells, macrophages, endothelial cells, and others—with striking variability in their proportions across molecular subtypes. For example, a BRCA1-mutant triple-negative breast cancer (TNBC) sample showed dense immune infiltration, whereas an estrogen receptor (ER)-positive tumor was mostly epithelial, consistent with known subtype differences in immunogenicity. We applied inference of copy number variations (inferCNV) to distinguish malignant epithelial cells, identifying ~90,000 tumor cells with significant copy-number aberrations enriched for cancer hallmark pathways. Re-clustering of these malignant cells revealed five discrete subpopulations. Notably, a KRT17-positive subcluster displayed the highest stemness score and a distinctive ETS-family transcription factor (ERG) regulon, suggesting a stem-like phenotype. Using The Cancer Genome Atlas (TCGA) cohort, we found that genes upregulated in this KRT17+ subpopulation, particularly NFKBIA, PDLIM4, and TCP1 stratified patient survival. An 8-gene risk signature derived from the KRT17 program segregated patients into high- and low-risk groups with markedly different outcomes. High-risk tumors were characterized by an immunosuppressive TME enriched in M2-like macrophages, whereas low-risk tumors more often harbored lymphocyte-predominant infiltrates. Focusing on TCP1, a chaperonin subunit upregulated in high-risk tumors, we demonstrate that TCP1 knockdown in breast cancer cell lines substantially impairs cell migration (~50% reduction in wound closure) and invasion (P < 0.01). These findings reveal functionally di…
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format: text/html
creator: Houman Wu
creator: Haiyang Du
creator: Gao Si
creator: Xuejie Song
creator: Fuchun Si
subject: Biochemistry
subject: Bioinformatics
subject: Cell Biology
subject: Genomics
subject: Oncology
description: doi:10.7717/peerj.20451
publisher: PeerJ Inc.
rights: © 2025 Wu et al.
abstract: Breast cancer is composed of diverse cell populations, and this intratumoral heterogeneity profoundly affects clinical behavior. Here, we leveraged single cell RNA sequencing (scRNA-seq) of 68 breast cancer specimens to dissect tumor heterogeneity at high resolution. Unsupervised clustering identified all major cell types of the tumor microenvironment (TME)—including malignant epithelial cells, fibroblasts, T cells, macrophages, endothelial cells, and others—with striking variability in their proportions across molecular subtypes. For example, a BRCA1-mutant triple-negative breast cancer (TNBC) sample showed dense immune infiltration, whereas an estrogen receptor (ER)-positive tumor was mostly epithelial, consistent with known subtype differences in immunogenicity. We applied inference of copy number variations (inferCNV) to distinguish malignant epithelial cells, identifying ~90,000 tumor cells with significant copy-number aberrations enriched for cancer hallmark pathways. Re-clustering of these malignant cells revealed five discrete subpopulations. Notably, a KRT17-positive subcluster displayed the highest stemness score and a distinctive ETS-family transcription factor (ERG) regulon, suggesting a stem-like phenotype. Using The Cancer Genome Atlas (TCGA) cohort, we found that genes upregulated in this KRT17+ subpopulation, particularly NFKBIA, PDLIM4, and TCP1 stratified patient survival. An 8-gene risk signature derived from the KRT17 program segregated patients into high- and low-risk groups with markedly different outcomes. High-risk tumors were characterized by an immunosuppressive TME enriched in M2-like macrophages, whereas low-risk tumors more often harbored lymphocyte-predominant infiltrates. Focusing on TCP1, a chaperonin subunit upregulated in high-risk tumors, we demonstrate that TCP1 knockdown in breast cancer cell lines substantially impairs cell migration (~50% reduction in wound closure) and invasion (P < 0.01). These findings reveal functionally di…
bibliographic citation: Wu et al. (2025) Single-cell RNA-seq reveals breast cancer heterogeneity and identifies TCP1 as a therapeutic target in breast cancer. PeerJ 13:e20451 https://doi.org/10.7717/peerj.20451
date submitted: 2025-06-30
date accepted: 2025-10-31
issued: 2025-12-09
is part of: PeerJ
license: https://creativecommons.org/licenses/by-nc/4.0
author list: Agent
  family name: Wu
  given name: Houman
author list: Agent
  family name: Du
  given name: Haiyang
author list: Agent
  family name: Si
  given name: Gao
author list: Agent
  family name: Song
  given name: Xuejie
author list: Agent
  family name: Si
  given name: Fuchun
doi: 10.7717/peerj.20451
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-09
copyright: © 2025 Wu et al.
attribution name: Wu et al.

Knowledge, attitude, and practice toward perioperative neurocognitive disorders among healthcare workers in Shandong, China: a cross-sectional study
type: item
type: AcademicArticle
description: Background Perioperative neurocognitive disorders (PND) refer to neurocognitive abnormalities detected during the perioperative period, currently including postoperative delirium, delayed neurocognitive recovery, postoperative neurocognitive disorder, and both mild and major cognitive impairments. It is a prevalent complication among surgical patients, particularly in older populations. Moreover, PND can have a profound effect on the quality of life for these patients. PND has been previously reported to occur with a prevalence of 10–54% during the first few weeks following surgery, and when persistent at the time of discharge or in the longer term, PND may increase mortality. Therefore, it is of considerable importance for healthcare professionals to accurately identify the occurrence of PND and implement appropriate management measures. This research aims to investigate the knowledge, attitude, and practice (KAP) of healthcare workers concerning perioperative neurocognitive disorders (PND) in Shandong Province, China. Methods This cross-sectional study recruited healthcare workers from twelve hospitals in Shandong Province, China, utilizing self-administered questionnaires distributed between February and May 2025. There are 12 items in the knowledge dimension, and the total score range for this dimension is 0 to 12 points. There are a total of seven items in the attitude dimension, and the total score range for this dimension is 7 to 35 points. There are a total of nine items in the practice dimension, and the total score range for this dimension is from 9 to 45 points. Results The analysis included a total of 309 valid questionnaires, which represents an impressive 87.78% response rate. Among them, a total of 193 doctors (62.5%) and 116 nurses (37.5%) participated in the survey, respectively. The PND knowledge score was 9.14 (SD = 2.85, range = 0–12). The PND attitudes score was 30.89 (SD = 3.81, range = 7–35). The PND practices score was 36.16 (SD = 7.77, range…
format: application/pdf
format: text/html
creator: Ke Zhang
creator: Xuefeng Gu
creator: Xiaoru Li
creator: Honghai Peng
subject: Neuroscience
subject: Cognitive Disorders
subject: Science and Medical Education
description: doi:10.7717/peerj.20450
publisher: PeerJ Inc.
rights: © 2025 Zhang et al.
abstract: Background Perioperative neurocognitive disorders (PND) refer to neurocognitive abnormalities detected during the perioperative period, currently including postoperative delirium, delayed neurocognitive recovery, postoperative neurocognitive disorder, and both mild and major cognitive impairments. It is a prevalent complication among surgical patients, particularly in older populations. Moreover, PND can have a profound effect on the quality of life for these patients. PND has been previously reported to occur with a prevalence of 10–54% during the first few weeks following surgery, and when persistent at the time of discharge or in the longer term, PND may increase mortality. Therefore, it is of considerable importance for healthcare professionals to accurately identify the occurrence of PND and implement appropriate management measures. This research aims to investigate the knowledge, attitude, and practice (KAP) of healthcare workers concerning perioperative neurocognitive disorders (PND) in Shandong Province, China. Methods This cross-sectional study recruited healthcare workers from twelve hospitals in Shandong Province, China, utilizing self-administered questionnaires distributed between February and May 2025. There are 12 items in the knowledge dimension, and the total score range for this dimension is 0 to 12 points. There are a total of seven items in the attitude dimension, and the total score range for this dimension is 7 to 35 points. There are a total of nine items in the practice dimension, and the total score range for this dimension is from 9 to 45 points. Results The analysis included a total of 309 valid questionnaires, which represents an impressive 87.78% response rate. Among them, a total of 193 doctors (62.5%) and 116 nurses (37.5%) participated in the survey, respectively. The PND knowledge score was 9.14 (SD = 2.85, range = 0–12). The PND attitudes score was 30.89 (SD = 3.81, range = 7–35). The PND practices score was 36.16 (SD = 7.77, range…
bibliographic citation: Zhang et al. (2025) Knowledge, attitude, and practice toward perioperative neurocognitive disorders among healthcare workers in Shandong, China: a cross-sectional study. PeerJ 13:e20450 https://doi.org/10.7717/peerj.20450
date submitted: 2025-05-19
date accepted: 2025-10-31
issued: 2025-12-09
is part of: PeerJ
license: https://creativecommons.org/licenses/by/4.0/
author list: Agent
  family name: Zhang
  given name: Ke
author list: Agent
  family name: Gu
  given name: Xuefeng
author list: Agent
  family name: Li
  given name: Xiaoru
author list: Agent
  family name: Peng
  given name: Honghai
doi: 10.7717/peerj.20450
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-09
copyright: ©2025 Zhang et al.
attribution name: Zhang et al.

Application of an interpretable machine learning model based on optimal feature selection for predicting triple-vessel coronary disease: a multicenter retrospective study
type: item
type: AcademicArticle
description: Objective This study aimed to evaluate the predictive value of the remnant cholesterol-inflammatory index (RCII) in assessing the risk of triple-vessel disease (TVD), and to construct a comparative framework of predictive models using six machine learning algorithms based on RCII and other clinical features for identifying high-risk individuals. Methods In this retrospective multicenter study, we enrolled 2,911 patients who underwent coronary angiography between January 1, 2024, and December 31, 2024, at two tertiary hospitals. Clinical and laboratory data were collected. Feature selection was performed using both Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression. Six machine learning (ML) algorithms were trained for risk prediction, with multilayer perceptron (MLP) selected as the optimal model for the final feature set. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), positive predictive value (PPV), and F1 score. SHapley Additive exPlanations (SHAP) analysis was applied to interpret feature contributions and interactions. Results A total of 16 features were selected by LASSO regression, while multivariate logistic regression identified six independent predictors. Four overlapping features—gender, age, aspartate aminotransferase (AST), and RCII—were used for ML model development. Among the six models, the MLP demonstrated the best overall performance on the test set. SHAP analysis revealed that RCII, age, AST, and gender were the top contributors to model prediction, with RCII showing notable interaction effects with other variables, highlighting its both independent and synergistic role in TVD risk stratification. Conclusion RCII, as a composite biomarker integrating lipid metabolism and chronic inflammation, demonstrates strong predictive utility in identifying individuals at high risk for triple-vessel coronary disease.
format: application/pdf
format: text/html
creator: Ling Hou
creator: Ke He
creator: Jinbo Zhao
creator: Ke Su
creator: Changjiang Zhang
subject: Cardiology
subject: Computational Science
subject: Data Mining and Machine Learning
description: doi:10.7717/peerj.20423
publisher: PeerJ Inc.
rights: © 2025 Hou et al.
abstract: Objective This study aimed to evaluate the predictive value of the remnant cholesterol-inflammatory index (RCII) in assessing the risk of triple-vessel disease (TVD), and to construct a comparative framework of predictive models using six machine learning algorithms based on RCII and other clinical features for identifying high-risk individuals. Methods In this retrospective multicenter study, we enrolled 2,911 patients who underwent coronary angiography between January 1, 2024, and December 31, 2024, at two tertiary hospitals. Clinical and laboratory data were collected. Feature selection was performed using both Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression. Six machine learning (ML) algorithms were trained for risk prediction, with multilayer perceptron (MLP) selected as the optimal model for the final feature set. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), positive predictive value (PPV), and F1 score. SHapley Additive exPlanations (SHAP) analysis was applied to interpret feature contributions and interactions. Results A total of 16 features were selected by LASSO regression, while multivariate logistic regression identified six independent predictors. Four overlapping features—gender, age, aspartate aminotransferase (AST), and RCII—were used for ML model development. Among the six models, the MLP demonstrated the best overall performance on the test set. SHAP analysis revealed that RCII, age, AST, and gender were the top contributors to model prediction, with RCII showing notable interaction effects with other variables, highlighting its both independent and synergistic role in TVD risk stratification. Conclusion RCII, as a composite biomarker integrating lipid metabolism and chronic inflammation, demonstrates strong predictive utility in identifying individuals at high risk for triple-vessel coronary disease.
bibliographic citation: Hou et al. (2025) Application of an interpretable machine learning model based on optimal feature selection for predicting triple-vessel coronary disease: a multicenter retrospective study. PeerJ 13:e20423 https://doi.org/10.7717/peerj.20423
date submitted: 2025-07-22
date accepted: 2025-10-29
issued: 2025-12-09
is part of: PeerJ
license: https://creativecommons.org/licenses/by/4.0/
author list: Agent
  family name: Hou
  given name: Ling
author list: Agent
  family name: He
  given name: Ke
author list: Agent
  family name: Zhao
  given name: Jinbo
author list: Agent
  family name: Su
  given name: Ke
author list: Agent
  family name: Zhang
  given name: Changjiang
doi: 10.7717/peerj.20423
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-09
copyright: ©2025 Hou et al.
attribution name: Hou et al.

Sex ratios in flux: seasonal dynamics and methodological insights in Rumex species
type: item
type: AcademicArticle
description: Dioecy–separate male and female individuals–occurs in less than 10% of angiosperms. Studying dioecy and plant sex chromosomes is key to understanding sex determination, genetic diversity, and ecological interactions, with implications for crop breeding, conservation, and pollination management. Many dioecious plant species deviate from the 1:1 sex ratio expected under Fisher’s principle, displaying male- or female-biased populations. The genus Rumex (Polygonaceae) is a valuable model for investigating sex-ratio variation and sex chromosome evolution. The dioecious species Rumex acetosa and R. thyrsiflorus possess heteromorphic sex chromosomes and typically exhibit female-biased sex ratios in natural populations. However, the environmental and developmental drivers of these biases remain largely unresolved. Previous studies on Rumex have often relied on single or infrequent population surveys, potentially overlooking the seasonal dynamics of sex ratios, especially given phenological differences between sexes. Female plants remain morphologically recognizable for longer periods due to seed set, which can bias sex-ratio estimates when sampling is limited to specific reproductive stages or time points. To address these limitations, we systematically investigated the temporal dynamics of observable sex ratios in R. acetosa and R. thyrsiflorus throughout an entire growing season using regular monitoring. Our results demonstrate that observable sex ratios in these populations are dynamic, with significant seasonal fluctuations driven by differences in developmental timing and the duration of morphological recognizability between sexes. As a result, the period during which field-observed sex ratios accurately reflect the true population structure is both limited and highly dependent on the timing of observations. Notably, the earlier flowering of male plants in R. acetosa can lead to male-biased sex ratios in early-season surveys, while the prolonged recognizability of frui…
format: application/pdf
format: text/html
creator: Barbara Pawełek
creator: Dagmara Kwolek
creator: Grzegorz Góralski
subject: Conservation Biology
subject: Developmental Biology
subject: Ecology
subject: Evolutionary Studies
subject: Plant Science
description: doi:10.7717/peerj.20391
publisher: PeerJ Inc.
rights: © 2025 Pawełek et al.
abstract: Dioecy–separate male and female individuals–occurs in less than 10% of angiosperms. Studying dioecy and plant sex chromosomes is key to understanding sex determination, genetic diversity, and ecological interactions, with implications for crop breeding, conservation, and pollination management. Many dioecious plant species deviate from the 1:1 sex ratio expected under Fisher’s principle, displaying male- or female-biased populations. The genus Rumex (Polygonaceae) is a valuable model for investigating sex-ratio variation and sex chromosome evolution. The dioecious species Rumex acetosa and R. thyrsiflorus possess heteromorphic sex chromosomes and typically exhibit female-biased sex ratios in natural populations. However, the environmental and developmental drivers of these biases remain largely unresolved. Previous studies on Rumex have often relied on single or infrequent population surveys, potentially overlooking the seasonal dynamics of sex ratios, especially given phenological differences between sexes. Female plants remain morphologically recognizable for longer periods due to seed set, which can bias sex-ratio estimates when sampling is limited to specific reproductive stages or time points. To address these limitations, we systematically investigated the temporal dynamics of observable sex ratios in R. acetosa and R. thyrsiflorus throughout an entire growing season using regular monitoring. Our results demonstrate that observable sex ratios in these populations are dynamic, with significant seasonal fluctuations driven by differences in developmental timing and the duration of morphological recognizability between sexes. As a result, the period during which field-observed sex ratios accurately reflect the true population structure is both limited and highly dependent on the timing of observations. Notably, the earlier flowering of male plants in R. acetosa can lead to male-biased sex ratios in early-season surveys, while the prolonged recognizability of frui…
bibliographic citation: Pawełek et al. (2025) Sex ratios in flux: seasonal dynamics and methodological insights in Rumex species. PeerJ 13:e20391 https://doi.org/10.7717/peerj.20391
date submitted: 2025-07-09
date accepted: 2025-10-24
issued: 2025-12-09
is part of: PeerJ
license: https://creativecommons.org/licenses/by/4.0/
author list: Agent
  family name: Pawełek
  given name: Barbara
author list: Agent
  family name: Kwolek
  given name: Dagmara
author list: Agent
  family name: Góralski
  given name: Grzegorz
doi: 10.7717/peerj.20391
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-09
copyright: ©2025 Pawełek et al.
attribution name: Pawełek et al.

Development and content validity of the evaluation of multidimensional functioning and risks in aging scale
type: item
type: AcademicArticle
description: Introduction Rising life expectancy has led to an increased prevalence of age-related conditions such as pain, dementia, and falls. To address these challenges, healthcare systems require efficient tools to identify which health domains are preserved or impaired in older adults. Existing frailty instruments present both conceptual and operational limitations. Therefore, there is a need to shift toward domain-specific evaluations of functioning and potential risks, aligned with established protocols such as the Comprehensive Geriatric Assessment and framed within the International Classification of Functioning, Disability and Health (ICF). This study aimed to develop the Evaluation of Multidimensional Functioning and Risks in Aging (EMFRA) scale, encompassing four assessment domains: physical function, cognitive function, emotional status, and social situation. Methods The EMFRA scale was developed by identifying potential items through a comprehensive literature review and expert input. The first preliminary version was validated by a panel of 15 experts, who assessed the scale’s clarity, coherence, and relevance using a 5-point Likert scale. Cognitive interviews were then conducted with 10 clinicians and 10 older adults to evaluate the comprehensibility and practical applicability of the second preliminary version. Results Following the literature review, 24 items were grouped into four domains (six items per domain), each supported by evidence linking them to health-related adverse outcomes. Expert evaluation showed substantial agreement on comprehension, coherence, and relevance (Aiken’s V >0.7) for all but two items—language and fear—which were excluded. Cognitive interviews led to the exclusion of one additional item (sedentarism) and further refinement of the remaining items. These changes were incorporated into the final version of EMFRA, enhancing its usability and comprehensiveness. Conclusion EMFRA provides a multidimensional framework for assessing functi…
format: application/pdf
format: text/html
creator: José Fierro-Marrero
creator: Álvaro Reina-Varona
creator: Joaquín Pardo-Montero
creator: Alba Paris-Alemany
creator: Roy La Touche
subject: Geriatrics
subject: Public Health
description: doi:10.7717/peerj.20108
publisher: PeerJ Inc.
rights: © 2025 Fierro-Marrero et al.
abstract: Introduction Rising life expectancy has led to an increased prevalence of age-related conditions such as pain, dementia, and falls. To address these challenges, healthcare systems require efficient tools to identify which health domains are preserved or impaired in older adults. Existing frailty instruments present both conceptual and operational limitations. Therefore, there is a need to shift toward domain-specific evaluations of functioning and potential risks, aligned with established protocols such as the Comprehensive Geriatric Assessment and framed within the International Classification of Functioning, Disability and Health (ICF). This study aimed to develop the Evaluation of Multidimensional Functioning and Risks in Aging (EMFRA) scale, encompassing four assessment domains: physical function, cognitive function, emotional status, and social situation. Methods The EMFRA scale was developed by identifying potential items through a comprehensive literature review and expert input. The first preliminary version was validated by a panel of 15 experts, who assessed the scale’s clarity, coherence, and relevance using a 5-point Likert scale. Cognitive interviews were then conducted with 10 clinicians and 10 older adults to evaluate the comprehensibility and practical applicability of the second preliminary version. Results Following the literature review, 24 items were grouped into four domains (six items per domain), each supported by evidence linking them to health-related adverse outcomes. Expert evaluation showed substantial agreement on comprehension, coherence, and relevance (Aiken’s V >0.7) for all but two items—language and fear—which were excluded. Cognitive interviews led to the exclusion of one additional item (sedentarism) and further refinement of the remaining items. These changes were incorporated into the final version of EMFRA, enhancing its usability and comprehensiveness. Conclusion EMFRA provides a multidimensional framework for assessing functi…
bibliographic citation: Fierro-Marrero et al. (2025) Development and content validity of the evaluation of multidimensional functioning and risks in aging scale. PeerJ 13:e20108 https://doi.org/10.7717/peerj.20108
date submitted: 2025-02-18
date accepted: 2025-08-28
issued: 2025-12-09
is part of: PeerJ
license: https://creativecommons.org/licenses/by/4.0/
author list: Agent
  family name: Fierro-Marrero
  given name: José
author list: Agent
  family name: Reina-Varona
  given name: Álvaro
author list: Agent
  family name: Pardo-Montero
  given name: Joaquín
author list: Agent
  family name: Paris-Alemany
  given name: Alba
author list: Agent
  family name: La Touche
  given name: Roy
doi: 10.7717/peerj.20108
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-09
copyright: ©2025 Fierro-Marrero et al.
attribution name: Fierro-Marrero et al.

Chronic cervical instability in mice and rats: a reproducible model to simulate human intervertebral disc degeneration
type: item
type: AcademicArticle
description: Background Chronic low-back pain, a leading cause of global disability, is closely linked to intervertebral disc degeneration (IVDD). Traditional animal models have faced challenges in replicating the gradual, chronic nature of human IVDD. Objective To address these limitations, we aimed to develop a novel mouse model of cervical spine instability that more accurately mimics the progressive degeneration observed in humans. Animals This study used 48 male Sprague–Dawley rats (3 months old, weighing 230 ± 20 g) and 48 male C57BL/6 mice (12 weeks old, weighing 20 ± 2 g). Methods A bilateral cervical laminectomy combined with spinous process resection was performed while preserving the facet joints and posterior cervical muscles to induce chronic intervertebral instability. Longitudinal assessments were conducted using in vivo magnetic resonance imaging (MRI), histological staining (H&E and Safranin O-fast green), immunofluorescence and western blot analyses at 4, 8, and 12 weeks post-operation. Results MRI findings demonstrated progressive degeneration at the C4/5, C5/6, and C6/7 levels, with the most pronounced changes observed at 4 and 8 weeks post-surgery and partial recovery at 12 weeks. H&E and Safranin O staining confirmed significant cellular loss, structural disorganization, and proteoglycan depletion in the affected discs. Immunofluorescence staining revealed a progressive decrease in collagen type II and aggrecan expression over time. Conversely, collagen type I expression increased, indicating a shift toward fibrosis. Western blot analysis confirmed elevated levels of oxidative stress markers (albumin and AOPPs), matrix metalloproteinases (MMP3 and MMP13), senescence markers (p53, p21, p16), and inflammatory cytokines (IL-1β, TNF-α) at 4 and 8 weeks, with a partial decline by 12 weeks. Conclusions This innovative cervical instability model not only minimizes the risk of nerve injury and reduces animal stress compared to previous models but also offers a repr…
format: application/pdf
format: text/html
creator: Kewu Tu
creator: Junhao Tan
creator: Guanhai Zeng
creator: Fuzhou Xu
creator: Dongteng Liao
creator: Weiqi Lu
creator: Kun Zhao
creator: Zhaomou Chen
creator: Beidi Zhou
creator: Xiangheng Dai
subject: Biochemistry
subject: Anatomy and Physiology
subject: Orthopedics
description: doi:10.7717/peerj.20465
publisher: PeerJ Inc.
rights: © 2025 Tu et al.
abstract: Background Chronic low-back pain, a leading cause of global disability, is closely linked to intervertebral disc degeneration (IVDD). Traditional animal models have faced challenges in replicating the gradual, chronic nature of human IVDD. Objective To address these limitations, we aimed to develop a novel mouse model of cervical spine instability that more accurately mimics the progressive degeneration observed in humans. Animals This study used 48 male Sprague–Dawley rats (3 months old, weighing 230 ± 20 g) and 48 male C57BL/6 mice (12 weeks old, weighing 20 ± 2 g). Methods A bilateral cervical laminectomy combined with spinous process resection was performed while preserving the facet joints and posterior cervical muscles to induce chronic intervertebral instability. Longitudinal assessments were conducted using in vivo magnetic resonance imaging (MRI), histological staining (H&E and Safranin O-fast green), immunofluorescence and western blot analyses at 4, 8, and 12 weeks post-operation. Results MRI findings demonstrated progressive degeneration at the C4/5, C5/6, and C6/7 levels, with the most pronounced changes observed at 4 and 8 weeks post-surgery and partial recovery at 12 weeks. H&E and Safranin O staining confirmed significant cellular loss, structural disorganization, and proteoglycan depletion in the affected discs. Immunofluorescence staining revealed a progressive decrease in collagen type II and aggrecan expression over time. Conversely, collagen type I expression increased, indicating a shift toward fibrosis. Western blot analysis confirmed elevated levels of oxidative stress markers (albumin and AOPPs), matrix metalloproteinases (MMP3 and MMP13), senescence markers (p53, p21, p16), and inflammatory cytokines (IL-1β, TNF-α) at 4 and 8 weeks, with a partial decline by 12 weeks. Conclusions This innovative cervical instability model not only minimizes the risk of nerve injury and reduces animal stress compared to previous models but also offers a repr…
bibliographic citation: Tu et al. (2025) Chronic cervical instability in mice and rats: a reproducible model to simulate human intervertebral disc degeneration. PeerJ 13:e20465 https://doi.org/10.7717/peerj.20465
date submitted: 2025-04-22
date accepted: 2025-11-03
issued: 2025-12-08
is part of: PeerJ
license: https://creativecommons.org/licenses/by/4.0/
author list: Agent
  family name: Tu
  given name: Kewu
author list: Agent
  family name: Tan
  given name: Junhao
author list: Agent
  family name: Zeng
  given name: Guanhai
author list: Agent
  family name: Xu
  given name: Fuzhou
author list: Agent
  family name: Liao
  given name: Dongteng
author list: Agent
  family name: Lu
  given name: Weiqi
author list: Agent
  family name: Zhao
  given name: Kun
author list: Agent
  family name: Chen
  given name: Zhaomou
author list: Agent
  family name: Zhou
  given name: Beidi
author list: Agent
  family name: Dai
  given name: Xiangheng
doi: 10.7717/peerj.20465
volume: 13
issn: 2167-8359
publication name: PeerJ
publication date: 2025-12-08
copyright: ©2025 Tu et al.
attribution name: Tu et al.

PeerJ
type: Periodical
uri: PeerJ
issn: 2167-8359