Elevated albumin-bilirubin score as a predictor of kidney stones in adults with type 2 diabetes mellitus: evidence from a cross-sectional study
The presence of kidney stones in individuals with type 2 diabetes mellitus (T2DM) poses a significant challenge and burden, yet the underlying pathogenesis remains elusive. This study aimed to reveal the relationship between the albumin-bilirubin (ALBI) score and kidney stones in adult patients with T2DM. This cross-sectional study was conducted using data from 9,511 eligible patients. The main outcome of interest was the incidence of kidney stones, with the ALBI score serving as the primary exposure factor. Logistic regression analysis was performed to calculate the odds ratios and 95% confidence intervals for the association between ALBI score and kidney stones. Our study found that a higher ALBI score was independently related to the presence of kidney stones in adult patients with T2DM. When the ALBI score was stratified into tertiles, compared to patients with an ALBI score in the T1 category, those with ALBI scores in the T2 and T3 categories exhibited a significantly higher prevalence of kidney stones after adjusting for multiple potential confounding factors. Additionally, our results revealed a non-linear relationship between ALBI score and the presence of kidney stones, which was further supported by subgroup and interaction analyses. These findings offer preliminary insights that could potentially inform future approaches to understanding kidney stone risk in adults with T2DM. Additional studies are needed to validate our conclusions.
Mo et al. (2025) Elevated albumin-bilirubin score as a predictor of kidney stones in adults with type 2 diabetes mellitus: evidence from a cross-sectional study. PeerJ 13:e19419 https://doi.org/10.7717/peerj.19419
Experimental study on the impact of Speed-Agility-Quickness Training method on the agility performance of collegiate sanda specialty students
Research objective This study investigates the effects of Speed, Agility, and Quickness (SAQ) training on the agility of collegiate sanda athletes at Henan Normal University. Research methods The experimental group (EG) (n = 12, Age: 19.58 ± 1.165, height: 176.592 ± 3.181 cm, weight: 71.38 ± 15.84 kg, training years: 2.92 ± 0.793) was trained by the SAQ training method, and the control group (CG) (n = 12, Age: 19.92 ± 1.084, 177.308 ± 2.171 cm, 71.63 ± 16.80 kg, training years: 2.75 ± 0.754) was trained by traditional agility. The data of the CG group and the EG group were compared by repeated measures of analysis of variance (ANOVA) in different periods of the test indexes (pro agility run, Illinois agility run, compass pointer run, cross quadrant jump, 15s repeated ring jump, and punch-kick combination test) in the CG group and EG group. Research results Post-experiment, the EG group showed significant differences in all six agility test indicators after adopting SAQ training. There were no significant differences in the Pro Agility Test, the Compass Pointer Test, and the 15s Repeated Ring Jump after the CG group used traditional agility performance training (P > 0.05). There were significant differences in the Illinois agility test (effect size D = 0.626), the cross quadrant jump test (effect size D = 0.558), and the punch-kick combination test (effect size D = 0.519) in the CG group after the experiment (P < 0.001). Similarly, the EG group showed significant differences in the Illinois agility test (effect size D = 0.894), the cross quadrant jump test (effect size D = 0.852), and the punch-kick combination test (effect size D = 0.896). Research conclusion SAQ training significantly enhances the agility performance of collegiate sanda specialty students. The effects of improving agility performance through SAQ training are superior to those achieved with traditional agility training methods.
Si et al. (2025) Experimental study on the impact of Speed-Agility-Quickness Training method on the agility performance of collegiate sanda specialty students. PeerJ 13:e19406 https://doi.org/10.7717/peerj.19406
Gaze behavior and decision-making among handball referees: exploring gender and expertise differences
Background Gaze behavior has been extensively studied in various sports, yet research on handball referees remains limited. Understanding gaze behavior in handball officiating is crucial for enhancing training programs, particularly for novice referees. This study investigates gaze behavior and decision-making processes among male and female handball referees of varying expertise levels. Methods A total of 51 handball referees (aged 30.25 ± 7.61 years), including 11 females and 40 males from the Polish Handball Federation, participated in the study. The sample comprised 31 higher-level referees (Super League and First League) and 20 lower-level referees (Second and Regional League). Participants wore head-mounted mobile eye-trackers to assess fixations and saccades while watching video clips of handball match scenarios. After each scene, referees made decisions based on the handball rules. Results Higher-level referees demonstrated significantly greater decision-making accuracy compared to lower-level referees (p < 0.05; Cohen’s d = 0.678), particularly in “punishment” scenarios (p < 0.001; Cohen’s d = 1.407). Although no significant differences in gaze behavior (e.g., number and duration of fixations and saccades) were observed concerning gender or expertise level, specific differences in decision-making accuracy emerged, particularly regarding expertise and free-throw scenarios. Conclusion The findings indicate that differences in decision-making accuracy among handball referees are likely influenced by factors such as experience and cognitive processing rather than gaze behavior. The absence of gender differences in gaze patterns challenges prior research suggesting systematic visual search disparities. Future studies in real-game settings are needed to explore the impact of physical and psychological demands on referees’ performance, providing practical insights for training programs.
Świdwa et al. (2025) Gaze behavior and decision-making among handball referees: exploring gender and expertise differences. PeerJ 13:e19401 https://doi.org/10.7717/peerj.19401
Comparative efficacy of targeted therapy, chemotherapy and their combination for advanced cholangiocarcinoma: a systematic review and network meta-analysis
Background Cholangiocarcinoma is a malignant tumor with a poor prognosis. Multiple randomized controlled trial (RCT) have shown conflicting benefits of different therapies. The study was to assess the effectiveness of chemotherapy (CT), targeted therapy (TT) and both of them (targeted therapy + chemotherapy; TT+CT) for advanced cholangiocarcinoma by a systematic review and network meta-analysis. Methods PubMed, EmBase, Medline, Cochrane were searched. Two reviewers independently selected published reports of RCT comparing any targeted therapy, chemotherapy and targeted therapy combined with chemotherapy vs. placebo. The outcomes were overall survival (OS) and progression-free survival (PFS) on the hazard ratio-scale (HR) and mean differences-scale (MD). Results We included 13 RCT involving 1,914 patients. We revealed a differential reporting of outcomes. All three treatments significantly reduced the HR in OS and PFS when compared with the placebo. HR and MD values of OS and PFS in TT+CT group were significantly better than those in the other two groups. Only targeted therapy can significantly improve PFS in patients. Conclusions 1) All treatments significantly reduced the hazard ratio in OS and PFS when compared with the placebo; 2) HR and MD values of OS and PFS in TT+CT group were significantly better; 3) Only targeted therapy alone significantly increased the PFS of patients, thereby improving the quality of life of patients.
Liao et al. (2025) Comparative efficacy of targeted therapy, chemotherapy and their combination for advanced cholangiocarcinoma: a systematic review and network meta-analysis. PeerJ 13:e19386 https://doi.org/10.7717/peerj.19386
Enhancing effect of 5-azacytidine on saline–alkaline resistance of Akebia trifoliata and underlying physiological and transcriptomic mechanisms
Saline-alkaline stress is a common problem in Akebia trifoliata cultivation. In this study, the enhancing effects of 5-azacytidine (5-AzaC) on the resistance of A. trifoliata to saline–alkaline stress and the underlying mechanisms were investigated. Plant height, stem diameter, biomass, root length, fresh weight of root, and root/shoot ratio of 6-month-old A. trifoliata seedlings were measured after saline–alkaline stress with or without 5-AzaC treatment. Moreover, the contents of photosynthetic pigments, malondialdehyde (MDA), H2O2, sodium, soluble sugar, and proline; activities of superoxide dismutase, peroxidase (POD), and catalase (CAT); and anatomical structures of root, stem, and leaf were assessed. Furthermore, comparative transcriptome sequencing was performed. The results demonstrated that growth and development of A. trifoliata were severely inhibited under saline–alkaline stress, suggesting that the seedlings were exposed to severe oxidative and osmotic stresses. Treatment with exogenous 5-AzaC could significantly relieve the symptoms of saline–alkaline stress in A. trifoliata. Under saline–alkaline stress, 5-AzaC could increase the stem diameter, biomass, root length, fresh weight of root, and root/shoot ratio and minimize damages to the anatomical structure. Moreover, absorption of Na+ was reduced; ionic balance was maintained; POD and CAT activities were significantly improved; proline and soluble sugar contents increased, and H2O2 and MDA contents decreased. Transcriptome analysis revealed that 5-AzaC functioned via regulating KEGG pathways such as plant hormone signal transduction, phenylpropanoid biosynthesis, photosynthesis, amino sugar and nucleotide sugar metabolism, and glutathione metabolism under saline–alkaline stress. Particularly, enhanced expression of genes from the auxin pathway in plant hormone signal transduction; the lignin synthetic pathway in phenylpropanoid biosynthesis; and photosystem II, photosystem I, photosynthetic electron transport, and F-type ATP pathway in photosynthesis may be related to 5-AzaC-induced saline–alkaline resistance. The results provided theoretical references for A. trifoliata cultivation in saline–alkaline soil and application of 5-AzaC to improve saline–alkaline tolerance in plants.
Bi et al. (2025) Enhancing effect of 5-azacytidine on saline–alkaline resistance of Akebia trifoliata and underlying physiological and transcriptomic mechanisms. PeerJ 13:e19285 https://doi.org/10.7717/peerj.19285
Associations of obesity-related indices with mild cognitive impairment in adults 60 years and older with type 2 diabetes: a retrospective study
Objective To investigate the relation between obesity-related indices and mild cognitive impairment (MCI) in elderly patients with type 2 diabetes (T2D). Methods A total of 597 eligible elderly patients with T2D were included in this retrospective study. All patients were divided into MCI group and normal cognitive group based on neuropsychological assessment. Twelve obesity-related indices were calculated, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), lipid accumulation product (LAP), body roundness index (BRI), conicity index (CI), visceral adiposity index (VAI), body adiposity index (BAI), abdominal volume index (AVI), a body shape index (ABSI), triglyceride glucose (TyG) index and cardiometabolic index (CMI). Multivariate logistic regression analysis, tests for trend and restricted cubic splines were used to assess the relationships between the tests for trend and MCI in elderly patients with T2D. Receiver operating characteristic (ROC) curves and areas under the curves (AUC) were used to assess the performance and predictive ability of the obesity-related indices for identifying MCI in elderly patients with T2D. Results Multivariate logistic regression showed that elevated BMI, WHR, WHtR, LAP, BRI, CI, VAI, AVI, TyG index, and CMI were associated with an increased risk of MCI in elderly T2D patients after adjusting for potential confounders (all P < 0.05). In addition, TyG index, LAP, CMI, VAI, AVI, WHR, WHtR, BRI, and CI had negative correlations with Montreal Cognitive Assessment (MoCA) scores (all P < 0.05). There was a significant linear trend between the levels of BMI (P for trend = 0.004, P for non-linearity = 0.637), WHR (P for trend = 0.006, P for non-linearity = 0.430), WHtR (P for trend < 0.001, P for non-linearity = 0.452), BRI (P for trend < 0.001, P for non-linearity = 0.252), AVI ( P for trend < 0.001, P for non-linearity = 0.944), and TyG index (P for trend < 0.001, P for non-linearity = 0.514) and risk of MCI in elderly patients with T2D after adjusting for potential confounders. There was a nonlinear association between LAP, VAI or CMI and risk of MCI in elderly patients with T2D (all P for non-linearity < 0.001). CMI had the greatest AUC (AUC = 0.682), followed by VAI (AUC = 0.679), TyG index (AUC = 0.673), LAP (AUC = 0.669), AVI (AUC = 0.580), WHtR and BRI (AUC = 0.575), BMI (AUC = 0.560), CI (AUC = 0.556), WHR (AUC = 0.554), BAI (AUC = 0.547), and ABSI (AUC = 0.536). Conclusion Elevated obesity-related indices, particularly CMI, VAI, TyG index and LAP, which displayed the higher predictive power, were instrumental in forecasting and evaluating MCI in elderly T2D patients. These findings may provide clues for future studies exploring early diagnostic biomarkers and treatment of MCI in elderly T2D patients.
Feng et al. (2025) Associations of obesity-related indices with mild cognitive impairment in adults 60 years and older with type 2 diabetes: a retrospective study. PeerJ 13:e19442 https://doi.org/10.7717/peerj.19442
Fitts’ law-based identification of motor development stages for the upper limb: proof of concept in three age groups
Background Psychomotor development, including fine motor skills, progresses throughout childhood and stabilizes in adulthood. This process is closely tied to neurological maturation, with “reaching and pointing tasks” considered fundamental upper limb functions. According to Fitts’ law, movement time (MT) depends on the task’s index of difficulty (ID). From an Information Theory perspective, throughput (TP) reflects processing speed in reaching tasks, while error rate (ER) quantifies incorrect selections. As motor control improves, TP is expected to increase and ER to decrease, indicating greater efficiency and coordination. This study aimed to compare TP and ER across three age groups to assess motor control evolution. Methods Sixty participants were divided into three groups: children (5–6 years), adolescents (14–15 years), and adults (21–24 years). All participants performed a 2D reaching task on a tablet using their dominant hand, in accordance with the International Organization for Standardization (ISO) 9241-411 standard. Each participant completed 23 trials under four IDs, varying target size and distance. TP and ER were calculated and the data were statistically analyzed using an analysis of variance (ANOVA) and post-hoc tests to identify differences between groups. Results TP and ER showed significant differences across age groups. Children (5–6 years) had the lowest TP (3.84 ± 0.95 bits/s) and the highest ER (17.07 ± 8.15%). Adolescents (14–15 years) demonstrated higher TP (5.88 ± 0.64 bits/s) and lower ER (5.06 ± 3.13%), while adults (21–24 years) exhibited the highest TP (6.46 ± 1.05 bits/s) and a slightly higher ER (6.81 ± 5.07%) than adolescents. A one-way ANOVA confirmed a significant effect of age on TP (F2,57 = 47.18, p < 0.001, ${\rm \eta_p^2}$ηp2 = 0.623) and ER (F2,57 = 22.1, p < 0.001, ${\rm \eta_p^2}$ηp2 = 0.437). Post-hoc comparisons revealed that children had significantly lower TP and higher ER than both adolescents and adults (p < 0.001). Additionally, adolescents showed significantly lower TP than adults (p < 0.05). However, no significant differences in ER were found between adolescents and adults. Conclusions The results indicate that TP and ER, derived from Fitts’ law, effectively capture age-related differences in motor control across different developmental stages. These findings align with typical neuromotor development. Children show the lowest performance in both speed and accuracy, with adults outperforming both children and adolescents in processing speed, and adolescents demonstrating similar accuracy compared to adults. These metrics show potential for clinical and research applications, particularly in evaluating motor impairments or tracking rehabilitation progress in neurological conditions and advancing motor development research. Future studies should explore its use in clinical populations and across various age ranges to enhance assessment and intervention strategies.
Sanchez et al. (2025) Fitts’ law-based identification of motor development stages for the upper limb: proof of concept in three age groups. PeerJ 13:e19433 https://doi.org/10.7717/peerj.19433
Husbands’ knowledge and attitudes regarding postpartum depression
Background Postpartum depression (PPD) is a prevalent mental health disorder that can occur anytime within the first year after childbirth. PPD has negative health consequences for mothers, infants, and other family members. Early detection and treatment are essential in mitigating these effects. This study aims to assess husbands’ knowledge and attitudes toward PPD among men aged 20 years and older residing in Saudi Arabia. Methods This study employed a cross-sectional design. Participants were recruited through social media and face-to-face methods using a convenience sampling approach. A total of 401 husbands were included in the study. The data were analyzed using descriptive statistics and Pearson’s simple correlation analysis. Results In this study, the majority of participants (89.5%, n = 359) were Saudi nationals. Approximately half of the husbands (48.4%, n = 194) were between the ages of 30 and 39, whereas only 10% (n = 40) were 50 or older. Nearly half of the participants (45.4%) demonstrated a high level of knowledge about PPD. Additionally, 66.1% of the husbands had a positive attitude toward PPD and had received prior information about the condition. Family and friends were the most commonly cited sources of PPD knowledge. A positive correlation was found between husbands’ knowledge and attitudes toward PPD (r = 0.117, P < 0.005). Furthermore, significant associations were observed between husband’s knowledge and attitude and several sociodemographic characteristics, including nationality, educational level, occupation, monthly income, and years of marriage (P < 0.05). Conclusion The husbands demonstrated a good level of knowledge and a positive attitude toward PPD. However, further research is needed to enhance their understanding and attitudes, particularly in addressing the negative beliefs about PPD identified in this study.
Aqeeli et al. (2025) Husbands’ knowledge and attitudes regarding postpartum depression. PeerJ 13:e19426 https://doi.org/10.7717/peerj.19426
Multiplex polymerase chain reaction (PCR) with Nanopore sequencing for sequence-based detection of four tilapia pathogens
Background Tilapia aquaculture faces significant threats posed by four prominent pathogens: tilapia lake virus (TiLV), infectious spleen and kidney necrosis virus (ISKNV), Francisella orientalis, and Streptococcus agalactiae. Currently, employed molecular diagnostic methods for these pathogens rely on multiple singleplex polymerase chain reactions (PCR), which are time-consuming and expensive. Methods In this study, we present an approach utilizing a multiplex PCR (mPCR) assay, coupled with rapid Nanopore sequencing, enabling the one-tube simultaneous detection and one-reaction Nanopore sequencing-based validation of four pathogens. Results Our one-tube multiplex assay exhibits a detection limit of 1,000 copies per reaction for TiLV, ISKNV, and S. agalactiae, while for F. orientalis, the detection limit is 10,000 copies per reaction. This sensitivity is sufficient for diagnosing infections and co-infections in clinical samples from sick fish, enabling rapid confirmation of the presence of pathogens. Integrating multiplex PCR and Nanopore sequencing provides an alternative approach platform for fast and precise diagnostics of major tilapia pathogens in clinically sick animals, adding to the available toolbox for disease diagnostics.
Delamare-Deboutteville et al. (2025) Multiplex polymerase chain reaction (PCR) with Nanopore sequencing for sequence-based detection of four tilapia pathogens. PeerJ 13:e19425 https://doi.org/10.7717/peerj.19425
Susceptibility and resistance profiles of field and laboratory strains of Trogoderma granarium Everts to pirimiphos-methyl, alpha-cypermethrin and spinetoram
The khapra beetle, Trogoderma granarium Everts, 1898, is a significant pest of stored commodities worldwide. Insecticides are heavily relied upon to manage T. granarium. However, the long-term usage of insecticides has led to the development of resistance to insecticides, reducing their effectiveness against T. granarium. This study investigated variations in susceptibility to pirimiphos-methyl, alpha-cypermethrin and spinetoram in a laboratory and seven field strains of T. granarium, using dose-mortality bioassays. Metabolic resistance mechanisms were investigated through synergism studies using piperonyl butoxide (PBO) and S,S,S-tributyl phosphorotrithioate (DEF). Susceptibility of the laboratory strain was the highest to all insecticides compared to the field strains. For field strains, the LD50 values ranged from 25.9 to 49.6 mg/kg grain for pirimiphos-methyl, 15.0 to 40.5 mg/kg grain for alpha-cypermethrin, and 2.2 to 6.0 mg/kg grain for spinetoram. Compared to the laboratory strain, field strains of T. granarium exhibited significant resistance ratios ranging from: 19.9 to 38.1 fold against pirimiphos-methyl, 12.3 to 45.0 fold against alpha-cypermethrin, and 7.3 to 20.0 against spinetoram. In synergism bioassays, there was a significant effect of enzyme inhibitors on enhancing suceptibility to pirimiphos-methyl only in field strains, suggesting P450 monooxygenase and esterases may contribute to pirimiphos-methyl resistance. In conclusion, variable susceptibility to insecticides was observed across different strains of T. granarium. Reduced susceptibility to insecticides in field strains compared to the laboratory strain poses challenges for effective control of T. granarium.
Bukhari et al. (2025) Susceptibility and resistance profiles of field and laboratory strains of Trogoderma granarium Everts to pirimiphos-methyl, alpha-cypermethrin and spinetoram. PeerJ 13:e19423 https://doi.org/10.7717/peerj.19423