title: PeerJ description: Articles published in PeerJ link: https://peerj.com/articles/index.rss3?journal=peerj&month=2026-01 creator: info@peerj.com PeerJ errorsTo: info@peerj.com PeerJ language: en title: Causal modelling of climate-fish-fisheries: confronting models with data link: https://peerj.com/articles/20738 last-modified: 2026-01-30 description: Understanding the interplay of environmental and anthropogenic drivers is essential to interpret past changes and anticipate future dynamics of marine fish stocks. Using Norwegian spring-spawning herring (NSSH) as a case study, we applied an iterative structured causal modelling framework combining causal knowledge analysis and inference—using structural equation models—to quantify the respective effects of climate and fisheries on stock biomass and catches. Initial simple models, grounded in prior ecological understanding, yielded implausible estimates when confronted with observational data, underscoring the necessity to treat data structure and content as integral to model design. We gradually incorporated multiple causal pathways, feedback loops, and confounders. Final models explained over 90% of observed variation in both biomass and catch and showed strong support for the roles of recruitment, prior biomass, and total allowable catch (TAC) advice. We found no causal effect of ocean climate variables (Relative Heat Content and Arctic Water Content) on year-to-year changes in NSSH biomass, nor of Spawning Stock Biomass on catches. Instead, catch levels were primarily governed by TAC advice and the degree of agreement between fishing nations. We conclude that reliable causal inference in ecological systems requires iterative model refinement, causal knowledge analysis, and explicit accounting for data structure. Adopting and transparently reporting this approach would benefit ecological studies used to support fisheries management. creator: Benjamin Planque creator: Etienne Hamard creator: Lucie Buttay uri: https://doi.org/10.7717/peerj.20738 license: https://creativecommons.org/licenses/by-nc/4.0 rights: © 2026 Planque et al. title: Spotlights on ubiquitin-specific proteases in lung cancer: from multifaceted pathophysiological mechanisms to potential therapeutic targets link: https://peerj.com/articles/20702 last-modified: 2026-01-30 description: Lung cancer ranks as the leading cause of cancer-related mortality worldwide, characterised by complex molecular mechanisms and high therapeutic resistance. Ubiquitin-specific proteases, as core members of the deubiquitinating enzyme family, extensively participate in the initiation, progression, metastasis, and treatment resistance of lung cancer by regulating the stability of key proteins. Recent studies indicate that multiple Ubiquitin-Specific Proteases (USP) family members play pivotal roles in lung cancer: Ubiquitin-Specific Peptidase 7 (USP7) promotes proliferation and osimertinib resistance in non-small cell lung cancer by stabilising proteins such as ERβ, c-Abl, and KRAS; Ubiquitin-Specific Peptidase 9, X-linked (USP9X) mediates radiotherapy resistance by regulating KDM4C and REV1; USP10 influences cellular metabolism and chemotherapy sensitivity via PTEN/AKT/mTOR and HDAC6 pathways; Ubiquitin-Specific Peptidase 14 (USP14) enhances tumour migration by regulating β-catenin and Acf7 stability; Ubiquitin-Specific Peptidase 22 (USP22) amplifies tumour stem cell properties and suppresses ferroptosis via EGFR and BMI1 signalling; Ubiquitin-Specific Peptidase 35 (USP35) and Ubiquitin-Specific Peptidase 38 (USP38) respectively modulate apoptosis resistance and proliferation through BIRC3 and KLF5; while Ubiquitin-Specific Peptidase 39 (USP39) influences mitochondrial metabolism via PDHA, thereby promoting tumour growth. This paper systematically reviews the mechanisms of action of the aforementioned USPs in multiple key signalling pathways, including KRAS, TGF-β/SMAD, ferroptosis, and DNA damage repair. It further explores the potential value of small-molecule inhibitors targeting USPs (such as P5091, IU1, and gentiopicroside) in reversing drug resistance, inducing apoptosis, and enhancing immunotherapy. Nevertheless, current research remains subject to certain limitations, including insufficient systematic and synergistic understanding of USP family members’ functions, poor inhibitor selectivity and preclinical toxicity concerns, as well as unresolved functional heterogeneity across different molecular subtypes of lung cancer. This paper reviews the molecular mechanisms and targeting strategies of USPs in lung cancer based on a systematic literature search of PubMed and Web of Science databases. It further explores their potential applications in precision lung cancer therapy, providing theoretical foundations and directional guidance for future research. creator: Xiaoyun Shen creator: Ruoqi Wang creator: Fei Su creator: Juanjuan Guo creator: Da Zhao creator: Fangyun Yuan creator: Tao Zhang creator: Xiaoming Hou uri: https://doi.org/10.7717/peerj.20702 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Shen et al. title: Identification and validation of a glutamine metabolism-related gene signature as a diagnostic and therapeutic target in osteoarthritis through integrated multi-omics analysis link: https://peerj.com/articles/20701 last-modified: 2026-01-30 description: BackgroundThe understanding of the pathogenesis of osteoarthritis (OA) is often fragmented, with studies focusing on individual tissues. A holistic view integrating multi-tissue molecular changes with systemic metabolic shifts is urgently needed. Glutamine metabolism, a central bioenergetic and biosynthetic hub, represents a critical but largely unexplored nexus in this disease network. This study leverages a multi-omics, multi-tissue approach to deconstruct the role of glutamine metabolism in OA and identify a robust, blood-based signature for potential diagnostic use.MethodsWe conducted a comprehensive bioinformatic investigation by integrating multiple GEO transcriptomic datasets from cartilage, synovium, subchondral bone, and peripheral blood. A machine learning pipeline, incorporating weighted gene co-expression network analysis (WGCNA) and least absolute shrinkage and selection operator (LASSO) regression, was employed to identify a signature of glutamine metabolism-related genes (GMRGs). The signature’s clinical relevance was then validated in an independent cohort of 62 subjects (31 OA patients vs. 31 healthy controls) using RT-qPCR on peripheral blood samples and plasma metabolomics. Furthermore, we computationally explored its potential regulatory mechanisms and predicted candidate therapeutic compounds.ResultsOur multi-layered analysis identified a core three-gene signature (F13A1, IRS2, RELA). Functional analysis linked this signature to pathways essential for OA pathogenesis, including mechanical stress, metabolic regulation, and inflammatory responses. Clinical validation in an independent cohort confirmed significant downregulation of all three genes in OA peripheral blood (P < 0.001) and revealed distinct regulatory patterns, including disease-specific activation of RELA and a metabolic regulatory reversal of IRS2, as well as negative correlations with disease severity and alterations in circulating glutamine-related metabolites. The resulting diagnostic model showed strong discriminatory performance across both training and validation datasets. Plasma creatine emerged as an independent predictor of disease severity. Finally, exploratory analyses suggested potential epigenetic regulation and identified several candidate drugs capable of modulating the signature.ConclusionsThis study identifies a blood-based, multi-omics-derived gene signature that links localized joint pathology with systemic metabolic dysfunction in osteoarthritis. The signature offers a robust non-invasive diagnostic marker and reveals new opportunities for patient stratification and therapeutic development. creator: Yang Lu creator: Jinkun Liu creator: Shasha Wang creator: Jianping Gan creator: Wenfu Cao creator: Bin Wu uri: https://doi.org/10.7717/peerj.20701 license: https://creativecommons.org/licenses/by-nc/4.0 rights: © 2026 Lu et al. title: The temporal dynamics of resting-state EEG microstates reflected the differences in socioeconomic status among college students link: https://peerj.com/articles/20697 last-modified: 2026-01-30 description: BackgroundSocioeconomic status (SES) is a distal ecological factor that predicts the trajectory of human development. Exposure to low SES may have lasting effects on brain structure and function. Although prior research has identified static neural correlates of SES disparities, it remains unclear how socioeconomic contexts shape dynamic brain states. Therefore, the present study employs electroencephalography (EEG) microstate analysis to investigate how SES influences the dynamics of resting-state brain activity.MethodsBased on SES scores, participants in the top and bottom 27% were categorized as the high-SES group (n = 29), and the low-SES group (n = 29). Resting-state EEG signals were collected from all participants, and microstate analysis identified the temporal features of four canonical large-scale neural networks (microstates A, B, C, and D) to explore socioeconomic differences in brain dynamics across different SES groups.Results(1) The correlation between SES and the temporal characteristics of both microstates A (ps < 0.05) and C (ps < 0.05) was significant, suggesting that SES may be associated with neural dynamics involved in auditory-language processing and the default mode network (DMN). (2) High- and low-SES groups exhibited divergent temporal characteristics in microstate dynamics. Compared with the high-SES group, participants in the low-SES group demonstrated larger duration (p = 0.025), occurrence (p = 0.002), and time coverage (p < 0.001) in microstate A, while exhibiting reduced occurrence (p < 0.001) and time coverage (p = 0.005) in microstate C. The results indicate that the low-SES individuals may have compensatory reinforcement of the auditory-language network and a weakened DMN activity. (3) High- and low-SES groups exhibiting different microstate transition patterns may reflect distinct cognitive control mechanisms. Compared with the high-SES group, the low-SES group demonstrated that the transition probabilities between microstates A and B (ps < 0.05), A and D (ps < 0.05) were significantly higher, whereas those between microstates B and C (ps < 0.05), C and D (ps < 0.05) were significantly lower.ConclusionThese findings reveal a robust association between SES disparities and spatiotemporal EEG microstate dynamics. The reconfiguration of metastable brain states may represent the way the brain responds to challenging environments. creator: Qidan Ren creator: Fangfang Long creator: Yunlu Xie creator: Huiling Chen creator: Ying Jiang uri: https://doi.org/10.7717/peerj.20697 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Ren et al. title: Genome-wide identification of SMALL AUXIN UP RNA (SAUR) gene family and its expression profiles in response to abiotic stress and auxin in tea plants (Camellia sinensis) link: https://peerj.com/articles/20681 last-modified: 2026-01-30 description: Tea plant (Camellia sinensis (L.) O. Kuntze) is particularly vulnerable to abiotic stresses, with impacts on its growth and the production of bioactive compounds. SMALL AUXIN UP RNA (SAUR) genes, the largest family of early auxin-responsive genes, regulate plant growth and abiotic stress responses. However, their roles in tea plant remain unknown. In this study, we conducted a comprehensive genome-wide analysis of CsSAURs, including phylogenetic relationships, gene structure, chromosomal distribution, duplication events, motif composition, cis-elements, and gene ontology (GO) annotations. Expression profiles were examined using transcriptome data and validated by qRT-PCR. A total of 97 CsSAURs were identified and classified into eight phylogenetic groups, with 90 mapped to 15 chromosomes and seven to contigs. Genes within the same group exhibit conserved gene structures and motif compositions. Segmental duplication predominantly contributes to family expansion. The predominant CsSAUR expression was found in flowers, with their promoters containing auxin-responsive, phytohormone, and stress-related cis-elements. A limited number of CsSAURs exhibit responsiveness to cold, drought, salinity, and methyl jasmonate (MeJA). Notably, CsSAUR10, 16, and 73 exhibited significant upregulation under abiotic stress and auxin treatment. Overall, this study characterizes the SAUR family in tea plant and highlights its potential roles in the regulation of growth and stress responses. The identified auxin and stress-responsive CsSAURs represent potential targets for genetic improvement of tea plants. creator: Yan Wang creator: Fan Ye creator: Jialing Nie creator: Yuanyuan Wu creator: Mengxin Zhou creator: Kun Wang creator: Kuanru Hu creator: Guofeng Liu uri: https://doi.org/10.7717/peerj.20681 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Wang et al. title: The role of flower consumption in Howler Monkey Females’ diet: adjustment across reproductive states link: https://peerj.com/articles/20659 last-modified: 2026-01-30 description: BackgroundAlthough the genus Alouatta is considered a folivore and frugivore species, the consumption of vegetative parts like flowers often represents a considerable percentage of their diet. Flowers are high in tannins and flavonoids, which are beneficial for the animals due to the antioxidant and anti-inflammatory properties. However, there is a notable lack of knowledge regarding the role of flowers in howler’s diet, especially for the specific needs of females. The objective of this study is to gain further insight into the role of flowers for howler monkey females’ diets during lactation.MethodsBetween 2021 and 2023, we collected data on the feeding behavior of 20 wild Alouatta palliata mexicana females during non-lactation, early lactation and late lactation on the Agaltepec Island, Mexico.ResultsIn 670 contact hours, a total of 1,471 feeding sessions were recorded. From 29 documented feeding items, five were flowers from the trees of Andira galeottiana, Bursera simaruba, Dendropanax arboreus, Gliricidia sepium and Spondias mombin. Documented feeding items were collected and evaluated for their tannin and flavonoid content. The annual weight-based flower consumption was 12.5%, which increased to 30.3% during blooming months. The tannin content of the flower species exhibited considerable variation, with levels ranging from 0 to 2,038.0 µg/g. In contrast, the qualitative evaluation of principal groups of flavonoid content detected a pronounced presence of flavanones in all five species and flavones in three. Notably, early lactating females exhibited a higher consumption of flowers compared to non-lactating and late lactating females. Conversely, the floral tannin intake was the highest in late lactating and lowest in early lactating females. Our findings suggest that dietary choices of howler monkey females are influenced by seasonal flower availability, with polyphenols playing an important role, suggesting physiological and behavioral adaptations in response to reproductive demands. creator: Anna Gisbrecht creator: John F. Aristizabal creator: Juan Francisco Rodríguez-Landa creator: Laura Teresa Hernández-Salazar uri: https://doi.org/10.7717/peerj.20659 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Gisbrecht et al. title: Land-use shapes the composition and stability of soil water-stable aggregates in a plateau agro-pastoral ecotone link: https://peerj.com/articles/20643 last-modified: 2026-01-30 description: BackgroundThe northeastern Tibetan Plateau is a typical agro-pastoral ecotone that experiences frequent land-use changes. Maintaining stable soil aggregates in this region is key to protecting the environment and supporting food production on the Tibetan Plateau. Nevertheless, comparative data on soil aggregate composition and stability across diverse land-use types and soil depths in this region are currently limited.MethodsHerein, soil samples from 0–20 cm and 20–40 cm depths were gathered at 52 sites spanning four dominant land-use types in the northeastern Tibetan Plateau: grassland (GL), cropland (CL), orchard (OC), and planted forest (PF). The composition and stability of soil aggregates were assessed using the wet sieving method.ResultsThe results exhibited that silt and clay particles (SC, <0.053 mm) were the predominant aggregate fraction across all land-use types, followed by microaggregates (MIA, 0.053–0.25 mm), while small macroaggregates (SMA, 0.25–2 mm) and large macroaggregates (LMA, >2 mm) had relatively low mass proportions. Aggregate stability in the 0–20 cm layer ranked PF > GL > CL > OC, with PF and GL significantly more stable than OC. In the 20–40 cm layer, the highest aggregate stability was found in GL. Except for PF, aggregate stability varied little between different soil layers for other land-use types. Aggregate stability is positively associated with the contents of soil organic carbon, total nitrogen, and alkali-hydrolyzable nitrogen, underscoring the critical role of soil organic matter in regulating soil aggregation.ConclusionsThe findings suggest that land-use type is a key determinant of soil structure in the northeastern Tibetan Plateau. creator: Ling Bai creator: Wei Wang creator: Yujuan Mo creator: Xubin Zhang creator: Jianchao Fu creator: Longfei Shu creator: Zining Yue creator: Peng Liu creator: Jian Hao creator: Xiang Liu creator: Deming Zhang uri: https://doi.org/10.7717/peerj.20643 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Bai et al. title: Retrospective study of postoperative pleural effusion with hypoxemia in critically ill pancreatic surgery patients: model development and restricted cubic spline analysis link: https://peerj.com/articles/20635 last-modified: 2026-01-30 description: BackgroundPleural effusion is a common postoperative complication following pancreatic surgery. It is associated with hypoxemia, often requiring prolonged mechanical ventilation and contributing to adverse clinical outcomes. Identifying risk factors and developing predictive models in critically ill patients after pancreatic surgery may facilitate early recognition and guide timely interventions to improve prognosis.MethodsWe retrospectively reviewed 518 intensive care unit (ICU)-admitted patients who underwent pancreatic surgery at Peking University People’s Hospital from January 2016 to June 2024. Patients were grouped by postoperative pleural effusion status. Least absolute shrinkage and selection operator (LASSO)-logistic was used to identify key predictors and guide model development. Internal validation was conducted using 1,000 bootstrap resamples. Model discrimination and calibration were assessed using receiver operating characteristic (ROC) curve (area under the curve, AUC) and calibration plots. Decision curve analysis evaluated clinical utility, while restricted cubic spline analysis was applied to explore nonlinear effects of continuous predictors.ResultsAmong 518 patients, 144 developed postoperative pleural effusion. Independent predictors included age, body mass index (BMI), atrial fibrillation, American Society of Anesthesiologists (ASA) grade, and intraoperative transfusion. A nomogram-based model incorporating these variables demonstrated good discrimination (AUC = 0.733, 95% CI [0.683–0.783]) and reliable calibration. Decision curve analysis confirmed clinical utility across a range of threshold probabilities. Restricted cubic spline analysis revealed nonlinear associations: age-related risk rose sharply beyond 65 years, while BMI showed a U-shaped relationship, with elevated risk below and above the inflection point of 22.6.ConclusionThis study developed a predictive model for postoperative pleural effusion in critically ill patients undergoing pancreatic surgery using LASSO-logistic regression. The model demonstrated robust discrimination and calibration, highlighting its potential utility in early risk stratification and individualized clinical decision-making. creator: Bin Wang creator: Jie Zhao creator: Shuguang Yang creator: Xiaojiang Liu creator: Fengxue Zhu uri: https://doi.org/10.7717/peerj.20635 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Wang et al. title: Preparing for an AI-driven future: insights from Saudi pharmacy students link: https://peerj.com/articles/20600 last-modified: 2026-01-30 description: AimThe current study was conducted to assess pharmacy students outlook towards artificial intelligence (AI), pharmacy education, and pharmacy practice.MethodsThe study used a cross-sectional, self-administered, anonymous online questionnaire. The study was conducted at the college of pharmacy in Saudi Arabia.ParticipantsYear 4 and year 5 undergraduate pharmacy students were chosen as the study population.ResultsA total of 133 pharmacy students completed the survey (response rate: 82%). The mean Likert score for perceptions of AI use in pharmacy education and practice was 3.43 ± 0.6, while the mean score for incorporation of AI in pharmacy education programs was 3.55 ± 0.78. Students demonstrated generally positive attitudes toward AI, supporting its development and integration into pharmacy curricula, though ethical awareness remained moderate.Discussion and ConclusionMost students were supportive of the development of AI in the pharmacy field and valued the importance of having some basic understanding of AI. Ethical and legal consideration of AI used was raised by participants. They were supportive of integrating AI into pharmacy program curricula. Their top-rated learning objectives involved understanding and interpreting AI generated results, gaining awareness of ethical consideration of using AI in clinical practice, comprehend how basic technology process the work, expressing how technology functions in a way that others can grasp. creator: Dalia Almaghaslah creator: Arwa Khaled creator: Shadma Wahab creator: Geetha Kandasamy uri: https://doi.org/10.7717/peerj.20600 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Almaghaslah et al. title: Mini-review: red seaweed Hydropuntia edulis and agar derivatives for food, medicinal and agriculture applications link: https://peerj.com/articles/20393 last-modified: 2026-01-30 description: The red seaweed Hydropuntia edulis is found in Southeast Asia in the Indian and Pacific Oceans. Due to ease of cultivation and a greater concentration of sulfated polysaccharides, H. edulis is a superior source for agar production compared to other species. However, the pretreatments and extraction conditions strongly impact agar’s final gel strength and yield. Agar is made up of agarose, which is approximately 70%, and agaropectin, 30%, and has found a wide range of applications as a thickening, gelling, and stabilizing agent. This review highlighted agar extraction, its application in food as an ingredient, coating, and packaging. In-depth discussions about the interaction of agar with non-agar biopolymers have been made to diversify its utility in different avenues. Additionally, by considering the richness of bioactive derivatives of H. edulis, the applications in pharmaceuticals, agriculture, and aquaculture have been elaborated, followed by some limitations. Detailed investigation of H. edulis review aims to encourage increased cultivation of the species for producing agar and other bioactive compounds that support sustainable food, pharmaceutical, agriculture, and aquaculture industries. creator: Tracy Saptu creator: Kaiser Mahmood creator: Wan-Teng Leong creator: Mohd Fakhrulddin Ismail creator: Irina Harun creator: Uthumporn Utra creator: Shahrul Razid Sarbini creator: Ahmad Hussaini creator: Muta Harah Zakaria creator: Yus Aniza Yusof creator: Shiamala Devi Ramaiya creator: Hanisah Kamilah uri: https://doi.org/10.7717/peerj.20393 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Saptu et al. title: Effect of swallowing related fatigue on eating and drinking behaviors across the age spectrum link: https://peerj.com/articles/20349 last-modified: 2026-01-30 description: BackgroundSwallowing related fatigue refers to the decline in swallowing efficiency and safety due to sustained muscular effort over time. It can significantly impact eating and drinking behaviors, potentially leading to aspiration, malnutrition and diminished quality of life. Understanding the effects of swallowing fatigue across the age spectrum can help guide clinical interventions and management strategies. Hence, this study aims to evaluate the effects of swallowing-related fatigue on eating and drinking behaviors in young, middle-aged and older adults.MethodsA cross-sectional study was conducted, recruiting 400 healthy individuals divided into three groups consisting of young adults, middle-aged adults and older adults. Participants with speech, language, swallowing, neurological, or cognitive impairments were excluded. The study utilized standardized assessments, including the Swallowing and Eating-Related Fatigue Scale (SERF) to measure swallowing fatigue. Objective swallowing function was evaluated using the Timed Water Swallow Test (TWST) for liquid intake, the Test of Masticating and Swallowing Solids (TOMASS) for solid food consumption, and the Mealtime Assessment Scale (MAS) to assess overall mealtime behaviors. Video recordings of swallowing tasks were analyzed to measure efficiency, speed, and fatigue-related changes.ResultsSwallowing fatigue was significantly higher in older adults compared to middle-aged and young adults. TWST results showed that older adults exhibited longer swallowing durations, smaller bolus volumes per swallow, and reduced swallowing efficiency, though correlations between TWST parameters and fatigue were weak. In contrast, TOMASS scores revealed moderate associations with swallowing fatigue, as older adults took more bites, had longer mastication durations, and required more swallows per bolus. MAS scores demonstrated moderate to strong correlations with swallowing fatigue across all age groups, indicating that individuals experiencing higher fatigue levels displayed compromised mealtime efficiency and safety. Reliability analyses confirmed excellent test-retest reliability for TWST & TOMASS, with good to excellent interrater reliability.ConclusionThis study underscores the impact of swallowing-related fatigue on eating and drinking behaviors, particularly among older adults. While swallowing fatigue had minimal to moderate influence on TWST and TOMASS parameters respectively, MAS demonstrated stronger associations, suggesting that swallowing endurance plays a critical role in overall mealtime performance. These findings highlight the importance of integrating fatigue assessments into clinical dysphagia evaluations, as fatigue-related impairments may increase the risk of nutritional deficits and aspiration. Future research should focus on developing interventions to mitigate swallowing fatigue and improve mealtime efficiency, particularly in aging & clinical populations. creator: Uzair Chilwan creator: K. Vijaya Kumar creator: Sudhin Karuppali creator: Venkataraja U. Aithal creator: Radish Kumar Balasubramanium uri: https://doi.org/10.7717/peerj.20349 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Chilwan et al. title: Sperm chromatin condensation defects and IVF outcomes: a retrospective cohort study link: https://peerj.com/articles/20749 last-modified: 2026-01-29 description: BackgroundThe clinical impact of sperm chromatin condensation defects (SCCD) on in vitro fertilization (IVF) outcomes remains controversial. This study aimed to clarify the effects of SCCD on embryonic development, pregnancy, and neonatal outcomes in couples undergoing their first IVF cycle.MethodsThis retrospective cohort study included 647 couples. Multivariable logistic regression was used to evaluate associations between SCCD (assessed by aniline blue staining) and clinical outcomes, with stratification and generalized additive models employed to identify effect modifiers and nonlinear relationships.ResultsElevated SCCD levels (≥30%) were correlated with abnormal conventional semen parameters and a reduced two-pronuclei (2PN) cleavage rate, whereas no significant associations were observed with spontaneous abortion, gestational age, birth weight, or neonatal sex distribution. After adjusting for key confounders, increasing SCCD levels remained independently associated with reduced clinical pregnancy (OR = 0.98, P = 0.01) and live birth rates (OR = 0.98, P = 0.02), and no significant effect modification by any subgroup variable was observed (all P for interaction > 0.05). Moreover, individuals with SCCD levels ≥30% showed a trend toward substantially reduced clinical pregnancy (OR = 0.64, P = 0.05) and live birth rates (OR = 0.65, P = 0.06). Nonlinear analysis further identified a significant risk threshold for live birth at 10.6% (OR = 0.86, P = 0.01), with risk plateauing until a declining trend emerged beyond 24.1%.ConclusionsThis study provides evidence that SCCD is independently associated with reduced IVF success, supporting its assessment in pre-IVF evaluation. creator: Wen Zhou creator: Shan Lu creator: Aiai Wang creator: Manbo Jiang creator: Sinan Li creator: Huanqun Zhou uri: https://doi.org/10.7717/peerj.20749 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Zhou et al. title: The dual roles of chemokine (C-C motif) ligand 7 in tumors and inflammatory diseases link: https://peerj.com/articles/20685 last-modified: 2026-01-29 description: Chemokines are regarded as major contributors to tumor growth and inflammation. They participate in cancer progression directly and accelerate tumor microenvironment (TME) remodeling because of the inflammatory response and immune cell infiltration. C-C motif chemokine ligand 7 (CCL7) is widely expressed across various cell types. In tumors, CCL7 facilitates progression by shaping the TME and promoting cell invasion and metastasis. It also enhances anti-tumor immune responses by recruiting immune cells such as T cells and NK cells. Moreover, emerging evidence indicates that the overexpression of CCL7 is associated with inflammatory diseases. CCL7 predominantly attracts macrophages and monocytes, thereby modulating inflammatory responses, driving fibrosis progression, and maintaining systemic homeostasis. However, the exact mechanisms underlying these processes remain unclear and lack systematic investigation. This review systematically integrates CCL7’s dual roles in tumors (both pro-tumor and anti-tumor) and its stage-specific functions across inflammation (both pro-inflammatory and anti-inflammatory), fibrosis, and obesity, filling gaps in fragmented prior research. It also links the common regulatory mechanisms across multiple diseases, and puts forward specific strategies such as CCL7/CCR antagonists and combined immunotherapy, thereby providing new therapeutic strategies for the exploration and treatment of related diseases, aiming to contribute to the maintenance of human health globally. creator: Danhong Qian creator: Yikang Mo creator: Jinji Chen creator: Wenqing Guan creator: Lihui Yan creator: Qi Zhou uri: https://doi.org/10.7717/peerj.20685 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Qian et al. title: Thiamin addition to soil increases potato tuber thiamin content under greenhouse conditions link: https://peerj.com/articles/20684 last-modified: 2026-01-29 description: Thiamin is essential for human health, but humans do not synthesize it and must consume it through regular dietary intake. Plants synthesize thiamin in photosynthetic tissues to support various primary metabolic pathways. In addition, plants can also absorb thiamin from the soil. Interestingly, plant growth can be improved by supplying exogenous thiamin, but this effect has not been investigated in potato (Solanum tuberosum). Here, we report the effect of soil thiamin amendment on yield and tissue thiamin content of three potato varieties grown in a greenhouse. We watered plants with different concentrations of thiamin on a weekly basis from emergence until harvest. Under optimal growth conditions, thiamin supplementation did not affect tuber yield, regardless of soil type. Thiamin accumulated up to 58, six and three times in roots, tubers and stems, respectively, of plants grown in soil supplemented with thiamin compared to control plants, while leaf thiamin content did not significantly change. Quantitative polymerase chain reaction analysis showed that soil thiamin supplementation had no or little effect on the expression of two key thiamin biosynthesis genes in leaves. Our results indicate that increasing soil thiamin concentration does not improve potato yield under optimal growth conditions at the greenhouse scale. However, increased yield at field-scale under stress conditions remains to be tested. Intriguingly, the accumulation of thiamin in potato tubers suggests that soil thiamin supplementation may be a viable strategy for biofortification. creator: Aymeric Goyer creator: Ravi Phillips creator: Aidan Seidel creator: David Handy creator: Jeffrey C. Anderson creator: Andrea Schiffer creator: Alexandra J. Weisberg creator: Paul C. Bethke uri: https://doi.org/10.7717/peerj.20684 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Goyer et al. title: Exploring new rehabilitation pathways for stroke based on the comorbidity of post-stroke hypoesthesia with anxiety and depression link: https://peerj.com/articles/20679 last-modified: 2026-01-29 description: BackgroundPost-stroke hypoesthesia is a common yet often overlooked sequela, involving diminished capacities in touch, temperature, and pain perception. Recent studies suggest that sensory deficits not only hinder functional recovery but also show a high rate of comorbidity with anxiety and depression.ObjectiveThis study aims to systematically integrate the neural mechanisms, perceptual processing features, and behavioral consequences of post-stroke hypoesthesia and emotional disorders, to explore their comorbid relationship and propose more targeted rehabilitation strategies based on these mechanisms.MethodsThis review conducts an interdisciplinary literature search, integrating research from neuroimaging, cognitive neuroscience, and rehabilitation medicine, including 73 relevant studies. The keywords used in the screening are “Hypesthesia,” “Impaired Sensation,” “Anxiety,” and “Depression,” covering studies on sensory impairments and mood disorders. By comparing the sensory-emotion interaction mechanisms in stroke and non-stroke populations, a bidirectional model is constructed.ResultsFindings indicate that post-stroke hypoesthesia results not only from structural damage in regions such as the thalamus, insula, and prefrontal cortex, but also from functional disruptions in perceptual processing. These impairments contribute to a closed-loop mechanism involving neural dysconnectivity and predictive coding dysfunction, which facilitates the emergence of anxiety and depression. In turn, these emotional disorders further suppress sensory recovery, significantly reducing patients’ motivation and rehabilitation compliance.ConclusionPost-stroke hypoesthesia should be recognized as a critical etiological and maintaining factor in anxiety and depression. The coexistence of pathological and functional mechanisms underscores the need for rehabilitation strategies that transcend the boundaries of perception, emotion, and cognition. Developing a rehabilitation pathway centered on “sensory–emotional co-regulation” can facilitate early identification, subtype-specific intervention, and comprehensive support for emotional comorbidities following stroke. creator: Yuyan Chen creator: Yusheng Zhao creator: Bangqi Wu creator: Yupei Cheng creator: Jingjie Huang creator: Chaoran Wang creator: Jing Bai creator: Yuxing Zhang uri: https://doi.org/10.7717/peerj.20679 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Chen et al. title: Effects of exercise combined with brain stimulation on hand function in children with cerebral palsy: a meta-analysis of randomized controlled trials link: https://peerj.com/articles/20670 last-modified: 2026-01-29 description: BackgroundCerebral palsy (CP) is a paediatric condition generally characterized by persistent motor disabilities in hand function. This review examined the impact of exercise with and without brain stimulation on hand function in children with CP.MethodologyA systematic literature search was conducted from January 2010 to June 2025 across four electronic databases: Web of Science, Scopus, PubMed, and EBSCO. This review established the inclusion criteria as follows: 1. Children with CP; 2. Randomised controlled trial; 3. Exercise with and without brain stimulation; 4. Measurements included gross motor function (GMF), fine manual control (FMC) and grip strength (GS) evaluated at pre- and post-intervention. The quality of the included studies was assessed using the Cochrane Risk of Bias tool. For data analysis, the standardized mean difference (SMD) was selected as the appropriate effect size index, and RevMan 5.4 software was employed to analyze the mean differences in the data extracted from the included articles. (Registration number: CRD420251106181).ResultsThe results showed that exercise with brain stimulation comprising more than 16 sessions could notably improve GS (SMD, 1.38 (0.88, 1.88), p < 0.05, I2 = 0%), whereas that comprising fewer than 10 sessions did not demonstrate a statistically significant effect (SMD, 0.19 (−0.29, 0.67), p = 0.44, I2 = 0%). Consequently, brain stimulation intervention could substantially enhance FMC (SMD, 0.46 (0.15, 0.76), p < 0.05, I2 = 47%). Subgroup analysis also presented that exercise with transcranial direct current stimulation (tDCS) resulted in a significant improvement in FMC (SMD, 0.71 (0.29, 1.14), p < 0.05, I2 = 49%) compared to exercise with repetitive transcranial magnetic stimulation (SMD, 0.19 (−0.25, 0.63), p = 0.09, I2 = 47%).ConclusionThis review demonstrated that exercise with brain stimulation could significantly enhance hand function in children with CP. Specifically, more than 16 sessions has greater benefits for GS, and the tDCS may confer benefits for FMC. creator: Shuoqi Li creator: Shenhao Guo creator: Ruihan Wang creator: Jiayuan Ma creator: Hu Lou uri: https://doi.org/10.7717/peerj.20670 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Li et al. title: Do ureteral stents improve clinical outcomes in renal transplantation? A systematic review and meta-analysis comparing stented and non-stented anastomosis techniques link: https://peerj.com/articles/20665 last-modified: 2026-01-29 description: BackgroundUrological complications following renal transplantation (RT) remain a significant clinical challenge. The role of ureteral stents in mitigating these complications is a subject of ongoing debate. This study aimed to assess whether ureteral stents improve clinical outcomes in RT, comparing stented and non-stented anastomosis techniques.MethodsAn extensive search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials, and the Chinese Biomedical Literature Service System from inception to November 26, 2025, following the PRISMA and AMSTAR standards. This study was registered with PROSPERO (CRD42024557423). The primary outcomes were urological mechanical complications (UMCs) and urinary tract infections (UTIs), whereas the secondary outcomes included hematuria, graft rejection, renal function, cost-effectiveness, stent-related complications, and quality of life (QOL). The Mantel-Haenszel test was used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs) for the outcomes.ResultsSixteen RCTs involving 2,486 patients met the inclusion criteria. Meta-analysis revealed that the stent group had a significantly lower incidence of urine leakage (RR = 0.25, 95% CI [0.13–0.47]) and ureteral obstruction or stricture (RR = 0.42, 95% CI [0.25–0.71]) compared to the non-stent group. However, the incidence of UTIs was higher in the stent group (RR = 1.41, 95% CI [1.08–1.84]). No significant differences were observed in hematuria, graft rejection, or renal function between groups.ConclusionsRoutine ureteral stent placement in RT significantly reduces the incidence of UMCs despite potentially increasing the risk of UTIs. This balance between benefits and risks supports the continued use of ureteral stents in RT, pending further high-quality studies. creator: Shengnan Yin creator: Xiaodong Hao creator: Xiaoping Cai creator: Xiaowei Wang creator: Chenyang Zhao creator: Yaxiong Li creator: Shuo Zheng uri: https://doi.org/10.7717/peerj.20665 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Yin et al. title: Organic amendments to potato soils inconsistently enrich yield-associated soil microbiota across growing regions of the continental US link: https://peerj.com/articles/20595 last-modified: 2026-01-29 description: Plant health is regulated by complex consortia of soil microbes with growth-promoting and pathogenic functions. In potato production, various soil management practices are undertaken to boost yields and suppress diseases, but connections between these practices, soil microbiomes, and tuber yields have not been characterized across diverse growing regions. To identify growing practices and microbes associated with increased yields, we established four-year field trials across eight US sites from Oregon to Maine that consisted of controls, fumigations, organic amendments, and mustard incorporations. Amplicon sequencing of 16S ribosomal RNA (rRNA) genes and intergenic transcribed spacer (ITS) regions was used to investigate bacterial and eukaryotic soil microbiomes, respectively. Fumigation and organic amendment treatments increased tuber yields in 23% and 29% of treatments relative to controls. While soil treatments influenced both microbiome types differently across all field sites, eukaryotes were more sensitive than bacteria to all treatments. Across field sites, soil treatments impacted relative abundances of amplicon sequence variants (ASVs) to varying degrees, even among ASVs belonging to the same genus. Associations between ASVs and tuber yields similarly varied within genera, highlighting the lack of consistent yield-associated taxa across US growing regions. Nevertheless, forty-five “target ASVs” across nine bacterial and three fungal phyla were identified as both treatment-impacted and yield-associated within any particular field site. Models identified three of thirteen organic amendment scenarios and one of thirteen fumigation scenarios where increased relative abundances of specific target ASVs accounted for up to a 23% increase in tuber yields compared to control treatments. These ASVs were largely site-specific and not influenced by treatment-associated changes in soil nutrients or organic matter, highlighting complex relationships within field sites that require further study to achieve the goal of implementing sustainable, microbiome-informed potato production techniques. creator: Scott A. Klasek creator: James E. Crants creator: Kenneth E. Frost creator: Brenda K. Schroeder creator: Carl J. Rosen creator: Linda L. Kinkel uri: https://doi.org/10.7717/peerj.20595 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Klasek et al. title: Rheumatoid arthritis and stroke risk: a systematic review and meta-analysis link: https://peerj.com/articles/20568 last-modified: 2026-01-29 description: ObjectivesThis meta-analysis aims to evaluate the association between rheumatoid arthritis (RA) and stroke risk. Methods: PubMed, Cochrane Library, and Embase were searched for observational studies published from database inception to October 7, 2025, using medical subject headings (MeSH) and keywords. Random effect models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for evaluating the associations between RA and stroke risk. All statistical analyses were performed using Stata statistical software version 17.0. The funnel plot, Egger’s test and Begg’s test were used to evaluate publication bias.ResultsThis meta-analysis included 12 observational studies with a total of 1,715,001 participants, published between 2003 and 2025. The pooled analysis revealed a significant association between RA and increased stroke risk (OR = 1.35; 95% CI [1.26–1.45]; P = 0.000). Subgroup analysis showed that women with RA had a slightly higher stroke risk than men (OR = 1.60; 95% CI [1.19–2.16]; P = 0.002). Additionally, RA patients aged over 65 were at higher risk of stroke (OR = 1.24; 95% CI [1.02–1.50]; P = 0.032). No significant publication bias was detected, and sensitivity analyses confirmed the robustness of our findings.ConclusionsThis meta-analysis demonstrates that RA is associated with an increased risk of stroke, supporting the recognition of RA as an independent stroke risk factor. creator: Lulu Yang creator: Xinyu Liu creator: Guangyuan Yang creator: Hongmei Wu creator: Xingsen Li creator: Jinyu Xuan creator: Shuxin Dong uri: https://doi.org/10.7717/peerj.20568 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Yang et al. title: Optic disc parameters and choroidal vascular index as potential risk indicators in non-arteritic anterior ischaemic optic neuropathy: a retrospective study link: https://peerj.com/articles/20695 last-modified: 2026-01-28 description: BackgroundAlthough previous research has explored the involvement of the choroid in the pathogenesis of non- arteritic anterior ischaemic optic neuropathy (NAION), the relationship between optical coherence tomography angiography (OCTA) findings and choroidal features remains unclear. An understanding of this relationship may help clarify the vascular mechanisms underlying this disease. The aim of this study was to investigate the relationships between OCTA and choroidal parameters in patients with NAION during the post-acute phase, after the resolution of optic disc oedema.MethodsThis retrospective analysis included the affected eyes of patients with unilateral NAION, their unaffected fellow eyes, and the eyes of age- and sex-matched healthy controls. The three groups were compared with regard to OCTA and choroidal parameters. Retinal imaging was conducted approximately 2 months after NAION occurrence to allow for the spontaneous resolution of characteristic optic disc oedema.ResultsA total of 75 eyes were included in the final analysis: 25 NAION-affected eyes, 25 fellow eyes, and 25 control eyes (13 women and 12 men). Age and sex distributions were similar across groups. The peripapillary vessel density (pVD), flow area (FA), retinal nerve fibre layer (RNFL) thickness, and choroidal vascularity index (CVI) in all quadrants were significantly lower in NAION eyes than in unaffected and control eyes. Unaffected eyes also demonstrated significantly lower radial peripapillary capillary (RPC) mean, RPC temporal, and RPC FA values than did the healthy controls. A moderate correlation was observed between RPC pVD and the mean RNFL thickness in NAION eyes and between RPC FA and the mean RNFL thickness in both NAION and unaffected eyes. The strong relationship between RPC perfusion and RNFL thinning could not be statistically confirmed after false discovery rate correction; thus, a direct cause-and-effect relationship could not be validated.ConclusionsThere were no significant correlations between OCTA and choroidal parameters across all groups. These findings suggest that the retina and choroid are affected through distinct mechanisms in NAION. However, reductions in OCTA parameters, including CVI, were evident in NAION eyes. Overall, the study findings underscore the potential of OCTA as a non-invasive tool for identifying risk factors and monitoring disease progression in NAION. creator: Emine Atalay creator: Abdullah Beyoğlu uri: https://doi.org/10.7717/peerj.20695 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Atalay and Beyoğlu title: UBE2S and HIF1α expression patterns and stratified analysis reveal prognostic value in esophageal squamous cell carcinoma link: https://peerj.com/articles/20694 last-modified: 2026-01-28 description: BackgroundThe prognostic heterogeneity of esophageal squamous cell carcinoma (ESCC) necessitates robust biomarkers. Although hypoxia-inducible factor 1α (HIF1α) is implicated in ESCC progression, its interplay with ubiquitin-conjugating enzyme E2S (UBE2S) remains uncharacterized.MethodsWe investigated UBE2S and HIF1α expression via immunohistochemistry (IHC) in a cohort of 259 ESCC patients. Transcriptomic data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases were used for validation. Prognostic value was assessed using Kaplan–Meier and multivariate Cox regression analyses. Stratified analysis was employed to identify high-risk subgroups.ResultsUBE2S and HIF1α were significantly overexpressed in ESCC tissues at both protein and mRNA levels. UBE2S expression correlated with nationality (Kazak vs. Han, p = 0.001) and vessel invasion (p = 0.020), while HIF1α associated with gender (p = 0.040) and depth of invasion (p = 0.050). Multivariate analysis identified UBE2S as an independent prognostic factor for overall survival (OS; HR = 1.685, p = 0.041). Notably, co-expression analysis revealed that patients with UBE2S-positive/HIF1α-positive tumors had the poorest prognosis.ConclusionIn conclusion, our multi-platform data suggest that UBE2S and HIF1α may represent critical biomarkers in ESCC. Their consistent overexpression and association with adverse outcomes support their potential for improving risk stratification and lay the groundwork for exploring them as future therapeutic targets. creator: Mingfu Ma creator: Mengyan Li creator: Yuanyuan Lv creator: Yahao Zhang creator: Xuelian Pang creator: Yuqing Ma uri: https://doi.org/10.7717/peerj.20694 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Ma et al. title: Deciphering the modulatory role of short-chain fatty acids in Parkinson’s disease via phosphorylation-dependent signaling mechanisms link: https://peerj.com/articles/20688 last-modified: 2026-01-28 description: Parkinson’s disease (PD), the world’s second most prevalent neurodegenerative disorder, is characterized by progressive neuronal degeneration mediated through intricate pathological mechanisms. Phosphorylation signaling pathways have been increasingly recognized as critical modulators in the development and progression of PD. Meanwhile, short-chain fatty acids (SCFAs), primarily produced by gut microbiota, have shown considerable neuroprotective potential by promoting autophagy, alleviating mitochondrial dysfunction, and regulating neuroinflammatory responses. Recent research suggests that SCFAs may influence the phosphorylation dynamics of key signaling pathways, including MAPKs, NF-κB, JAK/STAT, PI3K/Akt, AMPK, and Nrf2/Keap1/ARE, thereby modulating disease pathophysiology. This review aims to systematically evaluate how SCFAs modulate phosphorylation pathways to influence neuroinflammation, α-synuclein aggregation, and mitochondrial dysfunction in PD. By investigating this issue, we identify potential molecular targets and propose future research directions, offering new insighreviewts and strategies for the development of novel therapeutic and preventive interventions for PD. creator: Jiaji Liu creator: Ruijun Su uri: https://doi.org/10.7717/peerj.20688 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Liu and Su title: Reproductive outcomes of different management strategies after hysteroscopic resection of the uterine septum with endometrial polyps: a retrospective study link: https://peerj.com/articles/20669 last-modified: 2026-01-28 description: BackgroundThe presence of a septate uterus combined with endometrial polyps significantly impacts women’s fertility. There is currently no study on whether medication is needed after surgery and which postoperative regimen is more beneficial for uterine recovery and pregnancy outcomes. This study aims to compare the reproductive outcomes and complications of artificial cycle therapy with those of short-acting contraceptives or no hormonal treatment after hysteroscopic resection of the uterine septum with coexisting endometrial polyps.MethodsA retrospective study was conducted on 189 women with a history of infertility or adverse pregnancy who underwent hysteroscopic resection of uterine septum with endometrial polyps between December 2017 and February 2023 . According to the postoperative medication regimens, patients were divided into three groups: artificial cycle (Group A), short-acting contraceptive (Group B), and no hormonal treatment (Group C). The primary outcome was pregnancy rates leading to live birth within 12 months post-surgery.ResultsThere were 92 patients in Group A, 52 in Group B, and 45 in Group C. The live birth rates were 40.2% in Group A, 34.6% in Group B, and 31.1% in Group C (χ2 = 1.192, P = 0.547). A multivariate logistic regression analysis was performed incorporating confounding variables including age, body mass index (BMI), types of fertility problems, and types of uterine septum. The results showed that only age (adjusted odds ratio (OR) = 0.892, 95%CI [0.822–0.968], P = 0.006) was significantly associated with live birth after surgery. The mean time to pregnancy resulting in live birth was 9.6 months in Group A, 10.2 months in Group B, and 10.4 months in Group C (log-rank P = 0.468). There were no significant differences in clinical pregnancy rate, pregnancy loss rate, preterm birth rate, placental abnormality rate, postoperative intrauterine adhesion rate, and endometrial polyp recurrence rate among the three groups (P > 0.05).ConclusionsHormonal therapy, including artificial cycles and short-acting contraceptives, may not be necessary after hysteroscopic septum resection with polypectomy for patients with short-term fertility requirements. creator: Kaili Wang creator: Jianmin Du creator: Xinxin Zhao creator: Xin Zhao creator: Canyu Li uri: https://doi.org/10.7717/peerj.20669 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wang et al. title: Battling biofilms: evaluating selected agents against Cutibacterium acnes—a review link: https://peerj.com/articles/20652 last-modified: 2026-01-28 description: BackgroundCutibacterium acnes (C. acnes) is a causative agent in the development of acne vulgaris, and this bacteria has been reported to show resistance against conventional antibiotics. One of the vital factors contributing to antibiotic resistance is the ability of C. acnes to form biofilms. Thus, the purpose of this review is to assess the efficacy of various recent developments and to identify acceptable methods for preventing infections associated with C. acnes biofilms.MethodologyA variety of criteria considered in the selection process, such as the site of infection, the mechanism of action against biofilms, and the methodology used to evaluate antibiofilm activity, were taken into consideration when choosing the studies.ResultsThe findings of existing research on the antibiofilm potential of conventional anibiotics, natural products and novel treatment strategies against C. acnes were compiled and compared. Clinical trials demonstrated that dalbavancin reduced biofilm formation while niosomes effectively decreased inflammation in acne lesions. Some studies have shown promising results with bacteriophages, plant-based and nanomaterial treatments, but lack further validation in the way of pre-clinical and clinical trials to accurately measure treatment effectiveness.ConclusionsThe review examines a range of effective agents and explores their potential applications in acne management, offering valuable insights for clinicians—especially dermatologists—seeking to optimize patient care. In addition, this review provides an understanding about the different agents and their antibiofilm properties that enable researchers to develop effective therapeutic approaches against C. acnes biofilm-related infectious diseases for the benefit of human health. creator: Wala Karar creator: Seedahmed A. Mohamed creator: Geetha Subramaniam creator: Zobidah Yousif Elamin Yousif creator: Bydaa Atron creator: Enas dk Dawoud creator: Harichandra Khalingarajah creator: Lalita Ambigai Sivasamugham uri: https://doi.org/10.7717/peerj.20652 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Karar et al. title: The role of ASIC2 in glioma progression: implications for prognosis and therapeutic targeting link: https://peerj.com/articles/20583 last-modified: 2026-01-28 description: Glioma, the most frequent primary intracranial tumor, is characterized by infiltrative growth in the central nervous system, pronounced invasiveness, high malignancy, and poor clinical prognosis. The existing treatment methods include surgery, radiotherapy and chemotherapy, but the efficacy is still limited. Analysis of The Cancer Genome Atlas (TCGA) dataset reveals marked downregulation of acid-sensing ion channel 2 (ASIC2) expression in glioma tissues, which significantly correlates with reduced patient survival. Moreover, ASIC2 expression is inversely associated with the extent of immune cell infiltration and glioma stem cell markers. Functional experiments demonstrate that both knockdown and overexpression of ASIC2 critically regulate glioma cell proliferation, invasion, and metastatic potential through mechanisms mediated by matrix metalloproteinase 2 (MMP2), calcineurin, and nuclear factor of activated T cells 1 (NFAT1) signaling pathways. These findings delineate a pivotal role for ASIC2 in governing glioma malignant behavior and establish its relevance as a potential molecular target for therapeutic intervention. creator: Wenxiu Tian creator: Yu Wang creator: Zhenming Wang creator: Fujun Peng creator: Jiayi Sun creator: Huimin Qi creator: Zhaorui Zhang creator: Ping Wang creator: Sen Qiao creator: Hongmei Wang creator: Junhong Dong uri: https://doi.org/10.7717/peerj.20583 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Tian et al. title: Integrative analysis for identification of key miRNA-mRNA regulatory axes in esophageal cancer and preliminary validation of the regulatory role of miR-15b-5p/BTG2 therein link: https://peerj.com/articles/20538 last-modified: 2026-01-28 description: BackgroundEsophageal cancer (ESCA), a leading cause of cancer-related mortality, lacks reliable biomarkers for early detection and prognosis. Dysregulated microRNAs (miRNAs) have emerged as pivotal regulators of tumor progression, yet their context-specific roles and interactions with target genes in ESCA remain underexplored.MethodsMulti-omics data from The Cancer Genome Atlas-esophageal cancer (TCGA-ESCA) and Gene Expression Omnibus (GEO) datasets were integrated to identify differentially expressed miRNAs and mRNAs. A miRNA-mRNA regulatory network was constructed using FunRich and validated through functional assays, including dual-luciferase reporter, quantitative reverse transcription polymerase chain reaction (qRT-PCR) and in vitro proliferation/migration/invasion experiments. Prognostic signatures were developed using Cox regression, least absolute shrinkage and selection operator (LASSO)-Cox and nomogram analysis.ResultsWe identified 1,131 differentially expressed mRNAs and 69 miRNAs in ESCA. The miR-15b-5p/BTG2 axis emerged as a central regulatory hub. miR-15b-5p was significantly upregulated in ESCA tissues and showed an inverse correlation with B-cell translocation gene 2 (BTG2) expression. Survival analyses established both molecules as independent prognostic factors. Mechanistically, miR-15b-5p directly targeted BTG2 3′UTR, suppressing its expression. Functional studies demonstrated that miR-15b-5p overexpression promoted proliferation, migration and invasion in ESCA cells, whereas BTG2 restoration reversed these effects. A prognostic nomogram integrating miR-15b-5p, BTG2 and clinical parameters demonstrated robust predictive accuracy (C-index: 0.78).ConclusionsThe miR-15b-5p/BTG2 axis represents a novel regulatory mechanism in ESCA progression with significant potential as both a prognostic biomarker and therapeutic target. creator: Wenyuan Hong creator: Chaoyang Xia creator: Gao Li uri: https://doi.org/10.7717/peerj.20538 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Hong et al. title: Comparing efficacy and safety of oral drugs in treatment of hyperthyroidism: a systematic review and network meta-analysis link: https://peerj.com/articles/20403 last-modified: 2026-01-28 description: BackgroundThyrotoxicosis refers to a condition where there is an excess of thyroid hormone production by the thyroid gland itself, leading to a form of hyperthyroidism.ObjectiveThis study is based on systematic review and network meta-analysis methods, aiming to provide a more reliable basis for the selection of clinical treatment plans by comprehensively considering the efficacy and safety of different drugs in treating hyperthyroidism, including the regulation of thyroid hormone levels and potential adverse reactions.MethodsComputerized searches were conducted in eight major domestic and international databases (PubMed, Cochrane Library, Embase, Web of Science, CBM, CNKI, WANFANG DATA, VIP) for randomized controlled trials (RCTs) on the efficacy of oral medications in improving the treatment outcomes of patients with hyperthyroidism. The search period covered from the inception of each database to October 2025. All researchers independently screened the literature, extracted data, and assessed the quality of the studies. For studies meeting the quality criteria, data analysis was performed using Stata 17.0 and RevMan 5.4 software.ResultsA total of 151 articles were ultimately included, involving 14,158 patients, with 7,084 in the treatment group and 7,074 in the control group. The network meta-analysis showed that in terms of total effective rate, the top three interventions with the highest Surface Under the Cumulative Ranking Curve (SUCRA) probability ranking curve area were I-131 (Iodine-131)+LC (lithium carbonate), MMI (Methimazole)+PHT (Propranolol), and I-131; in terms of reducing Free Triiodothyronine (FT3), the top three interventions with the highest SUCRA probability ranking curve area were MMI+PDN (prednisone), I-131+LC, and I-131; in terms of reducing free tetraiodothyronine (FT4), the top three interventions with the highest SUCRA probability ranking curve area were I-131+PTU (Propylthiouracil), I-131+LC, and I-131; in terms of increasing thyroid-stimulating hormone (TSH), the top three interventions with the highest SUCRA probability ranking curve area were I-131+PTU, I-131, and MMI+PDN; in terms of reducing adverse reactions, the top three interventions with the highest SUCRA probability ranking curve area were I-131+PTU, I-131, and I-131+MMI.ConclusionThis study indicates that among the interventions for treating hyperthyroidism, I-131+LC has a higher efficacy rate compared to other treatments, I-131+PTU is superior in reducing FT3, increasing TSH and reducing adverse reactions compared to other treatments. Due to the limitations in the quantity and quality of the included studies, the aforementioned conclusions await further validation from more large-sample, high-quality, and multicenter studies. PROSPERO study number CRD42024566298. creator: Hui Zhang creator: Minghao Lin creator: Peng Zhang creator: Dexi Zhao creator: XiangYue Ma creator: Yujuan Fu uri: https://doi.org/10.7717/peerj.20403 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Zhang et al. title: Clinical correlation of serum zinc and chromium levels in patients with type 2 diabetes mellitus and complications in Pakistan: a retrospective study link: https://peerj.com/articles/20184 last-modified: 2026-01-28 description: BackgroundType 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and hyperglycemia. The role of trace elements such as zinc and chromium in the pathophysiology of T2DM has garnered significant attention due to their involvement in glucose metabolism and insulin regulation.ObjectiveThis cross-sectional study evaluated the clinical correlation between serum zinc and chromium levels in T2DM patients with and without complications in Pakistan.MethodsA total of 145 participants were included, comprising 100 T2DM patients (80 with complications: retinopathy, nephropathy, cardiovascular disease, and neuropathy; 20 without complications) and 45 healthy controls. Serum zinc and chromium levels were measured using atomic absorption spectrometry and their associations with glycated hemoglobin (HbA1c), demographic factors, and clinical profiles were evaluated.ResultsThe results showed that serum zinc and chromium levels were significantly lower in T2DM patients as compared to healthy controls (p value = 0.02 and p value = 0.001, respectively). Among diabetic subgroups, patients with diabetic neuropathy had the lowest zinc levels (p = 0.0001), while those with cardiovascular disease had significantly reduced chromium levels (p = 0.0002). Multivariate regression analysis showed that HbA1c levels were significantly associated with both zinc (β = 1.588, p value = 0.02) and chromium (β = 1.485, p value = 0.001), suggesting that deficiencies in these trace elements may contribute to poor glycemic control and the progression of diabetic complications.ConclusionThese findings highlight the potential role of zinc and chromium supplementation as an adjunctive therapeutic approach in managing T2DM and preventing its complications. Further longitudinal studies are needed to establish causality and explore the underlying mechanisms of trace element deficiency in diabetic patients. creator: Humma Nayyar creator: Attya Bhatti creator: Peter John creator: Gohar Khan uri: https://doi.org/10.7717/peerj.20184 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Nayyar et al. title: Potential of Cladophialophora inabaensis EUCL1 and Exophiala sp. BCM1 for abiotic stress resilience in maize link: https://peerj.com/articles/19947 last-modified: 2026-01-28 description: This study investigated the effects of two dark septate endophytic (DSE) fungi, Cladophialophora inabaensis EUCL1 and Exophiala sp. BCM1, on maize growth under no-stress, drought, saline, and alkaline salt conditions. Maize was cultivated in agar and soil-based systems, and growth parameters including shoot and root lengths, biomass, chlorophyll content, and stem diameter were evaluated to assess the efficacy of DSE inoculation. Both C. inabaensis EUCL1 and Exophiala sp. BCM1 showed promising effects to ameliorate negative effects of drought, saline, and alkaline salt stress. Maize inoculated with C. inabaensis EUCL1 exhibited significantly enhanced growth under no-stress conditions. Under drought stress, C. inabaensis EUCL1 increased shoot length by 148.94% in vitro, while Exophiala sp. BCM1 improved shoot and root dry mass by 196.55 and 188.21% respectively, on soil cultivation compared with the control. Notably, C. inabaensis EUCL1 also demonstrated strong potential in supporting maize growth under both saline and alkaline salt stress in soil-based systems. In response to saline stress, C. inabaensis EUCL1-treated plants exhibited marked increases in shoot and root dry mass by 176.15 and 152.77%, respectively. Under alkaline salt stress, shoot and root dry mass increased by 352.28 and 153.3%, respectively, compared with the control. Overall improvements in observed growth parameters indicate that DSE inoculation successfully mitigated the negative effects of abiotic stress. This study is the first to report the efficacy of C. inabaensis EUCL1 and Exophiala sp. BCM1 as effective bioinoculants for enhancing maize resilience under multiple abiotic stresses. creator: Ni Luh Putu Citra Innosensia creator: Haoyue Lu creator: Kazuhiko Narisawa uri: https://doi.org/10.7717/peerj.19947 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Innosensia et al. title: The relationship between physical activity and smartphone addiction in Chinese college students—a latent profile analysis link: https://peerj.com/articles/20724 last-modified: 2026-01-27 description: BackgroundThis study aimed to examine the relationship between physical activity (PA) and smartphone addiction among Chinese college students, with the goal of understanding whether higher levels of PA can mitigate the risk of smartphone addiction.MethodsThe study adopted a questionnaire and psychological measurement method and used the International Physical Activity Questionnaire (IPAQ) and Smartphone Addiction Scale (SAS) to assess the PA levels and smartphone dependence of 9,569 college students. By considering the latent category structure of individual smartphone addiction, the study conducted a deep analysis of the impact of different intensities of PA on smartphone addiction.ResultsThe PA level among Chinese college students was generally high (t =  − 97.66, p < 0.001). However, the prevalence of smartphone dependence was also notably high, affecting 35.9% of students. The necessity of PA’s impact on smartphone dependencewas not significant (p > 0.05), indicating that PA was significantly associated with lower levels of smartphone dependence. Detailed analysis revealed that smartphone addicts experienced the highest level of loss of control, and significantly greater than average levels of withdrawal, inefficiency, and escapism (p > 0.05). College students with higher PA levels tended to have lower smartphone dependence than those with low PA levels (b =  − 0.422, p < 0.05, OR = 0.656).ConclusionThe results suggested that positive PA can effectively alleviate the negative impacts of smartphone addiction. Therefore, interventions aimed at increasing PA could be beneficial in reducing smartphone dependence. creator: Bao Le Tao creator: Hao Chen creator: Yueyan Jiang creator: Hanwen Chen creator: Tianci Lu creator: Jun Yan uri: https://doi.org/10.7717/peerj.20724 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Tao et al. title: How many species in the United States warrant consideration for Endangered Species Act protection? link: https://peerj.com/articles/20692 last-modified: 2026-01-27 description: The U.S. Endangered Species Act (“ESA”) currently protects 1,682 species as endangered or threatened. According to the independent scientific organization NatureServe, however, there are more than 10,000 imperiled species in the United States that may need protection. One barrier to protecting recognized imperiled species is a lack of threats information. To address this problem, we reviewed all species recognized as critically imperiled (G1) or imperiled (G2) by NatureServe to identify those facing documented threats. In total, we identified 2,204 species where there is sufficient threat information to indicate ESA protection may be warranted. This analysis indicates that more than double the species currently listed under the ESA may need protection to avoid extinction. The U.S. Fish and Wildlife Service (“Service”) has on average listed just 32 species per year since the law was passed in 1973. At this rate, most species currently recognized as imperiled and facing threats will not receive consideration for protection within any meaningful timeframe. creator: Noah Greenwald creator: Krista Kemppinen creator: Will Harlan creator: Jeff Miller uri: https://doi.org/10.7717/peerj.20692 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Greenwald et al. title: First morphological description of the Galápagos pink iguana (Conolophus marthae) hatchling: a critical step for its conservation link: https://peerj.com/articles/20683 last-modified: 2026-01-27 description: The Galapagos pink iguana (Conolophus marthae) is endemic to Wolf Volcano on Isabela Island in the Galapagos archipelago. Due to its remote and hard-to-access habitat, the recently discovered and critically small wild population of the pink iguana has been extremely challenging to study. Herein we provide a first description of the morphology and behavior of six C. marthae hatchlings, and compare them with 12 hatchlings of the sympatric C. subcristatus. Morphometric measurements (snout–vent length = 10.9 ± 1.63 (SD) cm, tail length = 17.9 ± 3.05 cm, and weight = 47.8 ± 25.4 g) revealed a longer tail relative to its body size (ratio = 1.65 ± 0.23) compared to the sympatric Galápagos land iguana (C. subcristatus) hatchling of similar size (ratio = 1.42 ± 0.11). C. marthae hatchlings also displayed distinctive coloration with a bright green dorsal background with irregular black maculations and a pale, nearly unpigmented ventral surface. A comparative photograph of a subadult C. marthae revealed a directional, ontogenetic color shift: green dorsal areas became black while black maculations gave rise to pink patches, possibly a retained ancestral trait with implications for camouflage or signaling. These findings fill a knowledge gap in the early ecology of Galápagos pink iguana, providing information useful for monitoring recruitment in this Critically Endangered species. creator: Jorge Carrión-Tacuri creator: Christian Sevilla creator: Jean Pierre Cadena-Murillo creator: Willians Castro creator: Walter Chimborazo creator: Adrián Cueva creator: Cristian Gil-Jaramillo creator: Roberto Jiménez Carrión creator: Janaí Yépez Ruiz creator: Gregory A. Lewbart creator: Diego Páez-Rosas creator: James P. Gibbs uri: https://doi.org/10.7717/peerj.20683 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Carrión-Tacuri et al. title: Socioeconomic disparities in basic life support awareness and training among Saudi adults: a cross-sectional study link: https://peerj.com/articles/20678 last-modified: 2026-01-27 description: BackgroundBasic life support (BLS) is a critical emergency intervention that significantly enhances survival rates in situations such as cardiac arrest. Bystander cardiopulmonary resuscitation (BCPR) enhances the chances of survival up to 24%. This study aimed to assess public awareness, knowledge, and attitudes toward BLS, as well as the factors influencing them in the Jazan region of Saudi Arabia.MethodsAn analytical cross-sectional study was conducted in the Jazan region during October 2024 and March 2025. A standardized questionnaire was used to evaluate participants’ BLS knowledge. Eligible participants included mentally competent Saudi and non-Saudi residents aged 18 years and older. Descriptive statistics and multiple linear regression analyses were performed, with a significance level set at p < 0.05.FindingsA total of 1,021 participants were included, with a mean age of 30 ± 11 years; 51% were female. Overall, 72% reported awareness of BLS, and 56% had received prior BLS training. However, only 5% had engaged in hands-on practice. Educational institutions (34%) and social media platforms (20%) were the most frequently cited sources of BLS knowledge. The majority of the participants were aware of cardiac arrest symptoms (80%), but more than half lacked practical knowledge of BLS (>50%). Higher BLS knowledge scores were significantly associated with holding a bachelor’s degree (β = 0.68; p < 0.001), higher income levels (β = 2.48; p < 0.001), and engaging in moderate to vigorous physical activity at least five times per week (β = 0.82; p = 0.019). Conversely, having children was negatively associated with BLS knowledge (β = −2.31; p = 0.002).ConclusionSocioeconomic factors such as income, education, smoking status, academic background, physical activity and having children showed a significant associated with BLS knowledge, highlighting the need for broader public education and accessible BLS training programs. creator: Mohammad A. Jareebi creator: Mohammed H. Ghasham creator: Naif M. Alshamrani creator: Turki I. Aljezani creator: Amani A. Mutaen creator: Yara A. Mutaen creator: Faris A. Alhazmi creator: Ryof M. Sahli creator: Ahmed Y. Alkadi creator: Majed A. Ryani creator: Ahmed A. Bahri creator: Ahmad Y. Alqassim creator: Nuha H. Abutalib creator: Mostafa Mohrag creator: Abdulrahman S. Hamdi uri: https://doi.org/10.7717/peerj.20678 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Jareebi et al. title: The orchestrated interplay between DNA methylation and N6-methyladenosine modification: status quo and future perspectives link: https://peerj.com/articles/20654 last-modified: 2026-01-27 description: DNA methylation (DNAme) and N6-methyladenosine (m6A) represent key mechanisms in epigenetic and epitranscriptomic regulation, respectively. While DNAme is a well-established modification, m6A has more recently emerged as a central focus of epitranscriptomic research. This review comprehensively explores the dynamic crosstalk between DNAme and m6A, addressing the molecular intricacies and functional consequences of their interplay. A systematic literature search conducted in Web of Science Core Collection identified 972 publications related to both modifications. After rigorous screening, 29 studies directly investigating interactions between DNAme and m6A were included for in-depth analysis. These interactions were systematically classified into six distinct modes: (1) DNAme-mediated regulation of m6A; (2) m6A-dependent modulation of DNAme; (3) indirect interplay mediated by intermediate factors; (4) direct bilateral regulation between DNAme and m6A; (5) cooperative targeting of common downstream genes or biological processes; and (6) co-expression patterns suggestive of functional interplay. This categorization provides a novel conceptual framework that integrates disparate mechanistic insights, highlights under-explored areas, and proposes new hypotheses for future research. By synthesizing and structuring current knowledge, this review serves as a foundational resource for understanding the complex relationship between these two modifications and facilitates the identification of novel regulatory axes in epigenomic and epitranscriptomic research. creator: Jie Yang creator: Jun Liao creator: Bi-Wen Mo creator: Yan Gao creator: Yun-Xiang Chen creator: Yue Gu creator: Miao-Miao Liang creator: Hui-Min Li uri: https://doi.org/10.7717/peerj.20654 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Yang et al. title: Implications of LINC01094 for human malignancies link: https://peerj.com/articles/20621 last-modified: 2026-01-27 description: Long non-coding RNAs (lncRNAs) constitute a large class of ribonucleic acids, participating in multiple biological events within tumor cells, especially the regulation of transcription. A growing body of literature has revealed that abnormalities of lncRNA expression could result in carcinogenesis and oncogenesis by exerting inhibition or oncogenic effects. LINC01094 is a recently identified lncRNA found to be dys-regulated in an assortment of cancer tissues and control multiple biological processes via competing endogenous RNA (ceRNA) mechanisms. Specifically, LINC01094 functions as a ceRNA to modulate tumor cell growth, invasion, and migration by regulating critical signaling pathways including PI3K/AKT, PTEN/AKT, and Wnt/β-catenin, while also exerting oncogenic effects through transcriptional regulatory networks. Numerous recently published reports have shown that LINC01094 exerts critical functions during the regulation of malignant cell growth, migrating ability, and invasiveness, thereby controlling cancer cell growth and metastasis. In this review, multiple cancer biology functions of LINC01094 documented in published literature are summarized, aiming to inspire innovations in the management of human malignancies under laboratory and clinical settings. creator: Yan Wang creator: Yang Yang creator: Quanying Zhang creator: Ying Zeng creator: Yilin Cai creator: Haiqing Luo creator: Xiangyong Li uri: https://doi.org/10.7717/peerj.20621 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wang et al. title: Integrated eco-economic zoning and carbon neutrality zoning into the PLUS model to simulate land use change in the Guangdong–Hong Kong–Macao Greater Bay Area link: https://peerj.com/articles/20610 last-modified: 2026-01-27 description: Numerous studies have simulated land use dynamics in megacity regions for sustainable development and urban planning. However, many existing studies apply uniform transition rules across entire regions, ignoring the spatial heterogeneity among subregions. Guangdong–Hong Kong–Macao Greater Bay Area (GBA), one of the three typical urban agglomerations in China, witnesses increased ecological risks and carbon emissions. Aiming to strengthen environmental zoning control, we conducted partition and land use change simulation research. Taking GBA as the study area, we proposed two comprehensive partitions and compared their effects on the simulation accuracy of Patch-generating Land Use Simulation Model (PLUS). One partition was eco-economic zoning, and another was carbon neutrality zoning. The results showed that both partitioned strategies improved accuracy by more than 25% compared to the whole-region simulation. Additionally, the accuracy of the PLUS model varied in sub-partitions. The implementation of PLUS simulations based on different partitions provides a deeper understanding of the spatial differentiation mechanisms of land conversion rules, thereby supporting differentiated zoning control. creator: Mingsong Zhan creator: Yinyin Xu creator: Yue Yu creator: Chong Liu creator: Fan Wang uri: https://doi.org/10.7717/peerj.20610 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Zhan et al. title: Pet dogs prefer to work alone than to engage in a challenging cooperative task with conspecifics link: https://peerj.com/articles/20609 last-modified: 2026-01-27 description: Understanding the role of a partner is key to effective human cooperation. While we know that non-human animals extensively cooperate with each other, how well they understand the role of their partner is unclear. This has been explored using economic games, yielding mixed results. A previous study showed that dogs understand the role of their human partner in an economic game setting, adjusting their behavior according to the partner’s choices, but there are no clear results when it comes to dog conspecific cooperation. In this study, we tested pairs of pet dogs in the stag hunt game. In the typical payoff group, dogs had the option to perform a more challenging, cooperative action for a higher reward or work individually for a lower one. To test for a potential effect of motivation for the high value reward, we had a same reward group where cooperation or individual work led to the same reward. Dogs had minimal training and exposure to the contingencies of the game. Dog pairs from both groups only coordinated their choice on the cooperative action in 5% of the trials. Accordingly, we found that dogs were generally more likely to work individually, regardless of their partner’s actions and obtainable rewards. In the typical payoff group, dogs initially showed a greater tendency to cooperate during the first session, but this declined quickly, with dogs from pairs ultimately working alone. The low success on the cooperative apparatus was likely due to dogs not investing sufficient effort to find the solution by trial-and-error. This could be due to the fact that the high-quality reward was not good enough to invest that extra effort or a preference of dogs to work alone if given the choice. Overall, our results showed that dogs did not choose to cooperate with conspecifics, in contrast to their demonstrated success in interspecific contexts. We discuss how cooperation is potentially sensitive to contextual and social constraints rather than widespread. creator: Juliana Wallner Werneck Mendes creator: Giulia Cimarelli creator: Marie Vindevogel creator: Ilka van Peer creator: Gerd Ladurner creator: Friederike Range uri: https://doi.org/10.7717/peerj.20609 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Wallner Werneck Mendes et al. title: The implications of weeklong fostering and co-housing on shelter dog welfare link: https://peerj.com/articles/20608 last-modified: 2026-01-27 description: Meeting the needs of dogs in a typical animal shelter can be a challenging proposition. Negative environmental inputs, such as excessive noise, restrictive kenneling, and social isolation, contribute to the compromised welfare that dogs experience. Human-animal interaction, such as a temporary stay outside of the shelter in a caregiver’s home, has been shown to reduce dogs’ cortisol levels and increase their rest. What is less understood is if longer durations of foster care could extend those benefits. In addition, dogs living with a conspecific in the shelter, co-housing, has been even less explored, but available findings suggest that dogs’ behavior can be improved by living with another dog. In the present study, we investigated the impacts of weeklong fostering on dogs’ urinary cortisol and activity. Two animal shelters, one open and one managed admission, participated. Exclusively at the open admission facility, a smaller sub-study explored the effects of co-housing prior to foster care (i.e., with and without a dog) and following (i.e., without another dog or with a familiar or new dog) in the animal shelter. To answer these research questions, dogs’ urine was collected in the morning for cortisol: creatinine analysis and activity monitors were worn by the dogs for 17 days: five days in the animal shelter, seven days in a caregiver’s home, and five days in the shelter following foster care. In total, 84 dogs participated with 1,385 cortisol:creatinine values and 1,205 activity totals across five activity level types. At both shelters, we found dogs’ cortisol levels decreased, and they spent more time resting during weeklong fostering. Moreover, no significant differences in cortisol or activity were found pre- and post-fostering, with the exception of more time being spent in mid-intensity activity in the shelter following foster care as compared to before. These findings align with investigations of shorter durations of foster care, although the magnitude of the present intervention’s impact was greater. With regards to the type of housing dogs experienced (with or without another dog), no difference was found in dogs’ cortisol values in either the days before or after foster care with no effect on their activity detected pre-fostering; however, dogs’ activity was influenced by living with a familiar dog upon reentry to the animal shelter following foster care. Specifically, dogs rested more and engaged in less high activity, indicating a positive effect on their welfare. Lastly as has been previously observed, significant differences in cortisol and activity were found between our shelters, suggesting that environmental differences are contributing to canine welfare that require further scientific exploration. In total, a weeklong reprieve from the animal shelter, as well as co-housing with a familiar dog upon return to the shelter are two evidence-based interventions that can improve the welfare of shelter-living dogs. creator: Lisa M. Gunter creator: JoAnna M. Platzer creator: Jenifer L. Reed creator: Emily M. Blade creator: Rachel J. Gilchrist creator: Rebecca T. Barber creator: Erica N. Feuerbacher creator: Clive D.L. Wynne uri: https://doi.org/10.7717/peerj.20608 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Gunter et al. title: Mapping and modelling land degradation vulnerability in a semi-arid region: a case study from Battalgazi District, Turkiye link: https://peerj.com/articles/20606 last-modified: 2026-01-27 description: BackgroundLand degradation threatens and the provision of ecosystem services worldwide. Land degradation vulnerability (LDV) assessments still lack the necessary spatial detail and predictive accuracy, and the integration of multiple spectral indices with machine learning remains underexplored. This study addresses the critical importance of spatially mapping vulnerability to land degradation and develops a novel framework that combines advanced machine learning and uncertainty measurement with the STORIE Index Rating (SIR), a semi-quantitative method for assessing potential soil productivity. This framework aims to spatially predict the vulnerability of soils in the study area to land degradation with high accuracy.MethodsThis study addresses this gap by introducing HyStoRSM, a novel framework that integrates land-survey-derived data, remote sensing, and machine learning. This study presents a case study of the HyStoRSM framework in the Battalgazi district (940.5 km2) of Malatya province, which is representative of continental semi-arid conditions in the upper reaches of the Euphrates Basin in Eastern Anatolia. The framework integrates land survey data (major soil groups, land use capability, slope-depth combination, and erosion severity), spectral indices derived from Landsat 8 OLI/TIRS imagery, and topographic indices calculated from SRTM (Shuttle Radar Topography Mission) data. Landsat 8 and SRTM data from 2023 were processed on the Google Earth Engine platform. Local LDV scores were generated using the geometric mean form of the SIR. An extreme gradient boosting (XGBoost) regression model, optimized using Optuna, estimated continuous LDV scores, while SHapley Additive exPlanations (SHAP) provided insights into feature importance.ResultsThe optimized XGBoost regression model, with hyperparameters tuned using 5-fold cross-validation with Optuna-based hyperparameter optimization and validated on an independent 30% test dataset, achieved high prediction accuracy (R2 = 0.74, RMSE = 0.1285, MAE = 0.1002, and Huber Loss = 0.0083). SHAP analysis revealed that the length-slope factor was the most influential variable, followed by the stream power index and the Normalized Difference Vegetation Index (NDVI). These results demonstrated that hydro-topographic variables had a greater impact on LDV than spectral indices. Accordingly, an LDV map at 30 m spatial resolution was produced. Spatial analysis indicated that 21.7% and 20.3% of the study area exhibited high and very high LDV, primarily concentrated in the southern and southeastern regions. Conversely, low and very low vulnerabilities covered 16.9% and 12.4% of the area.ConclusionsThe HyStoRSM framework integrates multisource satellite data, land survey data, and advanced machine learning into a single, interpretable framework. This enables proactive, precise land degradation risk management, especially in semiarid regions where terrain and hydrologic controls drive erosion vulnerability. creator: Miraç Kılıç uri: https://doi.org/10.7717/peerj.20606 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Kılıç title: The reliability and quality analysis of health information about Helicobacter pylori on WeChat official accounts link: https://peerj.com/articles/20543 last-modified: 2026-01-27 description: Introduction Helicobacter pylori (H. pylori) has drawn considerable attention because of its high infection rate. Although WeChat Official accounts (WOAs) have become a prevalent source of public health information, the reliability and scientific validity of H. pylori-related content on the platform remain uncertain. Therefore, this study aimed to systematically evaluate the reliability and quality of health information on H. pylori disseminated through WOAs and propose evidence-based strategies for enhancing the standard of online health information.MethodsArticles containing the keywords “幽门螺杆菌” or “幽门螺旋杆菌” (Chinese for H. pylori) were retrieved from the WeChat platform. After selection, a total of 115 articles were included in this study. Subsequently, raters collectively evaluated the articles using the Journal of American Medical Association (JAMA) benchmark criteria, the modified DISCERN (mDISCERN) tool, and the Global Quality Scale (GQS). Statistical analyses were then conducted. All continuous data were described as median (interquartile range).ResultsThe median scores for JAMA, mDISCERN, and GQS across all articles were 2.00 (1.00), 3.00 (2.00), and 3.00 (2.00), respectively. Spearman correlation analysis revealed significant positive correlations between each pair of assessment tools (JAMA, mDISCERN, and GQS; P < 0.001). The Kruskal–Wallis test indicated that JAMA, mDISCERN, and GQS scores were all significantly associated with article sources (p < 0.001). Enterprise accounts contributed to the majority of articles (58.51%). Articles sourced from non-profit organizations demonstrated higher reliability and quality, whereas those from individual sources exhibited lower scores. The issues identified in the articles primarily concerned the treatment of H. pylori.ConclusionGenerally, the reliability and quality of H. pylori information found on WOAs was unsatisfactory. Users face a significant risk of exposure to misinformation. Content originating from non-profit organizations or large tertiary hospitals demonstrated strong correlations with higher reliability and quality scores. To address these challenges and enhance the credibility of online health information, concerted efforts are required. creator: Chunxi Shu creator: Xiaomin Zhang creator: Qin Zhong creator: Yin Zhu uri: https://doi.org/10.7717/peerj.20543 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Shu et al. title: The association between chronic disease resource utilization and illness uncertainty in COPD patients: a latent profile analysis link: https://peerj.com/articles/20674 last-modified: 2026-01-26 description: ObjectiveThis study aimed to identify distinct patterns of chronic disease resource utilization among patients with chronic obstructive pulmonary disease (COPD) and to examine their association with illness uncertainty.DesignA cross-sectional study.MethodsThis study enrolled COPD patients hospitalized in the Department of Respiratory Medicine at a tertiary hospital in Zhejiang Province, China, between April and December 2023. All participants completed a general information form, the Chronic Illness Resource Survey (CIRS), and the Mishel Uncertainty in Illness Scale (MUIS). Latent profile analysis (LPA) was conducted to identify subgroups of resource utilization patterns. Subsequently, hierarchical linear regression was employed to assess the associations between these patterns and illness uncertainty. Ethical approval was obtained from the Institutional Review Board of the Fourth Affiliated Hospital of Zhejiang University (Approval No. K2022057).ResultsA total of 308 participants were included. Two latent classes of resource utilization were identified: the Suboptimal Utilization Group (n = 209) and the Effective Utilization Group (n = 99). Patients in the effective utilization group reported significantly lower levels of illness uncertainty (R2 = 0.587, p < 0.001).ConclusionsDistinct patterns of chronic disease resource utilization exist among COPD patients and are significantly associated with illness uncertainty. Healthcare providers should recognize these subgroups and implement targeted interventions to enhance access to disease-related support resources, thereby mitigating illness uncertainty.ImplicationsUnderstanding COPD patients’ varying patterns of resource utilization enables healthcare professionals and related industries to deliver personalized, resource-based interventions tailored to individual needs, ultimately reducing illness-related uncertainty and improving disease management outcomes. creator: Yangjuan Bao creator: Lili Yang creator: Jing-yi Zhao creator: Zhiqian Wang creator: Leimian Fu creator: Min Fang creator: Jin’e Lin uri: https://doi.org/10.7717/peerj.20674 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Bao et al. title: Sex differences in gut microbiota composition, function, and assembly in the plateau zokor (Eospalax baileyi) link: https://peerj.com/articles/20646 last-modified: 2026-01-26 description: BackgroundGut microbiota play a vital role in nutrient metabolism, immune regulation, and host homeostasis. However, the role of sex differences in shaping the gut microbiota of plateau zokors (Eospalax baileyi) remains unclear. The present study aims to explore how sex influences the composition, function, and assembly processes of the gut microbiota in plateau zokors.MethodsIn this study, we performed Illumina 16S rRNA (V3–V4) sequencing on 15 gastrointestinal samples to assess sex-related differences in gut bacterial diversity, function, and community assembly.ResultsNo significant differences were observed in species richness or diversity between males and females; however, the gut microbial community structures differed significantly by sex (p < 0.01). At the phylum level, both sexes shared dominant phyla, including Firmicutes, Desulfobacterota, and Bacteroidota. Across both the phylum and genus levels, males and females shared the same dominant taxa, yet their relative abundances exhibited clear sex-specific differences. PICRUSt-based functional prediction indicated that the gut microbiota were mainly associated with energy metabolism, DNA repair, and cellular defense. Significant sex-related differences were detected in metabolic functions (p < 0.05), with males showing higher carbohydrate metabolism (p < 0.05), while females exhibited stronger xenobiotic biodegradation and metabolism (p < 0.05). Neutral community model (NCM) analysis showed that males (Nm = 228.21) had higher Nm values than females (Nm = 213.44), indicating greater microbial dispersal among males. Standardized neutrality score (NST) values (<0.5) indicated that deterministic processes predominantly governed community assembly in both sexes, with males exhibiting significantly lower values than females (p < 0.001). iCAMP analysis further revealed that drift and dispersal limitation were the primary assembly processes, with significant sex-related differences (p < 0.001).ConclusionSex differences markedly influence gut microbial structure, functions, and assembly processes in plateau zokors, offering new insights into the adaptive evolution of this species in cold, hypoxic environments. creator: Lei Si creator: Rui Zhang creator: Jialong Guo creator: Haijing Wang creator: Jingyan Yan creator: Daoxin Liu uri: https://doi.org/10.7717/peerj.20646 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Si et al. title: Impact of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors on intracranial atherosclerotic plaque characteristics and low density lipoprotein-cholesterol (LDL-C) reduction: a real-world observational study link: https://peerj.com/articles/20668 last-modified: 2026-01-23 description: Background and purposeThe combination of PCSK9 inhibitors and moderate statin therapy effectively stabilizes intracranial atherosclerotic plaques in patients with intracranial atherosclerotic stenosis (ICAS). This study aimed to explore the effect of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors on plaque characteristics in patients with symptomatic ICAS (sICAS) in the anterior circulation over a 6-month follow-up.MethodsThis study is a single-center, prospective, observational study, which continuously included stroke patients with sICAS in the anterior circulation. The patients were divided into two groups: the standard treatment group (atorvastatin) or the intensive treatment group (evolocumab combined with atorvastatin). The primary outcome is the change of atherosclerotic plaque characteristics over 6 months.ResultsA total of 50 patients were enrolled in this study, with 34 patients ultimately included in the analysis (15 in the standard treatment group and 19 in the intensive treatment group). Both groups succeeded in reducing low-density lipoprotein-cholesterol (LDL-C) levels, and the intensive treatment group showed a more pronounced reduction (P < 0.001). The intensive treatment group exhibited a significant improvement in the degree of stenosis (P = 0.001). Notable disparities were observed between the standard treatment group and the intensive treatment group regarding percentage change of plaque length (−85.70 vs. −1.25%, P = 0.009) and plaque volume after 6 months (265.06 vs. 125.34 mm3, P = 0.018).ConclusionCompared with statins alone, the utilization of PCSK9 inhibitors demonstrated a marked improvement in the progression of arteriosclerosis, effectively reducing stenosis degree, plaque length, and volume. creator: Zhenzhen Li creator: Xiaohui Li creator: Yiting Zhang creator: Jingwen Qi creator: Lifan Ji creator: Shuo Li creator: Mengmeng Gu creator: Yukai Liu creator: Yuqiao Zhang creator: Yanping Mei creator: Meng Wang creator: Junshan Zhou creator: Mouxiao Su creator: Lin Zhu creator: Qiwen Deng uri: https://doi.org/10.7717/peerj.20668 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Li et al. title: Antibacterial and proteomic profiling of Morus alba extract against methicillin-resistant Staphylococcus aureus link: https://peerj.com/articles/20647 last-modified: 2026-01-23 description: BackgroundAntimicrobial resistance, particularly from methicillin-resistant Staphylococcus aureus (MRSA), is a growing global health threat. Alternative therapies derived from medicinal plants are gaining attention for their potential to combat resistant pathogens. This study aimed to evaluate the antibacterial activity of Morus alba (white mulberry) extracts and investigate their action mechanisms using proteomic analysis.MethodsLeaf and stem samples of M. alba were extracted using both decoction and maceration techniques with water and ethanol as solvents. The antibacterial activity against MRSA was assessed through minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-kill assays. Chemical profiling of the most active extract was performed using liquid chromatography–quadrupole time-of-flight tandem mass spectrometry (LC-QTOF-MS/MS). Proteomic analysis was conducted to explore changes in bacterial protein expression after treatment.ResultsThe ethanol extract of M. alba stem exhibited the strongest antibacterial activity, with MIC values ranging from 0.3125 to 20 mg/mL and MBC values from 0.6250 to 40 mg/mL. A time-kill assay demonstrated that bacterial counts fell below the detection limit within 4 hours at four times the MIC concentration, based on three independent replicates. LC-QTOF-MS/MS profiling identified betulinic acid as the most abundant compound in the extract. Proteomic analysis revealed significant changes in MRSA protein expression, including upregulation of GlmU, N-acetylneuraminate lyase, and ribonuclease E, and downregulation of ribose-phosphate pyrophosphokinase and SecA. Pathway enrichment analysis suggested that the observed protein expression changes are consistent with enhanced N-acetylneuraminate catabolism and RNA polymerase activity, and suppression of protein export and fatty acid biosynthesis.DiscussionThese findings highlight the strong anti-MRSA potential of M. alba stem extract and provide mechanistic insights into its antibacterial action. The extract disrupts critical metabolic and regulatory pathways in MRSA, supporting its potential development as a novel antimicrobial agent. creator: Onrapak Reamtong creator: Thitiluck Swangsri creator: Tipparat Thiangtrongjit creator: Sompob Saralamba creator: Pakavadee Rakthong creator: Urusa Thaenkham creator: Naowarat Saralamba uri: https://doi.org/10.7717/peerj.20647 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Reamtong et al. title: High gene flow and lack of genetic structure in the commercially important crab Cancer porteri (Brachyura: Cancridae) along 1,500 km of the Chilean coast revealed by SNP markers link: https://peerj.com/articles/20727 last-modified: 2026-01-22 description: Studying the distribution of genetic diversity and connectivity patterns is crucial for understanding the ecology of marine species and informing fisheries management decisions. Despite the heterogeneity of the Chilean coast, characterized by upwelling zones and biogeographical breaks, specific benthic species display high genetic homogeneity, likely due to high migratory flow facilitated by long planktonic larval duration (PLD). In Chile, the artisanal fishery targets various crustacean species, with the crab Cancer porteri, commonly known as “Jaiba Limón” or lemon crab being one of the important species representing 17% of total brachyuran landings in the last decade. In this study, the population structure, genetic diversity, and gene flow of C. porteri were analyzed, using data from seven different sample sites along 1,500 km of the Chilean coast from two samples in 2014–2015 and five in 2023–2024. Based on variability at 3,532 single-nucleotide polymorphisms (SNPs) in 127 individuals, the results revealed stable genetic diversity in space and time, and a high effective population size, with no evidence of genetic structure among sampling sites. The results suggest that C. porteri constitutes a single large genetic population across the area between 23°37′S and 36°36′S, with high gene flow among sites in both temporal periods. This lack of genetic structure appears to result from the high gene flow among all studied locations, as observed in other cancrid species in the same area. The long PLD, high fecundity and strong offshore advection capacity may contribute to their high dispersal potential, being an important precedent for future management plans for the species, which should also be complemented with studies that better describe demographic and biological aspects of the species. creator: Juan Soto creator: Noemí Rojas-Hernández creator: Caren Vega-Retter creator: Luis Miguel Pardo creator: Carolina Parada Veliz creator: María de los Ángeles Gallardo Salamanca creator: David Veliz uri: https://doi.org/10.7717/peerj.20727 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Soto et al. title: Can increased prenatal exposure to thyroid hormones alter physiology and behaviour in the long-term? Insights from an experimental study in Japanese quails link: https://peerj.com/articles/20664 last-modified: 2026-01-22 description: Maternal thyroid hormones (triiodothyronine T3 and thyroxine T4) are important regulators of embryonic development and gene expression. In chickens, prenatal thyroid hormone treatment has been shown to influence embryonic gene expression and postnatal treatment to influence imprinting and learning. However, the potential long-term effects of maternal thyroid hormones on physiology and behaviour are unclear. This study aims to investigate the long-term effects of maternal thyroid hormones on behaviour, plasma thyroid hormone levels and brain gene expression using the Japanese quail (Coturnix japonica) as a model. Egg hormone levels were elevated by injecting unincubated eggs with either saline (control), T3, T4 or a mixture of T3 and T4. Social motivation, boldness and fearfulness to predators were tested shortly after hatching and as adults. Plasma thyroid hormone levels and pallial expression of thyroid hormone receptor A, type 2 deiodinase, and nuclear receptor coactivator 1 were measured in adulthood. We found no evidence that elevated thyroid hormone levels in eggs affected behaviour, plasma hormone levels, or gene expression in Japanese quails. This is the first study examining the potential long-term effects of elevated maternal thyroid hormones within the natural range. Although we found no evidence of long-term effects, other traits may still be affected and remain to be studied. creator: Kalle Aho creator: Antoine Stier creator: Tom Sarraude creator: Bin-Yan Hsu creator: Suvi Ruuskanen uri: https://doi.org/10.7717/peerj.20664 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Aho et al. title: Pathogens on fire: a scoping review of smoke-borne pathogen ecology in the One Health framework link: https://peerj.com/articles/20605 last-modified: 2026-01-22 description: BackgroundWildland fires are increasing in both frequency and severity in many areas globally. Smoke from wildland fires (wildfires and prescribed burns), as well as agricultural burning, releases not only pollutants but also viable microorganisms, including pathogens capable of long-distance dispersal, potentially posing unrecognized risks to human, animal, and plant health.ObjectivesThis scoping review synthesizes knowledge about pathogenic microbial dispersal in smoke from wildland fires, identifies gaps in pathogen ecology and epidemiology, and outlines research priorities in a One Health framework.MethodsThis review followed the Arksey & O’Malley framework with PRISMA-ScR guidance, using systematic searches in PubMed, Google Scholar, and grey literature sources (USDA Forest Service, World Health Organization, U.S. Environmental Protection Agency). After screening and applying inclusion criteria, 36 studies were retained that addressed microbial transport, viability, and disease associated with wildland fire smoke.ResultsThere is evidence that wildland fire smoke can aerosolize diverse microbial assemblages, including pathogenic fungi such as Coccidioides and Puccinia, and bacteria capable of forming heat-resistant spores. If microbes can remain viable in smoke across greater distances, there would be the possibility of long-distance dispersal while suspended in smoke plumes. However, data about infection outcomes, dose–response relationships, and host susceptibility are lacking. Current wildland fire smoke surveillance focuses almost exclusively on abiotic pollutants, leaving microbial risks largely ignored.ConclusionsA One Health approach integrates fire ecology, aerobiology, microbiology, and epidemiology across host species. After determining how important the role of dispersal in smoke is for human, animal, and plant health, priority actions may include improving pathogen viability sampling, incorporating microbial monitoring into smoke surveillance networks, and developing predictive models to assess health and ecological risks. creator: Ashish Adhikari creator: Nattapol Kraisitudomsook creator: Krista L. Bonfantine creator: Phinehas Lampman creator: Sam Fox creator: Jason A. Smith creator: Borna Mehrad creator: Leda N. Kobziar creator: Karen A. Garrett uri: https://doi.org/10.7717/peerj.20605 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Adhikari et al. title: Insights on the enigmatic millipede order Siphoniulida (Myriapoda, Diplopoda): a new species bearing ozopores and its phylogenetic implications link: https://peerj.com/articles/20594 last-modified: 2026-01-22 description: The millipede order Siphoniulida is one of the most enigmatic and rare groups within Diplopoda, with fewer than 10 complete specimens known from two extant species and two amber fossils. This study presents the discovery of a new species, Siphoniulus porosus sp. nov., from a tropical montane cloud forest in Veracruz, Mexico, representing the highest elevation record for the order in the New World. We obtained the first molecular data for the order, a DNA barcode sequence of the Cytochrome C Oxidase I (COI). Detailed morphological analysis using scanning electron microscopy (SEM) showed that, unlike previously described species, Siphoniulus porosus sp. nov. exhibits ozopores, challenging the current understanding that Siphoniulida lack these structures. Phylogenetic analyses using both Maximum Parsimony and Bayesian methods were conducted, including a reassessment of existing morphological data considering the presence of ozopores in Siphoniulida as the ancestral state for this character. The results suggest a phylogentic position within the subterclass Eugnatha, though relationships in this group are not resolved. This discovery indicates a potentially greater diversity of Siphoniulida in the Neotropical Region and highlights the need for further exploration of montane cloud forests to discover additional species. creator: Ernesto Recuero creator: E. Karen López-Estrada creator: Curt W. Harden uri: https://doi.org/10.7717/peerj.20594 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Recuero et al. title: Walking towards psychosocial well-being? Unveiling psychosocial impacts of a group-based walking program with and without cognitive enrichment in older adults—a mixed-methods randomized controlled trial link: https://peerj.com/articles/20569 last-modified: 2026-01-22 description: ObjectivesEvaluating the effects of a group-based cognitively enriched walking program (WALK+) and non-enriched walking program (WALK-only) on psychosocial well-being (as a secondary outcome) in community-dwelling older adults.MethodsA six-month randomized controlled trial was conducted, comparing WALK+, WALK-only and a passive control group. WALK+ and WALK-only involved two supervised group-based, and minimum one unsupervised walking session per week. Questionnaires on depressive symptoms, positive well-being, loneliness and social support measured psychosocial well-being at baseline, mid-intervention and post-intervention. Effects on these outcomes were assessed using linear mixed models with random intercepts. Self-perceived changes in psychosocial well-being were assessed post-intervention through a questionnaire and focus groups. Descriptive statistics were used for the questionnaire, and an inductive qualitative content analysis was conducted on the focus group data.ResultsNo significant intervention effects were found on depressive symptoms, positive well-being, loneliness and social support. Nevertheless, participants reported self-perceived improvements in psychological (40% of WALK+ and 56% of WALK-only participants) and social well-being (43% of WALK+ and 50% of WALK-only participants). The group sessions facilitated social connections, some lasting beyond the intervention period.ConclusionsAlthough no intervention effects were observed using standardized questionnaires, improvements in self-perceived psychosocial well-being suggest potential psychosocial benefits of WALK+ and WALK-only for older adults. creator: Pauline Hotterbeex creator: Jannique G.Z. van Uffelen creator: Julie Latomme creator: Melanie Beeckman creator: Stef Van Puyenbroeck creator: Sebastien Chastin creator: Greet Cardon uri: https://doi.org/10.7717/peerj.20569 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Hotterbeex et al. title: Composition of fish egg assemblages varies with depth on the West Florida Shelf link: https://peerj.com/articles/20498 last-modified: 2026-01-22 description: Genetic barcoding of fish eggs has furthered our knowledge of fish spawning patterns and locations, providing valuable insights for conservation and management efforts. Since fish eggs tend to behave as buoyant, passive particles, most studies collect them from surface waters and assume that this method captures eggs from all the species that have recently spawned throughout the water column. To experimentally test this assumption, we used a Multiple Opening/Closing Net and Environmental Sensing System (MOCNESS) to collect fish eggs from six depth bins within the upper 130 m of the water column at five stations on the West Florida Shelf. We used DNA barcoding to identify fish eggs collected within each depth bin to determine if the diversity of eggs recovered was consistent throughout the water column. Fish egg assemblage composition was heterogeneous throughout the water column, with most taxa only detected at one or two distinct depth bins per station, only a few taxa found at more than half the depth bins at any given station, and only a single taxon found at all depths within a single station. Disproving the hypothesis that all eggs present throughout the water column would be detected at the surface, only 19 of the 44 taxa identified in this study were observed in the samples collected from the upper 20 m. These findings suggest that exclusively sampling at the surface provides an incomplete picture of the fish assemblage spawning at a given station, which is difficult to predict due to variability in the rates of egg rise through the water column and further complicated by potential mismatches in the time of spawning relative to when collections are made, encounters with subsurface currents while rising to the surface, and the potential for denser eggs to reach neutral buoyancy at deeper isopycnals. creator: Arianna Rodriguez creator: Keith Keel creator: Glenn Zapfe creator: Kaili Qiao creator: Yonggang Liu creator: Christopher D. Stallings creator: Mya Breitbart uri: https://doi.org/10.7717/peerj.20498 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Rodriguez et al. title: Arthroscopic internal drainage of popliteal cysts using the figure-of four position: a retrospective case series link: https://peerj.com/articles/20658 last-modified: 2026-01-21 description: PurposeThis study aimed to evaluate the efficacy and safety of arthroscopic internal drainage for popliteal cysts using the figure-of-four position.MethodsBetween January 2016 and June 2024, 61 patients with symptomatic popliteal cysts underwent arthroscopic internal drainage with the knee positioned in a figure-of-four, while intra-articular lesions were managed with synovial debridement, meniscal repair/formation, and removal of loose bodies. Preoperative magnetic resonance imaging confirmed the presence of popliteal cysts and concomitant intra-articular lesions. Operation time and intraoperative blood loss were recorded. Patient satisfaction was evaluated by Rauschning-Lindgren (R-L) grade, Lysholm scale, visual analogue scale (VAS) score preoperatively and postoperatively, and popliteal cyst recurrence.ResultsAll patients underwent successful surgery without major vascular and nerve injury. The average operation time was 66.1 ± 9.0 min. The average intraoperative blood loss was 8.34 ± 1.82 ml. All patients were followed up for an average of 13.46 months (5–24 months). No knee joint infection, lower extremity thrombosis, or neurovascular bundle injury were found during follow-up. The VAS score decreased from 5.54 ± 1.19 points preoperatively to 2.75 ± 0.77 points at 1 month postoperatively (P < 0.05). The Lysholm knee score improved from 62.71 ± 4.22 points preoperatively to 89.70 ± 2.66 points at 6 months postoperatively (P < 0.05). The R-L grade of popliteal cyst symptoms showed significant improvement at 6 months postoperatively compared to the preoperative assessment (P < 0.05). Postoperative recurrence of popliteal cysts occurred in five cases without any symptoms (R-L grade 0), and the cyst volume did not increase significantly during follow-up.ConclusionArthroscopic internal drainage of popliteal cysts using the figure-of-four position is a technically feasible and safe procedure that resulted in significant clinical improvement and a low rate of asymptomatic recurrence at short-to-mid-term follow-up. The figure-of-four position appears to be a useful technical adjunct for improving access and working space in the posteromedial compartment, and warrants further investigation. creator: Zhengfeng Mei creator: Wei Ma creator: Wentao Lei creator: Guobiao Pan creator: Lingzhi Ni uri: https://doi.org/10.7717/peerj.20658 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Mei et al. title: Research advances in rumen development and regulatory mechanisms in young ruminants link: https://peerj.com/articles/20626 last-modified: 2026-01-21 description: Rumen development in young ruminants is pivotal for determining their overall growth performance and production efficiency. Here this review outlines the progression of rumen development and its primary influencing factors in young ruminants. Additionally, this review examines the potential regulatory mechanisms underlying rumen development from two critical perspectives: the GH/IGF hormonal axis and the RAP1A/GPR41-PPAR-mediated cellular signaling pathway. These findings aim to establish a robust theoretical framework for future research by interested scholars focused on optimizing feeding management strategies and developing nutritional interventions, thereby fostering healthy rumen development and enhancing efficient ruminant production. creator: Guangxu Yu creator: Duanqin Wu uri: https://doi.org/10.7717/peerj.20626 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Yu and Wu title: Predicting loss of hepatitis B surface antigen and evaluating the durability of functional cure induced by pegylated interferon alpha: insights from a real-world study link: https://peerj.com/articles/20587 last-modified: 2026-01-21 description: BackgroundThis study aims to identify the key factors influencing the loss of hepatitis B surface antigen (HBsAg) and durability of functional cure. Understanding these factors is crucial for identifying patient groups that may benefit from a pegylated interferon alpha (Peg-IFN-α) induced “functional cure” for hepatitis B, as well as for optimizing strategies to achieve and sustain HBsAg loss.MethodsThe study utilized real-world data, including 378 patients with chronic hepatitis B virus (HBV) infection who received treatment with Peg-IFN-αfor 24 weeks or longer. Patients were grouped based on their response at 24 and 48 weeks of treatment, and predictive factors for the response were calculated through regression analysis. Additionally, 195 subjects who achieved HBsAg loss were included to assess factors influencing the durability of HBsAg loss. The primary endpoint was reverse seroconversion of HBsAg (HBsAg-RS).ResultsThe findings suggest that the degree of HBsAg at baseline and HBsAg decline at 12/24 weeks of treatment is critical for predicting treatment response. Factors affecting durability include age, nucleoside treatment, baseline hepatitis B core antibody (anti-HBc) levels, the consolidation of Peg-IFN-α therapy, and hepatitis B surface antibody (anti-HBs) levels at the time of treatment discontinuation. Higher anti-HBs levels at discontinuation and higher baseline anti-HBc levels were associated with a reduced risk of HBsAg-RS. Moreover, a significant linear dose-response relationship was observed between anti-HBs levels and the risk of HBsAg-RS after HBsAg loss.ConclusionsThese results provide valuable insights for predicting responses to Peg-IFN-αtherapy and identifying high-risk groups for HBsAg-RS following HBsAg loss. This information may help refine strategies for achieving and maintaining HBsAg loss and guide post-HBsAg loss monitoring and management procedures. creator: Xin Xu creator: Jia-Quan Huang creator: Shuaiwen Huang uri: https://doi.org/10.7717/peerj.20587 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Xu et al. title: Advances in novel biomaterials for cardiovascular tissue engineering and regenerative medicine link: https://peerj.com/articles/20582 last-modified: 2026-01-21 description: Cardiovascular diseases remain a leading cause of mortality worldwide, with conventional treatments such as pharmacotherapy and surgery presenting significant limitations. In recent years, novel biomaterials have emerged as a promising avenue in cardiovascular tissue engineering and regenerative medicine, offering innovative solutions for disease treatment. This review highlights the current applications and latest advancements of these biomaterials in cardiovascular tissue engineering, emphasizing their potential to enhance myocardial regeneration, vascular repair, and heart valve replacement. Key developments in biocompatible scaffolds, bioactive hydrogels, and smart biomaterials are discussed, along with their roles in promoting cell adhesion, proliferation, and differentiation. Additionally, the review addresses the challenges associated with clinical translation, including biocompatibility, mechanical stability, and long-term efficacy. By exploring future directions, this article aims to provide insights into the transformative potential of biomaterials in revolutionizing cardiovascular therapy. creator: Wei Pan creator: Min Yu creator: Zeliang Chen uri: https://doi.org/10.7717/peerj.20582 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Pan et al. title: Nymphanthus belliflorus (Phyllanthaceae), a new species from Thailand link: https://peerj.com/articles/20559 last-modified: 2026-01-21 description: Nymphanthus belliflorus, a newly described species from the northeastern part of Thailand, is the most similar to N. chantaranothaii, N. glaucescens and N. huamotensis in having staminate flowers with four sepals bearing long-fimbriate margins and the pistillate flowers composed of 5–6 sepals with long-fimbriate margins. However, it is distinguished by its swollen stem base, young branchlets that are glabrous, disc glands of staminate flowers that are obdeltoid and yellow-reddish in color, long pedicel of pistillate flowers (3.2–4.8 cm long) and fruits (3.5–5.5 cm long). The description, distribution, ecological information and provisional conservation status are provided. creator: Piya Sukkharom creator: Pranom Chantaranothai creator: Pimwadee Pornpongrungrueng uri: https://doi.org/10.7717/peerj.20559 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Sukkharom et al. title: Characteristics and outcome of rhabdomyolysis in acute ischemic stroke patients: a 10-year retrospective study link: https://peerj.com/articles/20645 last-modified: 2026-01-20 description: IntroductionWhile acute ischemic stroke (AIS) and rhabdomyolysis (RML) have been reported to co-occur, their clinical relationship and associated outcomes remain poorly understood. This study aimed to investigate the clinical characteristics and outcomes of patients with concurrent AIS and RML.MethodsA retrospective analysis was conducted on patients admitted to the Department of Neurology from January 2014 to December 2023. The clinical and laboratory indicators, as well as the prognosis at discharge, were assessed.ResultsAmong 9,360 AIS patients, 146 with RML (CK > 1,000 U/L) were assigned to the RML group, while 146 without RML formed the control group. Patients with RML had a higher incidence of comorbidities and acute complications, including diabetes (43.15% vs. 26.03%, p = 0.002), coronary heart disease (22.60% vs. 10.96%, p = 0.008), and acute kidney injury (35.36% vs. 5.48%, p < 0.001). Poor outcome (death or discharge against medical advice, DAMA) was significantly higher in the RML group than in controls (28.77% vs. 3.42%, p < 0.001). Multivariable logistic regression identified NIHSS score > 15 (OR = 4.932, 95% CI [1.902–12.794], p = 0.001), infection (OR = 5.897, 95% CI [1.550–30.112], p = 0.033), and elevated troponin I (>0.03 ng/ml; OR = 3.384, 95% CI [1.185–9.664], p = 0.023) as independent predictors of poor outcomes. However, RML itself was not an independent predictor.ConclusionsAIS patients with RML exhibited an increased poor outcome rate. While multivariable analysis identified NIHSS score >15, infection, and elevated troponin I as independent predictors, RML was not an independent risk factor. Given the observational design and the co-occurrence with severity markers, these associations should not be interpreted as independent effects of RML. These findings pertain to in-hospital outcomes only. Post-discharge functional endpoints (e.g., 90-day modified Rankin Scale) were not available. creator: Zhen Wang creator: Bo Wang creator: Lirui Wang uri: https://doi.org/10.7717/peerj.20645 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wang et al. title: The effects of different sowing methods on the yield and quality of cereal species in forage production link: https://peerj.com/articles/20640 last-modified: 2026-01-20 description: This research compares the yield and quality of barley (Hordeum vulgare), rye (Secale cereale), triticale (×Triticosecale Wittmack), and wheat (Triticum aestivum) grown in dry conditions in winter and widely used in producing quality forage using straight and perpendicular row sowing methods. The study was conducted during the 2019–2020 and 2020–2021 growing seasons using a randomized complete block design with split plots and three replications. Cereal species were placed in the main plots, while sowing methods were assigned to the subplots. Harvesting times were determined according to the flowering stages of the cereal species. According to the two-year study results, the highest dry matter yield was obtained from rye with the straight sowing method, while the lowest yield was obtained from barley using the same method. The best results for crude protein content, digestible dry matter content, and relative feed value were observed in barley; the lowest acid detergent fiber (ADF) and neutral detergent fiber (NDF) contents were recorded in rye. When evaluated regarding sowing methods, the perpendicular rows sowing method was superior to the straight row sowing method in yield. However, no significant effect of sowing methods on quality was observed. The perpendicular rows method of triticale is recommended for producing quality and high-yield forage in arid and semi-arid regions. creator: Hakan Kır uri: https://doi.org/10.7717/peerj.20640 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Kır title: Development and validation of an early prediction model for hypertriglyceridaemic severe acute pancreatitis: a retrospective study link: https://peerj.com/articles/20607 last-modified: 2026-01-20 description: BackgroundThe incidence rate of hypertriglyceridaemic acute pancreatitis (HTG-AP) has been steadily increasing due to changes in lifestyle and dietary patterns. Moreover, HTG-AP tends to be more severe than pancreatitis caused by other aetiologies, which may be related to pancreatic steatosis (PS). However, currently, no universally accepted multifactorial clinical scoring system specifically for predicting the severity of HTG-AP exists. This study aimed to identify predictors of hypertriglyceridaemic severe acute pancreatitis (HTG-SAP) and specifically incorporated PS into a visual model for predicting HTG-SAP early.MethodsA total of 346 patients with HTG-AP were included. These patients were classified into HTG-SAP (n = 94) and hypertriglyceridaemic non-severe acute pancreatitis (HTG-NSAP, n = 252) groups. An additional 51 patients were included for prospective internal validation of the predictive model. SPSS 29.0 and R version 4.4 software programs were used for statistical data analysis and for establishing and validating the predictive model, employing various methods, including univariate analysis, binary logistic regression, calibration curve analysis, and decision curve analysis (DCA).ResultsEight variables, namely, respiratory rate (RR), D-dimer (D-D), blood urea nitrogen (BUN), serum calcium (Ca2+), potential of hydrogen (pH), and the presence of pancreatic necrosis (PN), pleural effusion (PE) and PS, were identified as independent predictors for HTG-SAP via multivariate binary logistic analysis. The AUC of the new HTG-SAP model was 0.937 (95% CI [0.908–0.966]), which was greater than those of the modified CT severity index (MCTSI), the Bedside Index for Severity in Acute Pancreatitis (BISAP) score, and the Sequential Organ Failure Assessment (SOFA) score (AUC: 0.832, 0.784, and 0.782, respectively) (P < 0.001). The calibration curve strongly aligned the predicted outcomes and the actual observations. DCA indicated that clinical intervention would be beneficial for patients who are predicted to be at risk of developing HTG-SAP.ConclusionRR; D-D, BUN, and Ca2+ levels; pH, and the presence of PN, PE, and PS are independent predictors of HTG-SAP. The prediction model developed based on these predictors highly consistent and practical for predicting HTG-SAP. creator: Yuzhi Cao creator: Wenxiu Li creator: Peng Peng creator: Jinrong Wu creator: Xiao Xiao creator: Xiaoqiang Wan creator: Cheng He creator: Chuanming Li creator: Yongchao Wang creator: Dianliang Fang uri: https://doi.org/10.7717/peerj.20607 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Cao et al. title: Phenology overshadows seed treatment and cultivar effects on fall armyworm gut microbiome following short-term feeding on rice link: https://peerj.com/articles/20458 last-modified: 2026-01-20 description: Plants mediate host susceptibility or resistance to infesting insects through various documented ways, and possibly via disrupting insect gut microbiota, an area that is underexplored in rice. The fall armyworm (FAW) (Spodoptera frugiperda (J.E. Smith) is a highly invasive herbivore that infests ∼350 host plant species, including rice (Oryza sativa L.). Exploring the impacts of chemical seed treatments on rice against FAW on the composition and attendant detoxification functionalities of the gut microbiota, as well as the subsequent effect on larval development, could inform the development of more effective management strategies. To test this, we characterized the gut microbiota of FAW 4 th instar larvae exposed to rice cultivars with and without chemical seed treatment (CruiserMaxx plus Vibrance package) at vegetative and reproductive stages for 96-hours. Results did not determine any statistically significant effects of chemical treatments and rice cultivars on larval microbiota composition. However, crop phenology (vegetative and reproductive stages) significantly impacted larval microbiota. Bacterial taxa previously implicated in FAW larval detoxification of plant secondary compounds, as well as FAW growth, and development, were uncovered across larvae. Hence, our findings highlight the importance of considering rice phenology and associated traits in developing management strategies against this highly polyphagous pest. creator: Devi Balakrishnan creator: Stephanie Cromwell creator: Paul A. Ayayee creator: Nick Bateman creator: Rupesh Kariyat uri: https://doi.org/10.7717/peerj.20458 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Balakrishnan et al. title: Genome-wide association study identifies GAK and KLF12 associated with curve severity of adolescent idiopathic scoliosis link: https://peerj.com/articles/20638 last-modified: 2026-01-19 description: BackgroundGenetic factors have been increasingly recognized as important contributors to the development and progression of adolescent idiopathic scoliosis (AIS). However, the genetic basis underlying AIS curve severity remains largely unclear. The objective of this study is to identify novel genetic variants associated with curve severity in AIS through a genome-wide association study (GWAS).MethodsIn the discovery stage, 620 female AIS patients were enrolled, including 323 with severe curves (> 40°) and 297 with mild curves (< 30°). Top single nucleotide polymorphisms (SNPs) from each locus were selected for replication in an independent cohort of 634 severe and 546 mild cases. Associations between gene expression and Cobb angle were evaluated using Spearman correlation, while correlations with myofiber–related genes were analyzed using Pearson correlation.ResultsFifteen novel SNPs showed potential association with AIS curve severity in the discovery stage (P < 1 × 10−4). Six lead SNPs were selected for replication, including rs2061846 (GAK), rs12200301 (DST), rs10820637 (SMC2/NIPSNAP3A), rs7330031 (KLF12), rs2469472 (ST8SIA5-DT), and rs738650 (SEZ6L). Among these, rs2061846 and rs7330031 were successfully replicated. For rs2061846 in GAK, the frequency of the G allele was significantly higher in the severe group (P = 0.001; OR = 1.32). For rs7330031 in KLF12, the C allele was significantly more frequent in the severe group than in the mild group (P = 0.001; OR = 1.46). Moreover, KLF12 mRNA expression in the paraspinal muscle of AIS patients was negatively correlated with Cobb angle and associated with muscle fiber–specific gene expression.ConclusionsThis study identified GAK and KLF12 as novel susceptibility genes associated with AIS curve severity, providing new insights into the genetic basis of curve progression. These findings may contribute to improved risk stratification and personalized management in AIS. creator: Zhicheng Dai creator: Zhichong Wu creator: Leilei Xu creator: Zhenhua Feng creator: Yong Qiu creator: Zezhang Zhu uri: https://doi.org/10.7717/peerj.20638 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Dai et al. title: The impact of physical activity levels and cardiorespiratory fitness on heart rate variability in overweight and obese college students: a cross-sectional study link: https://peerj.com/articles/20612 last-modified: 2026-01-19 description: ObjectiveThis study aimed to examine the impact of varying physical activity (PA) intensities on heart rate variability (HRV), to explore the relationships among cardiorespiratory fitness (CRF), body composition, and HRV, and to further characterize sex-specific HRV patterns in overweight and obese college students.MethodsA total of 184 overweight or obese college students were enrolled in this cross-sectional study. Participants were categorized into low, medium, or high intensity PA groups using the International Physical Activity Questionnaire–Short Form (IPAQ-SF). Body fat percentage and muscle mass were assessed using bioelectrical impedance analysis, while CRF was estimated from maximal oxygen uptake (VO2max) derived from a cycle ergometer test. Resting HRV indices were obtained under standardized conditions. Differences in body composition, CRF, and HRV were analyzed across groups. Multiple linear regression models were further employed to identify independent predictors of HRV.ResultsHigh-intensity PA independently predicted log(standard deviation of normal RR intervals (SDNN)) (b = 0.40, 95% CI [0.12–0.67], P = 0.005) and log(root mean square of successive differences (RMSSD)) (b = 0.48, 95% confidence interval (CI) [0.13–0.83], P = 0.007), while medium-intensity PA also showed a significant effect on log(SDNN) (b = 0.22, 95% CI [0.04–0.39], P = 0.014). Female participants exhibited higher log(high-frequency component (HFn)) (b = 0.25, 95% CI [0.11–0.39], P < 0.001) and lower log(low frequency/high frequency (LF/HF)) (b = −0.39, 95% CI [−0.62 to −0.17], P < 0.001) compared with males. VO2max was not significantly associated with most HRV indices, remaining significant only for log(SDNN) (b = 0.46, 95% CI [0.02–0.90], P = 0.042).ConclusionsMedium-to-high intensity PA independently predicted favorable HRV indices. Female students demonstrated higher HRV levels than males, suggesting sex specific. The association between PA and autonomic regulation appeared stronger than that between VO2max and HRV. creator: Meihua Su creator: Jiajing Wang creator: Fengxun Lin creator: Zange Lin creator: Jianming Chen uri: https://doi.org/10.7717/peerj.20612 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Su et al. title: Electrical impedance spectroscopy in plant cold resistance: a review link: https://peerj.com/articles/20596 last-modified: 2026-01-19 description: Low-temperature stress compromises the integrity of plant cell membranes, leading to lipid phase transitions and increased membrane permeability, which subsequently induce physiological damage. However, conventional methods for assessing cold resistance, such as relative electrolyte leakage measurement, growth recovery tests, and LT50 determination, are limited by their highly destructive nature, time-consuming procedures, or insufficient sensitivity. Electrical impedance spectroscopy (EIS), a non-destructive and efficient electrophysiological technique, has emerged as a valuable tool for evaluating cold resistance and screening cold-tolerant plant varieties. By applying multi-frequency alternating current to plant tissues and measuring the resulting impedance responses, EIS enables the extraction of key parameters such as extracellular resistance, intracellular resistance, and cell membrane capacitance. These parameters collectively reflect the structural integrity and physiological condition of cells from multiple perspectives. Notably, under low-temperature stress, plant genotypes with varying degrees of cold resistance exhibit distinct impedance spectral characteristics, allowing EIS to efficiently discriminate cold tolerance among different varieties or treatments. This review summarizes recent advances in EIS-based research on plant cold resistance, covering its underlying electrical principles, equivalent circuit models, and biophysical mechanisms. It also outlines practical applications, including the screening of cold-tolerant woody and herbaceous plants, as well as integration with traditional assessment methods, while highlighting the advantages of EIS in terms of accuracy, universality, and real-time monitoring. Furthermore, the review addresses key challenges such as species specificity, model standardization, and data analysis, and proposes future research directions, including integration with artificial intelligence, development of portable devices, and establishment of standardized stress resistance databases. creator: Zhanyu Wang creator: Shuoyu Di creator: Xinyi Zhang creator: Jia Yang creator: Chunyun Zhou creator: Xinmin Deng creator: Yu Meng creator: Luping Ma uri: https://doi.org/10.7717/peerj.20596 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Wang et al. title: Clinical outcomes with first-line tislelizumab plus lenvatinib in unresectable hepatocellular carcinoma: a retrospective analysis link: https://peerj.com/articles/20591 last-modified: 2026-01-19 description: PurposeThis retrospective analysis aimed to assess the therapeutic efficacy and adverse event profile of tislelizumab combined with lenvatinib in patients with unresectable hepatocellular carcinoma (uHCC), predominantly of hepatitis B virus (HBV) etiology. While this combination has shown promise in clinical trials, real-world data in HBV-endemic populations remain sparse.MethodsA total of 163 uHCC patients who initiated first-line systemic therapy with tislelizumab and lenvatinib between January 2021 and February 2025 were retrospectively analyzed. Treatment response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Key clinical endpoints included objective response rate (ORR), overall survival (OS), progression-free survival (PFS), disease control rate (DCR), treatment-emergent adverse events (TRAEs), and other relevant outcomes. Prognostic factors were explored through subgroup analyses and multivariate Cox proportional hazards modeling.ResultsOf the 163 patients (84.7% HBV-related), the ORR was 25.8%, DCR was 67.5%, and median PFS was 13.87 months. Additionally, 16.6% of patients achieved conversion therapy and subsequent surgical resection. Subgroup and multivariate analyses indicated that a larger tumor burden, particularly tumors ≥5 cm, was associated with shorter PFS but did not significantly affect OS. TRAEs were observed in 86% of patients, with grade ≥3 events occurring in 5%.ConclusionsThis analysis supports that tislelizumab plus lenvatinib provides substantial clinical benefit in HBV-related uHCC, including potential for conversion to surgical resection. Tumor burden emerged as a key predictor of progression. The regimen demonstrated a favorable safety profile, reinforcing its potential as a frontline treatment in HBV-endemic areas. creator: Jizong Lin creator: Qingxun Zhou creator: Zhicheng Yao creator: Qingliang Wang creator: Shilei Xu creator: Zhiyong Xiong creator: Xi Dang creator: Hao Liang creator: Bo Liu uri: https://doi.org/10.7717/peerj.20591 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Lin et al. title: The relationship between mode of delivery and Attention Deficit Hyperactivity Disorder: a meta-analysis and systematic review link: https://peerj.com/articles/20603 last-modified: 2026-01-16 description: BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder in children, with an etiology that remains incompletely understood. Recent studies have suggested that the mode of delivery, particularly cesarean section (C-section), may be associated with an increased risk of ADHD. This study aims to examine whether children born via C-section are at increased risk of developing ADHD using both cohort and case-control data.MethodsWe included observational studies (case-control or cohort) that examined the association between mode of delivery and ADHD in children. Inclusion criteria were: (a) ADHD diagnosed using standardized tools; (b) assessment of the relationship between C-section and ADHD; (c) availability of effect estimates (ORs with 95% CIs). Exclusion criteria were: (a) duplicate or overlapping data; (b) unavailable full text; (c) no extractable effect estimates. Literature searches were conducted in PubMed, Web of Science, CNKI, Wanfang, and VIP. Data were extracted using Excel and analyzed in R Studio with the meta, metabias, and metainf packages to pool the adjusted odds ratios (ORs) for the association between C-section and the occurrence of ADHD. Study quality was assessed using the Newcastle-Ottawa Scale (NOS).ResultsA total of 14 studies were included, consisting of six case-control and eight cohort studies across 10 countries in Asia, Europe, the Americas, and Australia. ADHD diagnoses were based on DSM-IV or ICD-10. Most studies adjusted for key confounders such as maternal age (57.14%), child’s sex (50.00%), and gestational factors (35.71%). The pooled ORs were 1.44 (95% CI [1.04–1.25]) for case-control studies and 1.12 (95% CI [1.10–1.15]) for cohort studies. All studies scored ≥ 7 on the NOS.ConclusionsThis meta-analysis suggests that C-section is associated with a moderately increased risk of ADHD in children. Both elective and emergency C-sections showed similar effects. However, limitations such as study heterogeneity, potential publication bias, and lack of genetic or biological mechanism data are to be acknowledged. Further research is needed to clarify causality and explore underlying mechanisms. creator: Jiali Wei creator: Zehao Zheng creator: Yao Zheng creator: Kaishan Hou creator: Xue Pan creator: Xinyu Li creator: Yue Qiu creator: Mei Han uri: https://doi.org/10.7717/peerj.20603 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wei et al. title: Effect of proprioceptive neuromuscular facilitation on pain and joint mobility in knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials link: https://peerj.com/articles/20581 last-modified: 2026-01-16 description: ObjectiveTo systematically assess the effect of proprioceptive neuromuscular facilitation (PNF), compared to control interventions or other rehabilitation techniques (RT), on pain intensity and knee active range of motion (AROM) in adults with knee osteoarthritis (KOA).MethodologyThis systematic review and meta-analysis was reported in accordance with PRISMA guidelines. A systematic search was conducted in PubMed, Embase, Web of Science, CENTRAL, CNKI, Wanfang, and VIP for studies published from database inception to August 2025. Randomized controlled trials comparing PNF with control interventions or RT were identified in adults with KOA. Primary outcomes were change in pain and change in AROM from baseline to post-intervention. Data were pooled using a random effects model, with risk of bias assessed using the Revised Cochrane risk-of-bias tool (RoB-2) and the certainty of evidence rated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.ResultsFive studies (n = 201) comparing PNF versus control and four studies (n = 202) comparing PNF versus RT were included. Meta-analysis was conducted only for comparisons between PNF and control. In addition, PNF was qualitatively compared with RT, which included soft tissue mobilization (two randomized controlled trials (RCTs)), neuromuscular exercise (one RCT), and stretching (one RCT). Compared to control interventions, PNF demonstrated significantly greater benefits in pain reduction (standardized mean difference (SMD) = −1.14, p < 0.001) and knee AROM improvement (weighted mean difference (WMD) = 10.08, p < 0.001), albeit the reduction in pain (WMD = −1.66, p < 0.001, four RCTs) did not reach the minimal clinically important difference (MCID). When compared with RT, findings for change in pain were mixed across four RCTs (one favored RT, two showed no difference, one favored PNF); for knee AROM, one favored PNF, while the other showed no difference (no pooling due to methodological heterogeneity).ConclusionsPNF appears to yield greater improvements in pain reduction and joint mobility compared to control interventions among individuals with KOA. While its efficacy relative to RT remains inconclusive, PNF shows potential as an alternative or adjunct rehabilitation approach. Further high-quality RCTs are needed to determine the effects of PNF on pain reduction and joint mobility in KOA. creator: Zihang Hu creator: Jie Dong creator: Yixian Zeng creator: Zijun He creator: Qingwei Wang creator: Qinglu Luo uri: https://doi.org/10.7717/peerj.20581 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Hu et al. title: Machine learning and radiomics for predicting therapeutic efficacy in newly diagnosed sputum-negative pulmonary tuberculosis: a retrospective study link: https://peerj.com/articles/20557 last-modified: 2026-01-16 description: BackgroundEarly assessment of tuberculosis progression and the efficacy of anti-tuberculosis drugs is crucial for improving disease cure rates. This study aimed to predict the therapeutic efficacy of newly diagnosed sputum-negative but bronchial alveolar lavage fluid (BALF)-positive pulmonary tuberculosis patients after intensive therapy.MethodsWe collected data from 255 patients (178 and 77 in center 1 and 2, respectively) diagnosed with newly diagnosed sputum-negative but BALF-positive pulmonary tuberculosis. Based on imaging and clinical follow-up results, the patients were divided into progression and improvement groups. Radiomics features were extracted from five computed tomography (CT) signs, and feature selection was performed using Pearson correlation analysis and the Least Absolute Shrinkage and Selection Operator (LASSO). Three machine learning models (random forest (RF), support vector machine (SVM), and logistic regression (LR)) were then constructed. Predictive performance was evaluated using receiver operating characteristic (ROC) curves, F1 scores, and Delong tests.ResultsA total of 118 radiomics features were used to construct three models that demonstrated good performance. In the training and test cohorts, the SVM model achieved area under the curves (AUCs) of 0.917 and 0.858, and F1 scores of 0.808 and 0.755, respectively. The RF model showed the highest predictive performance with AUCs of 0.996 and 0.824, and F1 scores of 0.982 and 0.832. The LR model achieved AUCs of 0.927 and 0.808, and F1 scores of 0.867 and 0.747.ConclusionsMachine learning models based on radiomic features extracted from various CT signs demonstrate potential for predicting the therapeutic efficacy in newly diagnosed pulmonary tuberculosis patients after intensive therapy, providing effective guidance for subsequent treatment. creator: Shanshan Sun creator: Ye Li creator: Yiyan Lu creator: Yan Lv creator: Dailun Hou creator: Liang Li uri: https://doi.org/10.7717/peerj.20557 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Sun et al. title: The dual role of activating transcription factor 4: from cellular stress sentinel to cardiovascular disease intervention link: https://peerj.com/articles/20494 last-modified: 2026-01-16 description: As the master orchestrator of integrated stress response, activating transcription factor 4 (ATF4) operates as a central molecular switch that directs cellular fate toward survival or death by regulating genes associated with oxidative stress, endoplasmic reticulum stress, apoptosis, ferroptosis and metabolism. The functional outcome of ATF4 activation is critically dependent on the context: it usually contributes to cellular adaption and survival under mild or transient stress, yet triggers cell death when stress is severe or prolonged. Dysregulation of this dichotomous function has been implicated in a variety of diseases, such as cancer, neurodegenerative disease, metabolic disease, etc., highlighting ATF4 as a potential therapeutic target. Recently, growing evidence has further underscored the dual roles of ATF4 as the guardian or executioner in cardiovascular disorders, such as coronary heart disease, cardiomyopathy, arrhythmia, valvular heart disease, heart failure and cardiovascular aging. Here in this review, we systematically decode the context-dependent opposing roles of ATF4 in cardiovascular diseases and also highlight the underlying regulatory mechanisms, thereby providing a rationale for developing context-specific therapeutic strategies targeting ATF4 for the personalized management of cardiovascular disorders. creator: Yaping Wang creator: Jie Yuan creator: Feifan Wang creator: Hong Ma uri: https://doi.org/10.7717/peerj.20494 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wang et al. title: Characteristics of rhizosphere and bulk soil microbial communities in pear trees link: https://peerj.com/articles/20627 last-modified: 2026-01-15 description: Rhizosphere bacteria play a crucial role in promoting plant health and development. A full understanding of the bacterial communities in rhizosphere soil and their relationship with those in bulk soil is important for supporting plant growth. Some beneficial bacteria are recruited to the root-zone when plants experience different stresses. However, it is unknown whether the rhizosphere of pear trees enriches some beneficial microorganisms that can resist pathogen infections in natural ecosystems. In this study, we found a higher proportion of antagonistic strains in the rhizosphere of pear trees compared to bulk soil under natural growth conditions. By deep sequencing the V3 and V4 hypervariable regions of 16S rRNA genes, we characterized the bacterial communities in the rhizosphere soil of ‘Yuluxiang’ pear trees and the adjacent bulk soil. Our analysis revealed that the diversity of the bacterial community in the rhizosphere soil was lower than that in the bulk soil, but their compositions differed between the two soil types. We found that 12 phyla, 97 families and 130 genera contributed to these differences. Proteobacteria was the dominant phylum and its relative abundance in the rhizosphere soil was significantly higher than that in the bulk soil. Notably, the two genera, Bacillus and Pseudomonas, were more abundant in the rhizosphere soil. Compared with the bulk soil, the pear rhizosphere soil existed a higher proportion of beneficial bacteria with antagonistic activities against Fusarium oxysporum. These findings indicated that the pear tree rhizosphere can selectively assemble beneficial bacteria with specific antagonistic activities to address threats from pathogens. The distinct bacterial community structure in the rhizosphere of plants reflects a spontaneous ecological adaptation mechanism of plants to their environment. creator: Jianxun Geng creator: Liang Chen creator: Xiaomin Yang creator: Lili Geng creator: Jiangyan Duan creator: Meiling Wang uri: https://doi.org/10.7717/peerj.20627 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Geng et al. title: Psychometric assessment of the Chinese version of the perceptions of palliative care instrument in advanced cancer patients: a cross-sectional study link: https://peerj.com/articles/20622 last-modified: 2026-01-15 description: BackgroundThis study aimed to validate the Chinese version of the perceptions of palliative care instrument (C-PPCI) for assessing the perceptions and needs of advanced cancer (AC) patients regarding palliative care in China.MethodsThe C-PPCI was translated following Brislin’s guidelines and tested for psychometric properties through a cross-sectional survey of 537 AC patients. Internal consistency was evaluated using Cronbach’s alpha, and test-retest reliability was assessed with the intra-class correlation coefficient (ICC). Content validity was examined with the content validity index (CVI), and construct validity was explored using exploratory factor analysis (EFA) and confirmed with confirmatory factor analysis (CFA). Concurrent validity was assessed by correlating the C-PPCI with the Edmonton symptom assessment scale (ESAS) and distress thermometer (DT).ResultsOf 537 recruited participants, 444 completed the questionnaire (response rate: 82.6%). The scale-level content validity index (S-CVI) was 0.99. The C-PPCI demonstrated strong internal consistency, with a Cronbach’s alpha of 0.852 for the total scale (subscale range: 0.820–0.872). Test-retest reliability was good, with an ICC of 0.855 for the total scale (subscale range: 0.751–0.815). EFA yielded a four-domain, nine-factor structure explaining 64% to 75% of the total variance. CFA supported this model with good fit indices (comparative fit index (CFI) = 0.917, Tucker-Lewis index (TLI) = 0.904, root mean square error of approximation (RMSEA) = 0.051, standardized root mean square residual (SRMR) = 0.072). Concurrent validity was supported by significant correlations with the ESAS and DT for most subscales.ConclusionsThe 35-item C-PPCI is a valid and reliable instrument for measuring Chinese AC patients’ perceptions and needs regarding palliative care, providing a valuable tool for clinicians to enhance palliative care (PC) utilization in this context. creator: Liping Jiang creator: Shangjin Li creator: Kaili Liu creator: Shanshan Cong creator: Shudan Zheng creator: Shaojie Zhao creator: Bing Zhang uri: https://doi.org/10.7717/peerj.20622 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Jiang et al. title: PLK1 overexpression as a dual-role biomarker and therapeutic vulnerability in pulmonary adenocarcinoma link: https://peerj.com/articles/20618 last-modified: 2026-01-15 description: BackgroundPLK1 is associated with various malignant tumors, but its correlation with lung adenocarcinoma (LUAD) remains unclear. This research seeks to explore the differences in PLK1 expression in LUAD and evaluate the relationship between PLK1 expression and the outcomes for LUAD patients.MethodsInformation on LUAD patients was sourced from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), and Genotype-Tissue Expression (GTEx). The XianTao Academic Online Platform was employed for systematic analysis of PLK1, including: (1) Wilcoxon rank-sum test to compare PLK1 expression between LUAD and normal tissues; (2) logistic regression analysis evaluating PLK1-clinicopathological feature relationships; (3) Kaplan–Meier and COX regression analyses assessing prognostic significance; (4) nomogram construction for survival prediction. Immunohistochemical (IHC) staining results from the Human Protein Atlas (HPA) validated PLK1 protein expression. Functional characterization using the XianTao platform included: (1) Analysis of PLK1-coexpressed genes using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways; (2) single-sample gene set enrichment analysis (ssGSEA) to measure immune cell infiltration in tumors with high PLK1 expression. In vitro validation included: (1) cell proliferation assessment (CCK-8 and colony formation assays); (2) apoptosis detection via Annexin V/PI staining; (3) cell cycle analysis by PI staining flow cytometry; (4) cell cycle-related protein expression evaluation using Western blotting (Cyclin B1, CDK1).ResultsPLK1 expression was significantly elevated in LUAD tumor tissues compared to adjacent normal samples across multiple cohorts. Elevated PLK1 expression was strongly associated with advanced clinicopathological stages (tumor/node/metastasis (T/N/M)) and poorer overall survival. Functional enrichment analysis revealed that genes co-expressed with PLK1 were predominantly involved in cell cycle regulatory pathways. Furthermore, transcriptomic profiling indicated a significant correlation between high PLK1 expression and an immunosuppressive tumor microenvironment. Experimental validation in A549 cells demonstrated that pharmacological inhibition of PLK1 (viaGSK461364) effectively suppressed cell proliferation, induced G2/M phase arrest, promoted apoptosis, and led to the accumulation of Cyclin B1 and CDK1 proteins.ConclusionPLK1 overexpression signifies aggressive disease and poor prognosis in LUAD, mechanistically linked to cell cycle dysregulation and an immunosuppressive microenvironment. Our findings nominate PLK1 as a promising therapeutic target and biomarker, warranting further investigation into PLK1-directed therapies. creator: Lukuan You creator: Yinmei Xu creator: Yankan Fu creator: Jianxiong Li uri: https://doi.org/10.7717/peerj.20618 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 You et al. title: Molecular characterization of early-stage multi-primary lung adenocarcinoma by transcriptome sequencing—a retrospective study link: https://peerj.com/articles/20617 last-modified: 2026-01-15 description: BackgroundTo investigate the molecular genetic features of multiple primary lung cancer (MPLC) to provide a basis and new methods for its identification, diagnosis, and treatment.MethodsTranscriptome sequencing (RNA-seq) was performed on 16 tissue samples from eight patients with synchronous multiple primary lung adenocarcinoma (sMP-LUAD) and eight tissue samples from eight patients with single primary lung adenocarcinoma (SP-LUAD). Differentially expressed genes selected by bioinformatic methods were validated in 24 sets of sMP-LUAD and SP-LUAD samples using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Based on The Cancer Genome Atlas (TCGA) database, the differentially expressed genes responsible for the biological behavior of lung adenocarcinoma and their clinical significance were analyzed.ResultsOverall, 194 differentially expressed genes were identified (P < 0.05), including 22 up-regulated and 172 down-regulated genes. Two up-regulated (DUOX1 and CACNA2D2) and three down-regulated (GPX8, COL1A2, and COL1A1) genes were selected for validation by qRT-PCR analysis. The qRT-PCR results showed that the expression of DUOX1 mRNA in the sMP-LUAD group was significantly higher (P < 0.05) than that in the SP-LUAD group; mRNA CACNA2D2, GPX8, COL1A2, and COL1A1 expression in the sMP-LUAD group was not statistically different from that in the SP-LUAD group (P > 0.05). Gene ontology (GO) enrichment analysis showed that DUOX1 mRNA was mainly enriched in the entries of positive regulation of wound healing and oxidation-reduction processes. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that DUOX1 can promote reactive oxygen species (ROS) production and be related to thyroid hormone production. Furthermore, based on the TCGA database, we analyzed the biological behavior and clinical significance of DUOX1 in lung adenocarcinoma using bioinformatics technology. DUOX1 mRNA expression was decreased in all stages and pathological subtypes of lung adenocarcinoma (P < 0.05). Immune infiltration analysis showed that DUOX1 with mast cells and eosinophils was positively correlated (P < 0.05), and Th2 cells were negatively correlated (P < 0.05). Logistic regression analysis showed that the expression of DUOX1 mRNA was significantly correlated with the patient’s age, lymph node metastasis, and pathologic stage (P < 0.05). Kaplan–Meier survival plots showed that low DUOX1 expression was not significantly correlated with OS, DSS, and PFI (P > 0.05). Univariate and multivariate COX regression analysis revealed that DUOX1 mRNA could not be used as an independent factor for predicting prognosis (P > 0.05). Therefore, we developed a predictive nomogram model combining clinicopathological variables and DUOX1 mRNA to predict the survival of patients with lung adenocarcinoma. creator: Fang Zhang creator: Guangqiang Zhao uri: https://doi.org/10.7717/peerj.20617 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Zhang and Zhao title: 4-week aerobic exercise training regulates systemic macrophage polarization in obese mice link: https://peerj.com/articles/20604 last-modified: 2026-01-15 description: BackgroundObesity is accompanied by chronic low-grade inflammation, largely driven by imbalances in macrophage polarization. While pro-inflammatory M1 macrophages accumulate in adipose tissue and circulation, contributing to insulin resistance and metabolic disruption, alternatively activated M2 macrophages exert anti-inflammatory and tissue-protective effects. Exercise is widely recognized as a non-pharmacological strategy to improve metabolic health; however, the extent to which short-term aerobic training influences systemic macrophage polarization in obesity is not fully understood. This study examined whether a 4-week aerobic exercise intervention alters systemic macrophage polarization in diet-induced obese mice and explored its role in attenuating obesity-related inflammation.MethodsMale C57BL/6J mice (8 weeks old) were fed either a standard chow diet (Ch) or a high-fat diet (HF; 60% kcal from fat) for 12 weeks. Following obesity induction, HF-fed mice were assigned to either a sedentary (HF-Sed) or exercise-trained (HF-Exe) group. The training protocol involved treadmill running at moderate intensity, performed twice daily, 5 days per week, for 4 weeks. Plasma concentrations of M1-associated markers (TNF-α, IFN-γ , IL-1β, IL-6) and M2-associated markers (IL-10, Arg1, CD163) were measured by an enzyme-linked immunosorbent assay (ELISA). Statistical differences were analyzed using analysis of variance (ANOVA) with post hoc testing.ResultsAfter 12 weeks of high-fat feeding, mice exhibited approximately 20% higher body weight than chow controls, confirming obesity induction. Four weeks of exercise training did not significantly reduce body weight but improved metabolic indices, including plasma glucose and insulin sensitivity. HF-Sed mice displayed elevated circulating M1 cytokines, whereas HF-Exe mice had significantly lower levels of IL-6, and TNF-α. Conversely, exercise enhanced M2-associated markers, including IL-10, Arg1, and CD163. Thus, aerobic training shifted systemic macrophage polarization away from a pro-inflammatory toward an anti-inflammatory profile, independent of substantial weight loss.ConclusionShort-term aerobic exercise is sufficient to promote M2 macrophage polarization and dampen systemic inflammation in obese mice. These findings underline the rapid immunomodulatory potential of exercise and support its role as an effective non-pharmacological approach to counteract obesity-related inflammation and metabolic dysfunction. creator: JingAo Qin creator: HaiBin Zhang creator: XinPeng Gao creator: Nan Zhang creator: Xin Zhang creator: Jeong-sun Ju uri: https://doi.org/10.7717/peerj.20604 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Qin et al. title: Influence of posture during mastication on body composition and nutritional intake in individuals with Down syndrome link: https://peerj.com/articles/20597 last-modified: 2026-01-15 description: IntroductionDown syndrome is associated with muscular hypotonia and feeding problems. The aim was to assess whether postural alterations during mastication had an impact on body composition, food intake and consumption.MethodsDescriptive cross-sectional study with 48 participants (8–45 years). The OMES-E protocol, anthropometric measurements of body composition and 72 h/3 days intake recording were used.ResultsA total of 35.4% of participants reported being overweight or obese. Statistically significant differences were found in body mass index (BMI) (p = 0.022) and body fat percentage (p = 0.005), both being lower in those participants with postural alteration during mastication. Likewise, a significant relationship was observed between saturated fat intake and postural alteration (p = 0.008). Vitamin D intake was lower than the recommended levels in 77.1% of the participants and vitamin E in 95.8%. Phosphorus (P), iron (Fe) and copper (Cu) were consumed in excess by more than 50% of the sample, especially among those with postural alteration during mastication (58.3%, 45.8% and 45.8%, respectively). As for the food groups, significant differences were recorded in beef consumption, with higher intake in the group with postural alteration.ConclusionsIndividuals with Down syndrome tend to present obesity and/or overweight. Those with a lower BMI and fat percentage presented postural alterations during mastication, associated with a lower overall intake than those without postural alterations. A higher intake of proteins, fats, and B-group vitamins was shown, which points to dietary behaviors that warrant closer attention due to their potential health implications. creator: Sonia Cañizares Prado creator: Jorge Molina-López creator: Maria Trinidad Moya Ruiz creator: Elena Planells uri: https://doi.org/10.7717/peerj.20597 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Cañizares Prado et al. title: Integrated transcriptomic and metabolomic analyses reveal flavonoid and lipid metabolic reprogramming in Dendrobiumofficinale during Colletotrichum fructicola-induced anthracnose link: https://peerj.com/articles/20563 last-modified: 2026-01-15 description: Anthracnose disease caused by Colletotrichum fructicola severely compromises the medicinal value and yield of Dendrobium officinale. To elucidate the host metabolic response to pathogen infection, we integrated transcriptomic and metabolomic analyses of D. officinale challenged with C. fructicola. Our results revealed a profound metabolic reprogramming orchestrated by the pathogen, characterized by upregulated flavonoid biosynthesis (e.g., DFR, LDOX activation) and enhanced lipid catabolism (e.g., β-oxidation via LACS, DECR, HACL). Metabolite profiling demonstrated a significant reduction in phosphatidylcholine (PC) and phosphatidylethanolamine (PE) alongside increased free fatty acids, indicating active lipid degradation. Notably, acyl-CoA intermediates linked lipid catabolism to flavonoid production, suggesting a metabolic axis where pathogen-induced lipid breakdown fuels defense-related secondary metabolite synthesis. This study identifies flavonoid and lipid metabolic reprogramming as critical axes in host-pathogen interactions, providing a foundation for developing targeted disease control strategies. creator: Jun Yang creator: Xinqiao Zhan creator: Yahui Zhang creator: Yichun Qian creator: Minxia Pang creator: Guoxiang Yao creator: Bizeng Mao uri: https://doi.org/10.7717/peerj.20563 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Yang et al. title: Status of financial toxicity and its influence on quality of life in patients with gynecological malignancies in China link: https://peerj.com/articles/20560 last-modified: 2026-01-15 description: BackgroundGynecological malignancies impose a substantial health and economic burden in China. The high cost of treatment often results in considerable financial toxicity, placing economic strain on patients and their families. These challenges can reduce treatment adherence, heighten emotional distress, and impair quality of life. This study aims to assess the degree of financial toxicity among patients with gynecological cancers, evaluate its impact on quality of life, and provide evidence to support the development of targeted clinical interventions to mitigate its adverse effects.MethodsA convenience sampling approach was employed to recruit 281 patients with gynecological malignancies from two hospitals in Nanjing. A cross-sectional survey was conducted between November 2022 and December 2024. Data were collected using general information questionnaires, the financial toxicity comprehensive scale, and the cancer patient quality-of-life assessment scale.ResultsData validity was confirmed using Harman’s single-factor test (first factor explanatory rate was 30.44%). The mean ± SD total financial toxicity score of the patients was 20.80 ±  7.32 points, with 73% (205/281) experiencing significant financial burdens. The financial resource dimension had the lowest mean score 3.40 ± 1.37 points. Multivariate linear regression analysis indicated that the age of children, family per capita monthly income, treatment costs in the past three months, and marital status were the core influencing factors (adjusted R2 = 0.310). The mean ± SD total quality of life score of the patients was 65.79 ± 11.39 points, and the total financial toxicity score was significantly positively correlated with quality of life (r = 0.553, P < 0.01). Participants had a mean age of 52.27 ± 10.78 years; cervical cancer accounted for the highest proportion (49.5%); 29.2% were unemployed or had resigned due to illness, and 96.8% reported medical expenses exceeding CNY 5,000 (roughly $701.50) in the past three months.ConclusionThe majority of studied patients experienced financial toxicity, with financial status, family dynamics, and widowhood being key influencing factors. creator: Lei Zhang creator: Yu Zhang creator: Sijing Chen creator: Jingjing Zhang creator: Minmin Song creator: Mingming Hu creator: Lin Liu creator: Ying Kong creator: Lingling Tang creator: Wanhong Wei creator: Zhen Hong uri: https://doi.org/10.7717/peerj.20560 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Zhang et al. title: Association between abdominal CT-based body composition parameters and early diabetic kidney disease in type 2 diabetes mellitus: a retrospective cross-sectional study link: https://peerj.com/articles/20535 last-modified: 2026-01-15 description: BackgroundEarly identification of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) remains challenging due to limitations of conventional biomarkers. Body composition analysis using computed tomography (CT) may provide novel insights into DKD risk stratification.ObjectiveTo investigate the association between abdominal CT-based body composition parameters and early diagnosis of DKD in patients with T2DM.MethodsThis retrospective cohort study enrolled 310 patients with T2DM from the Second Hospital of Ningbo between January 2020 and December 2024. Patients were stratified into the early DKD group (n = 131) and the T2DM control group without DKD (n = 179) based on the results of renal function assessment. Using Slice-O-Matic software, we measured area, index, and radiodensity of skeletal muscle and adipose tissue depots at the L3 vertebral level on abdominal CT images. Spearman correlation analysis evaluated associations between body composition parameters and renal function indicators. Univariate and multivariate logistic regression analyses identified independent risk factors for the development of early DKD. Receiver operating characteristic (ROC) curve analysis was employed to assess the predictive value of body composition parameters for early DKD.ResultsMultivariate logistic regression analysis revealed four independent risk factors of early DKD. Age (OR = 1.03, 95% CI [1.01–1.06], P = 0.044), high-sensitivity C-reactive protein (OR = 1.02, 95% CI [1.01–1.04], P = 0.005), renal sinus fat index (OR = 0.50, 95% CI [0.30–0.85], P = 0.010), and renal sinus fat density (OR = 0.79, 95% CI [0.74–0.85], P < 0.001). Multiple linear regression analysis demonstrated that renal sinus fat density maintained significant associations with both the urinary albumin-to-creatinine ratio (β = −1.88, P < 0.001) and the estimated glomerular filtration rate (β = 0.22, P = 0.017) after adjusting for confounding variables. The combined clinical-body composition model (AUC = 0.81, 95% CI [0.76–0.86]) and the body composition-only model (AUC = 0.77, 95% CI [0.72–0.82]) both demonstrated superior predictive performance compared to the clinical-only model (AUC = 0.67, 95% CI [0.61–0.73]).ConclusionsReduced renal sinus fat density is significantly associated with early DKD in T2DM patients, demonstrating potential utility as an imaging biomarker for risk stratification. These findings support the integration of CT-based body composition analysis into comprehensive DKD screening strategies. creator: Yinying Tang creator: Xinyi Cen creator: Qi Dai creator: Hai Chen creator: Jie Zhang creator: Fangfang Zhou creator: Jianjun Zheng creator: Jingfeng Zhang uri: https://doi.org/10.7717/peerj.20535 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Tang et al. title: Evaluation of the Cleveland Clinic Score for predicting acute kidney injury across different elective cardiac surgeries—a retrospective study link: https://peerj.com/articles/20533 last-modified: 2026-01-15 description: BackgroundAcute kidney injury (AKI) after cardiac surgery is a serious postoperative complication associated with an increased risk of mortality. The Cleveland Clinic Score (CCS) is one of the tools that allows preoperative assessment of the likelihood of developing AKI. However, the tool has not been validated in different types of cardiac surgery procedures. Our aim was to evaluate the CCS before different types of cardiac surgery and to assess the usefulness of this tool as a predictor of AKI.MethodsIn this retrospective study we included patients who underwent elective cardiac surgery in 2023. Our endpoint was AKI, as defined by the Kidney Diseases Improving Global Outcomes (KDIGO) criteria. The predictive value for AKI after cardiac surgery (CCS) was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC) values.ResultsA total of 610 patients underwent elective cardiac surgery. Patients with and without AKI were divided into CCS stages: stage I (57.8 vs 72.3%), stage II (36.1 vs 26.1%), stage III (5.4 vs 1.6%), stage IV (0.6 vs 0%). The AUC for all operations was 0.630 (95% CI [0.580–0.679], p < 0.001), stage I 0.428 (95% CI [0.376–0.480]; p = 0.006), stage II 0.550 (95% CI [0.498–0.602]; p = 0.057) and for stage III 0.519 (95% CI [0.467–0.572]; p = 0.464). The AUC values were significant only for coronary artery bypass grafting (CABG) 0.650 (95% CI [0.552–0.748]) and aortic valve replacement/plasty (AVR/AVP) 0.629 (95% CI [0.550–0.709]).ConclusionsThe overall CCS value showed a moderate predictive ability for AKI (AUC 0.630) and particularly useful for predicting renal replacement therapy (RRT), but for individual groups the scale should be modified by adding several new factors. creator: Mateusz Kozioł creator: Vladyslav Kyslyi creator: Dorota Sobczyk creator: Jacek Piatek creator: Janusz Konstanty-Kalandyk uri: https://doi.org/10.7717/peerj.20533 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Koziołet al. title: A survey of how biology researchers assess credibility when serving on grant and hiring committees link: https://peerj.com/articles/20502 last-modified: 2026-01-15 description: Researchers who serve on grant review and hiring committees have to make decisions about the intrinsic value of research in short periods of time, and research impact metrics such Journal Impact Factor (JIF) exert undue influence on these decisions. Initiatives such as the Coalition for Advancing Research Assessment (CoARA) and the Declaration on Research Assessment (DORA) emphasize responsible use of quantitative metrics and avoidance of journal-based impact metrics for research assessment. Further, our previous qualitative research suggested that assessing credibility, or trustworthiness, of research is important to researchers not only when they seek to inform their own research but also in the context of research assessment committees. To confirm our findings from previous interviews in quantitative terms, we surveyed 485 biology researchers who have served on committees for grant review or hiring and promotion decisions, to understand how they assess the credibility of research outputs in these contexts. We found that concepts like credibility, trustworthiness, quality, and impact lack consistent definitions and interpretations by researchers, which had already been observed in our interviews. We also found that, in our sample, assessment of credibility is very important to the majority (90%, 95% CI [87–92%]) of researchers serving in these committees but fewer than half of participants are satisfied with their ability to assess credibility. This gap between importance of an assessment and satisfaction in the ability to conduct it was reflected in multiple aspects of credibility we tested, and it was greatest for researchers seeking to assess the integrity of research (such as identifying signs of fabrication, falsification, or plagiarism), and the suitability and completeness of research methods. Non-traditional research outputs associated with open science practices—research data, code, protocols, and preprints—are particularly hard for researchers to assess, despite the potential of Open Science practices to signal trustworthiness. A substantial proportion of participants (57% [52%, 61%] of participants) report using journal reputation and JIF to assess credibility of research articles and outputs, despite journal reputation and JIF being proxies for credibility that rely on characteristics of research outputs that are extrinsic, rather than intrinsic, to the output itself. While our results only describe the practices and perspectives of our sample, they may suggest opportunities to develop better guidance and better signals to support the evaluation of research credibility and trustworthiness—and ultimately support research assessment reform, away from the use of proxies for impact and towards assessing the intrinsic characteristics and values researchers see as important. creator: Iain Hrynaszkiewicz creator: Beruria Novich creator: James Harney creator: Ross Gray creator: Veronique Kiermer uri: https://doi.org/10.7717/peerj.20502 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Hrynaszkiewicz et al. title: Influence of diurnal variations on cognitive coordination and misunderstanding in elite male handball players link: https://peerj.com/articles/20370 last-modified: 2026-01-15 description: This study examined how the time of day influences cognitive coordination in elite male handball players. We investigated misunderstandings and contradictions during cognitive exchanges to identify optimal times for shared understanding and collective performance. Six elite male handball players (age 17.5 ± 0.2 years) from Tunisia’s first division participated in simulated matches at three different time points: (10h00, 14h00, and 18h00). We analyzed cognitive coordination using audiovisual recordings and self-confrontation interviews, applying the Recognition-Primed Decision (RPD) model. Results revealed significantly higher frequencies of contradictory and misunderstanding coordination forms during morning sessions compared to afternoon and evening sessions across all cognitive components (actions, relevant cues, goals, expectations). These findings suggest that circadian factors influence team cognitive coordination, with the afternoon and evening periods being optimal for collective performance, which requires sophisticated coordination and a shared understanding. creator: Sana Essid creator: Hatem Ghouili creator: Yassine Negra creator: Tony D. Myers creator: Halil ibrahim Ceylan creator: Valentina Stefanica creator: Moktar Chtara creator: Haifa Jemili creator: Hamdi Chtourou creator: Nizar Souissi creator: Ismail Dergaa uri: https://doi.org/10.7717/peerj.20370 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Essid et al. title: Erector spinae plane block for pain management in lumbar percutaneous vertebroplasty: study protocol for a randomized controlled trial link: https://peerj.com/articles/20660 last-modified: 2026-01-14 description: BackgroundPercutaneous vertebroplasty (PVP) often causes moderate-to-severe intraoperative pain, with current local anesthesia methods providing limited relief. The erector spinae plane block (ESPB) has shown promise in regional analgesia but lacks evidence for PVP. This study aims to test the hypothesis that a preoperative bilateral ESPB provides superior intraoperative analgesia compared to local anesthetic infiltration alone in patients undergoing lumbar PVP. The primary objective is to compare the incidence of moderate-to-severe pain between the two groups.MethodsThis single-center, randomized, single-blind, parallel-group trial will enroll 66 patients undergoing lumbar PVP, who will be randomized to ESPB (20 mL 0.25% ropivacaine bilaterally) or local anesthesia (1% lidocaine). Primary outcome: incidence of moderate-to-severe pain (VAS > 3). Secondary outcomes will include maximum pain scores, patient/surgeon satisfaction, rescue analgesia, time to first mobilization, incidence of adverse events, anesthesia preparation time, and total operating-room occupancy time.DiscussionThe study aims to validate ESPB’s efficacy in PVP, potentially reducing opioid use and improving recovery. Strengths include CONSORT adherence and pragmatic outcomes, though single-center design and limited follow-up may affect generalizability.ConclusionThis trial will determine whether ESPB offers superior analgesia for PVP, guiding future pain management strategies. If proven effective, ESPB could be adopted as a key component of multimodal analgesia for vertebral augmentation, potentially leading to reduced opioid dependence, improved patient comfort, and faster recovery. The results will guide future evidence-based pain management strategies for these common procedures. creator: Ali Li creator: Yun Zhao creator: Yaru Li creator: Xuan Wang uri: https://doi.org/10.7717/peerj.20660 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Li et al. title: Passive smoking and the risk of hypertension in nonsmoking adults: a systematic review and meta-analysis link: https://peerj.com/articles/20639 last-modified: 2026-01-14 description: BackgroundPrevious studies on the association between passive smoking and hypertension are controversial. The association between these two elements remains inconclusive and requires a comprehensive meta-analysis. We conducted a systematic review and meta-analysis to explore this association.MethodsWe searched for full articles from four databases, including PubMed, Web of Science, Embase, and Cochrane databases, from 1971 until February 2025. Cross-sectional, case-control, and cohort studies examining the relationship between passive smoking exposure and the occurrence of hypertension were considered to be suitable for general analysis. Effect sizes and relevant 95% confidence intervals (CIs) were pooled and calculated.ResultsWe included 13 studies, with 783,798 nonsmoking adults being included in the pooled analysis An association between passive smoking and elevated risk of hypertension was observed in cross-sectional/case-control studies (Effect size = 1.20, 95% CI [1.08–1.34], p = 0.001, I2 = 99.1%) and in cohort studies (Effect size = 1.17, 95% CI [1.11–1.25], p < 0.001, I2 = 0%). The result was still significant for cross-sectional/case-control studies after excluding two studies based on sensitivity analysis (Effect size =1.29, 95% CI [1.08–1.54], p = 0.005, I2 = 73.5%). Subgroup analysis indicated that the increased risk was effective for both male and female populations. For the frequency and duration of secondhand smoking (SHS) exposure, only exposure ≥3 times/week (Effect size = 1.13, 95% CI [1.03–1.24], p = 0.012, I2 = 64.8%) and ≥10 years (Effect size = 1.21, 95% CI [1.13–1.29], p < 0.001, I2 = 0.0%) contributed to an increased risk of hypertension. Subgroup of hypertensive individuals defined by physical examination or self-reported diagnosis showed increased risk (Effect size = 1.15, 95% CI [1.09–1.22], p < 0.001, I2 = 28.8%), but not for those defined by a structured questionnaire.ConclusionExposure to passive smoking is significantly associated with an increased risk of hypertension in both cross-sectional/case-control and cohort studies, and for both male and female populations. Exposure ≥3 times/week and ≥10 years may have an adverse influence on hypertension. creator: Yang Song creator: Ke Du creator: Huanling Jiang uri: https://doi.org/10.7717/peerj.20639 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Song et al. title: Development of a tongue ultrasound-based predictive model for hypoxemia during painless gastroscopy in ASA I-II patients link: https://peerj.com/articles/20634 last-modified: 2026-01-14 description: BackgroundThe risk of hypoxemia in painless gastroscopy has been widely recognized, but reliable predictors are still lacking. Tongue ultrasonography has been shown to facilitate the identification of difficult airways. In this study, we hypothesize that tongue ultrasonography may predict hypoxemia during painless gastroscopy, and aim to develop a predictive model for hypoxemia based on its prognostic value.MethodsThis study included 304 patients underwent painless gastroscopy. Common and tongue ultrasound indicators were used for the prediction, including body mass index (BMI), Mallampati test score, tongue thickness (TT) and hyomental distance. Univariate and multivariate logistic regression were used to identify independent predictors of hypoxemia. Nomograms were constructed to predict hypoxemia based on the logistic regression analysis results and established risk factors documented in prior literature. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy of the nomograms. The nomogram was internally validated.ResultsBMI, Mallampati score, TT, and popofol dose were integrated for hypoxemia nomogram. The areas under the ROC curves were 0.833 (95% confidence interval (CI) [0.762–0.904]). The calibration curve and decision curve analysis of the prediction model indicated that the model could have favourable predictive ability.ConclusionNomograms based on tongue ultrasonography could be a reliable tool in predicting hypoxemia during painless gastroscopy. creator: Hao Wu creator: Xu Chen creator: Guanfeng Hou creator: Xuebing Zhang creator: Wei Zhang creator: Sheng Wang creator: Lijian Chen uri: https://doi.org/10.7717/peerj.20634 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wu et al. title: Single-inspiratory quantitative CT nomogram for enhanced PRISm and COPD differentiation: a cross-sectional study with interpretable diagnostic boundaries link: https://peerj.com/articles/20575 last-modified: 2026-01-14 description: BackgroundDifferentiating preserved ratio impaired spirometry (PRISm) from chronic obstructive pulmonary disease (COPD) is challenging. Traditional biphasic CT scans are limited by radiation exposure, while single-inspiratory CT-based deep learning lacks interpretability. This study aimed to develop a single-inspiratory quantitative computed tomography (QCT) nomogram integrating parenchymal, airway, and vascular parameters to redefine imaging definition boundaries.MethodsThis retrospective study (approved by Ethics Committee YJ-NBEY-KY-2023-107-01) screened 1,265 patients from Ningbo No. 2 Hospital (January 2021–December 2023), yielding 658 eligible participants (Normal: 135, PRISm: 328, COPD: 195) based on predefined inclusion/exclusion criteria. Single-inspiratory CT metrics (parenchymal, airway, vascular) were quantified using the Aview® system. Four logistic regression models distinguished PRISm from normal and COPD group receiver operating characteristic-area under the curve (ROC-AUC) evaluated performance.ResultsProgressive deterioration in age (COPD: 73.3 vs. PRISm: 69.1 vs. Normal: 64.1 years), male predominance (84.6% COPD vs. 57.9% PRISm), pulmonary function (FEV1%, FEV1/FVC), and CT markers (Pi10: PRISm 3.65 vs. Normal 3.26, P < 0.001) were observed. PRISm showed reduced superficial vessel diameter (AVD9: 2.64 mm vs. Normal 2.95 mm, P < 0.001). Diagnostic models achieved AUCs up to 0.984 (PRISm vs. severe COPD) and 0.853 (PRISm vs. all COPD).ConclusionThe QCT nomogram robustly differentiates PRISm from COPD, highlighting reduced superficial vessel diameter as a key biomarker. This radiation-efficient approach enables early COPD stratification via interpretable structural-functional metrics. creator: Qi Dai creator: Xiaoxiao Zhu creator: Qifeng Hua creator: Jingfeng Zhang creator: Zhaoxing Dong creator: Jianjun Zheng creator: Jingyun Shi uri: https://doi.org/10.7717/peerj.20575 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Dai et al. title: A green, fast protocol to estimate the accumulation of airborne anthropogenic microfibers in Pittosporum tobira in urban areas: effects of season and rainfall link: https://peerj.com/articles/20558 last-modified: 2026-01-14 description: Plastics represent a major organic pollutant, but research focused on their biomonitoring in the air has only recently received attention. In the present work, we investigated the ability of Pittosporum tobira leaves to distinguish different levels of air contamination due to anthropogenic microfibers (MFs) in six urban sites characterized by different land uses (industrial, urban, and green), and the effect of wet/dry season on their accumulation. Moreover, the effect of pouring rain on MFs accumulation was estimated by transplants of P. tobira. Microfiber extraction was done by tape tearing on 1 g composite leaf samples on the leaf surface. In summer, the highest number of MFs were found in the leaves from the industrial site (160), followed by urban ones (84–125), and green parks (48–54). The accumulation of MFs was overall higher in summer than in winter, due to the rain-washing effect in the latter, and the different leaf traits observed in the two seasons. The development of glandular hairs during summer could contribute to increasing the accumulation of MFs observed in this period under conditions of reduced precipitation. In agreement, when comparing MFs fallout on leaves of sheltered and unsheltered transplants after a heavy rainfall, the number counted on the latter was significantly lower, suggesting that precipitations reduce MFs deposition. These findings reinforce the suitability of Pittosporum tobira leaves as a bioindicator for airborne anthropogenic MFs. Moreover, the pronounced seasonal differences, as well as the higher MFs loads during dry summer months, indicate that monitoring sensitivity is enhanced under low-rainfall conditions. creator: Anna Gaglione creator: Angelo Granata creator: Fiore Capozzi creator: Antonio Rallo creator: Simonetta Giordano creator: Maria Cristina Sorrentino creator: Valeria Spagnuolo uri: https://doi.org/10.7717/peerj.20558 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Gaglione et al. title: Serum markers for prognostic value of EGFR-TKI in lung adenocarcinoma with bone metastases: a retrospective study link: https://peerj.com/articles/20537 last-modified: 2026-01-14 description: BackgroundLung adenocarcinoma is a prevalent malignancy. Mutations in the epidermal growth factor receptor (EGFR) have introduced novel prospects for targeted therapies. However, the status of EGFR mutations alone may be insufficient to fully predict treatment outcomes. To this end, the present research was performed to evaluate the serum markers associated with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in patients with lung adenocarcinoma and bone metastases, specifically focusing on the prognostic value of EGFR-TKI therapy.MethodsA retrospective analysis was conducted on 164 patients diagnosed with lung adenocarcinoma and bone metastases at Yunnan Cancer Hospital between January 2019 and December 2020. Clinical and follow-up data were collected, and a Cox regression model was employed to evaluate the combined predictive value of serum markers for survival outcomes.ResultsThe findings revealed that variables identified through Cox regression analysis included age, the neutrophil-to-lymphocyte ratio (NLR), carcinoembryonic antigen (CEA), and Cytokeratin 19 fragment (Cyfra21-1), all exhibiting significance levels of P < 0.05. The Cox model exhibited a c-index of 0.644, and the calibration curve demonstrated satisfactory performance, indicating the moderate predictive capacity of the model. A nomogram was subsequently constructed to visualize these results.ConclusionThis research successfully developed a nomogram based on the Cox regression model to predict prognosis and treatment outcomes in patients with lung adenocarcinoma and bone metastases undergoing EGFR-TKI therapy. This facilitates the avoidance of poor treatment outcomes by enabling individualized therapeutic approaches, thereby simplifying the development of the most appropriate treatment plans and ultimately improving patient prognosis. creator: Jiali Li creator: Shuting Wang creator: Zhiyong Deng creator: Lu Zhang creator: Min Liu creator: Yunlei Luo creator: Yunqiu Guo creator: Pengjie Liu creator: Chao Liu uri: https://doi.org/10.7717/peerj.20537 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Li et al. title: Genome-wide systematic characterization of bZIP transcription factors and their expression profiles during stem in tumorous stem mustard link: https://peerj.com/articles/20518 last-modified: 2026-01-14 description: The Basic Leucine Zipper (bZIP) proteins constitute a large family of transcription factors that play critical roles in plant growth regulation and the expression of resistance genes. However, to date, there have been few reports on the bZIP family in tumorous stem mustard (Brassica juncea var. tumida), an important vegetable crop. In this study, we identified 153 bZIP genes in tumorous stem mustard, which are unevenly distributed across 18 chromosomes and form 13 gene clusters. We systematically investigated their protein characteristics, phylogenetic relationships, gene structures, and conserved motifs. Most bZIP proteins exhibited random coil and α-helix as their predominant secondary structures. Based on RNA-Seq data from our laboratory, we analyzed the expression profiles of bZIP genes during the stem expansion of tumorous stem mustard. Furthermore, qRT-PCR analysis was performed to validate the expression of selected bZIP genes in tumorous stem mustard. The results showed that, compared with the 0 h control (25 °C untreated seedlings), five BjubZIP genes were significantly upregulated and eight were downregulated after 48 h of cold treatment, suggesting their potential involvement in temperature stress regulation in tumorous stem mustard. Under heat-treatment conditions, the transcription levels of BjubZIP111 and BjubZIP070 increased continuously over time, with expression at 48 hours significantly higher than at 12 hours. These findings provide a foundation for further functional research on bZIP genes in tumorous stem mustard, as well as for its breeding and production. Additionally, this study offers a theoretical basis for functional genomics research and the development of new cultivars of tumorous stem mustard. creator: Yuting Deng creator: Fu Li creator: Yongfang Xie creator: Jiaxin Guo creator: Jianzhong Shu creator: Rong Qin creator: Quan Sun creator: Keman Wu creator: Feibo Xu creator: Xiaohong He uri: https://doi.org/10.7717/peerj.20518 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Deng et al. title: Association between urinary incontinence and sarcopenic obesity among middle-aged and older Brazilian women link: https://peerj.com/articles/20470 last-modified: 2026-01-14 description: BackgroundUrinary incontinence (UI) is a common complaint among middle-aged and older women, associated with many negative impacts in health. The aim of this study was to analyze whether an association exists between UI and sarcopenic obesity (SO) among middle-aged and older women living in northeastern Brazil. The association of UI with sarcopenia or obesity alone was also assessed.MethodsIn a cross-sectional, analytical study, 531 women living in Santa Cruz and Parnamirim, Rio Grande do Norte state (Brazil), aged between 40 and 80 years, were assessed for the presence of UI in the last 12 months by self-reporting. Waist circumference equal to or greater than 88 cm was considered to classify obesity, while skeletal muscle mass below 5.93 kg/m2, assessed by bioelectrical impedance, classified the presence of sarcopenia. Based on these measurements, the participants were classified into four profiles: neither condition, sarcopenia, obesity, and sarcopenic obesity. Binary logistic regression investigated the association of UI with sarcopenia, obesity, and SO, adjusted for the covariates age, schooling, family income, marital status, hypertension, diabetes, parity, and menopausal status, considering p < 0.05.ResultsA total of 10.7% had no sarcopenia or obesity, 10.7% had only sarcopenia, 69.7% had only obesity and 8.9% had SO. Obesity alone was associated with a higher odss of UI compared to the group with neither conditions (OR = 1.95; p = 0.025). The associations between UI and sarcopenia alone or combined with obesity were not significant.ConclusionObesity alone was associated with UI. The results highlight the need for screening UI symptoms among women with abdominal obesity for early detection and timely interventions. creator: Caroline Nayane Alves Medeiros creator: Ingrid Guerra Azevedo creator: Sabrina Gabrielle Gomes Fernandes creator: Álvaro Campos Cavalcanti Maciel creator: Saionara M.A. Câmara uri: https://doi.org/10.7717/peerj.20470 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Medeiros et al. title: Prolonged growth and extended subadult development in the Tyrannosaurus rex species complex revealed by expanded histological sampling and statistical modeling link: https://peerj.com/articles/20469 last-modified: 2026-01-14 description: BackgroundTyrannosaurus rex, one of the most iconic non-avialan dinosaurs, remains a central focus of paleobiological research. Growth modeling suggests T. rex exceeded 8,000 kg within two decades and had a lifespan approaching 30 years. However, this understanding of T. rex growth dynamics is dependent on single-point histological sampling of multiple skeletal elements and lacks specimens encompassing the earliest growth states.MethodsWe present the most comprehensive histological analysis of Tyrannosaurus ontogeny to date, based on transverse diaphyseal sections of femora and tibiae from 17 individuals ranging from small juveniles to large adults. Four alternative statistical models were tested, differing in the treatment of cortical growth marks, including annulus-like birefringent bands visible only in cross-polarized light. Due to high intraspecies morphological variability, the taxonomic status of many Tyrannosaurus specimens is debated, prompting use of the term “Tyrannosaurus rex species complex” to describe our dataset.ResultsThe best-supported model incorporated all visible growth marks, produced the narrowest confidence bands, and indicated lower maximum growth rates and a delayed attainment of asymptotic size (~35–40 years) compared with earlier estimates. We also find that two immature specimens within the Tyrannosaurus rex species complex are not statistically compatible with the other growth series. Our approach is the first in dinosaur skeletochronology to simultaneously estimate the position of the earliest preserved growth mark across specimens, while fitting sigmoidal curves with simultaneous confidence bands. We find the inclusion of double growth marks and those visible only with cross polarized light provide better statistical model fits and this may have implications for modeling other taxa. Additionally, we find no strong link from extant vertebrates to support the idea that the growth inflection point is biologically significant and corresponds to sexual maturity. Our results suggest that the Tyrannosaurus rex species complex grew more gradually and over a longer lifespan than indicated by prior models, with a protracted period of subadult development. creator: Holly N. Woodward creator: Nathan P. Myhrvold creator: John R. Horner uri: https://doi.org/10.7717/peerj.20469 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Woodward et al. title: Phylogenetics within Camassia (Asparagaceae): examining difficult taxonomy and unusual variation using genomic restriction-site-associated DNA sequencing data link: https://peerj.com/articles/20438 last-modified: 2026-01-14 description: PremiseDiversification of Camassia (Asparagaceae) in North America has shaped variety in morphological, ecological, and reproductive traits, and resulted in a classification with ambiguity in taxon boundaries, including numerous putative subspecies. Phylogenetic analyses of restriction-site-associated DNA sequences (RADseq) allowed new insights into its evolution and taxonomy, enhancing understanding of basal relationships, geographic patterns, taxonomic boundaries, and potential new species.MethodsA total of 157 individuals in 71 populations across all 15 putative taxa of Camassia and 42 outgroup individuals in 21 populations from Hastingsia and Chlorogalum were sampled and genomic libraries were generated using the modified single-digest RADseq method known as multiplexed shotgun genotyping. Assembly in ipyrad included targeted comparisons across a range of parameters that influence homology assessment and amount of missing data, with analysis of the set of resulting datasets in RAxML and SVDquartets followed by comparison and summary across the sets of trees.Results and ConclusionsIncreasing the number of sampled loci improved phylogenetic signal despite concurrent increases in missing data. Each taxon was generally cohesive on the phylogenies, but some species and subspecies were not monophyletic. Results suggest that there was an early separation of C. howellii and C. leichtlinii from the rest of the genus during diversification. Different analysis parameters supported either a clade of both species as sister to the remainder of the genus, or C. howellii alone as sister. Relationships among all relatively deep clades within the genus were well supported. Within species, C. leichtlinii had particularly robust support for relationships compared to others in Camassia, and geographic patterns corresponding to the diversification of some subclades were resolved. The eight subspecies of C. quamash largely formed two main clades. Although most subspecies showed sufficient phylogenetic, morphological, or ecological distinctiveness to maintain recognition, we recommend synonymizing C. quamash ssp. intermedia into C. quamash ssp. maxima. Some outlier individuals of C. quamash were resolved with other species. For example, the status of C. quamash ssp. utahensis was called into question by a well-supported division placing two populations with C. cusickii. In the disjunct species complex distributed further east in North America (C. scilloides+), results confirmed at least one progenitor-derivative species pair (C. angusta arising from C. scilloides) and some evidence for a potential new taxon closely related to C. angusta. Overall, these taxa have diversified in traits that can result in genetic isolation, such as differences in flowering seasons and ecological preferences, but there also are indications of some continued gene flow among both subspecies and species. creator: Jenny K. Archibald creator: Susan R. Kephart creator: Patrick J. Monnahan creator: Kathryn E. Theiss creator: Theresa M. Culley uri: https://doi.org/10.7717/peerj.20438 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Archibald et al. title: The simple multivariable model for predicting liver fibrosis in Vietnamese male adults: a combination of Bayesian model averaging and stepwise method link: https://peerj.com/articles/20435 last-modified: 2026-01-14 description: BackgroundLiver fibrosis is a significant health burden in Vietnamese male adults, driven by high rates of hepatitis B and hepatitis C, excessive alcohol consumption, and genetic and environmental factors. Despite progress in diagnostic tools, there is a pressing need for cost-effective screening methods tailored to this high-risk group, particularly in resource-limited settings.MethodsThis study enrolled 952 Vietnamese male adults over 40 years old undergoing FibroScan, excluding those with conditions affecting test accuracy. Data on demographics, clinical history, and anthropometrics were collected, and fibrosis stages were classified using the METAVIR system. Model development combined Bayesian model averaging and forward stepwise methods, with predictive performance validated via receiver operating characteristic (ROC) analysis and area under the curve (AUC) estimation in the R environment.ResultsAmong 952 male participants, the prevalence of liver fibrosis was 19.9%, with most cases classified as mild (F1). Multivariate analysis identified significant risk factors, including advanced age (odds ratio (OR) = 1.6; 95% confidence interval (CI) [1.02–2.51]), alcohol abuse (OR = 4.44; 95% CI [2.65–7.42]), hepatitis B (OR = 6.76; 95% CI [3.14–14.54], hepatitis C (OR = 33.04; 95% CI [5.26–207.42]), family history of cirrhosis (OR = 16.14; 95% CI [3.28–79.55]), and hepatic steatosis (OR = 4.02; 95% CI [2.57–6.28]). The predictive model demonstrated good discriminative performance with an AUC of 0.769 (95% CI [0.734–0.800]) and showed satisfactory calibration through bootstrap resampling, indicating close agreement between predicted and observed risks.ConclusionThe current prevalence of liver fibrosis among Vietnamese male adults was found to be 19.9%, and the developed risk prediction model effectively identifies high-risk individuals, enabling early diagnosis and targeted prevention, particularly in resource-limited settings. However, the lack of external validation and the sample restricted to Vietnamese male adults limit the generalizability of the model, which should be further evaluated in other populations. creator: Nghia Nhu Nguyen creator: Bao The Nguyen creator: Huyen Thi Ngoc Le creator: Hoang Nhat Dang creator: Hao Minh Pham creator: Duong Dai Ngo creator: Duy Khanh Tran Nguyen creator: Tam Thai Thanh Tran creator: Hung Thanh Kim creator: Tan Ngoc Huynh Mai uri: https://doi.org/10.7717/peerj.20435 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Nguyen et al. title: Examination of factors affecting insomnia in older victims of the Kumamoto earthquake link: https://peerj.com/articles/20584 last-modified: 2026-01-13 description: ObjectivePost-disaster survivors are prone to increased risks related to mental disorders such as insomnia and depression. In addition, it has been recently noted that elderly people have difficulty falling asleep and waking up in the middle of the night, decreasing sleep efficiency. Therefore, there is a need to understand the actual situation of insomnia among the older persons affected after the earthquake and consider appropriate support. However, the actual situation after the Kumamoto earthquake in 2016 has not been clarified. Therefore, this study aimed to examine the factors affecting insomnia among the older adults affected by the Kumamoto earthquake.MethodsThe study included 4,758 persons (2,010 men and 2,748 women; mean age 75.36 ± 7.33 years) aged 65 years or older among those who had moved out of temporary housing in Kumamoto City. The survey was a self-administered questionnaire sent by mail. The independence of each variable was confirmed using the χ2 test. Binomial logistic regression analysis was used to examine factors influencing insomnia.ResultsPersons significantly more likely to report insomnia had the following characteristics: age ≥ 75, no exercise habits, not eating three times a day, no appetite, eating alone, not participating in community activities, not knowing information about community activities, no one to talk to, no family to talk to, and no coworkers to talk to. Conversely, those less likely to fall into the insomnia category had the following attributes: men, those who had no employers, those who consulted friends, those who consulted a medical institution, those who consulted a care welfare office, and those who consulted city hall. Additionally, the respondents were more likely to report insomnia when they moved out of the community.DiscussionSupport for insomnia requires both informal supports to prevent isolation based on mutual community support and formal support for those suspected of insomnia. creator: Yumie Kanamori creator: Tomonori Samiso creator: Ayako Ide-Okochi uri: https://doi.org/10.7717/peerj.20584 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Kanamori et al. title: Genetic diversity and structure of the red squat lobster (Grimothea monodon) in the Humboldt Current Ecosystem using SNP markers link: https://peerj.com/articles/20580 last-modified: 2026-01-13 description: The Humboldt Current Ecosystem (HCE) presents a wide variability of environmental and geographic conditions that play an important role in marine invertebrates, modulating variations not only in their behavior, physiology and morphology; but also changes in their patterns of genetic differentiation. Therefore, it is necessary to characterize genetic diversity and structure to develop management and conservation strategies in commercially important invertebrates such as the red squat lobster Grimothea monodon, which in the HCE presents two highly contrasting morphotypes and/or lifestyles (pelagic vs. benthic). The objective of the present study was to evaluate the diversity, structure, and genetic connectivity of the G. monodon population along the latitudinal gradient in the HCE using single nucleotide polymorphism (SNP) markers. Low heterozygosity (0.05 ± 0.1) and similar allelic richness among all studied populations (∼1.09) were observed. However, a slightly higher inbreeding was recorded in individuals from the Concepción population. At the level of genetic structure, using LEA and STRUCTURE, it is confirmed that G. monodon is a single population unit between the pelagic and benthic morphotypes, and that the difference observed in the discriminant analysis of principal components (DPCA) is due to the geographic distance (isolation by distance) between the extreme southern locations of the HCE (Constitución-Concepción: verified by Analysis of Molecular Variance (AMOVA) and Mantel test). The slight difference observed mainly in Concepción is due to inbreeding, however, this tends to be very low due to the high genetic flow explained by the prolonged development time of their planktonic larvae, which can positively influence an optimal recovery of their natural populations along the latitudinal gradient. This study emphasizes that the slight genetic differentiation of G. monodon could be due only to its wide geographic distribution range, generating only intra-population variability and not inter-population variability. This is due to the high dispersal potential of their planktonic larvae, which converges as a development trait of early ontogeny for both morphotypes and/or lifestyles of this squat lobster. creator: Marco Quispe-Machaca creator: Carlos Muñoz-Ramírez creator: Antonio Brante creator: Pepe Espinoza creator: Maximiliano Zilleruelo creator: Gabriela Torres creator: Ángel Urzúa uri: https://doi.org/10.7717/peerj.20580 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Quispe-Machaca et al. title: Independent effects of mental fatigue and drop height on drop jump performance in American football athletes: an exploration of central-peripheral interaction link: https://peerj.com/articles/20574 last-modified: 2026-01-13 description: BackgroundThis study aimed to investigate the effects of mental fatigue (MF) and different drop heights on the athletic performance of American football players executing the drop jump (DJ) movement.MethodsTwelve male American football athletes were selected as subjects. The Vicon infrared three-dimensional motion capture and analysis system, Kistler three-dimensional force platform, and other instruments were used. MF was induced through a Stroop task, and the DJ performance of the subjects was tested at drop heights of 30 cm, 40 cm, and 50 cm. A 2 × 3 repeated measures analysis of variance was employed.ResultsRegarding different jump heights, both under MF and baseline conditions, 40 cm and 50 cm heights resulted in lower jump heights compared to the 30 cm height (p = 0.002, p = 0.008); in terms of the rate of force development (RFD) metric, both under MF and baseline conditions, 40 cm and 50 cm heights showed lower RFD compared to the 30 cm height (p < 0.001); in the average power output metric, compared to the baseline, MF resulted in lower average power output across different drop heights (p < 0.001); in the reactive strength index (RSI) metric, compared to the baseline, MF resulted in lower RSI across different drop heights (p = 0.001), and compared to the 30 cm height, 40 cm and 50 cm heights showed lower RSI (p = 0.004, p = 0.008); in the Reactive Strength Ratio (RSR) metric, compared to the baseline, MF resulted in lower RSR across different drop heights (p = 0.001); in the Kleg metric, compared to the 30 cm height, 40 cm and 50 cm heights showed higher Kleg (p = 0.001, p = 0.008).ConclusionsUnder MF conditions, athletes’ performance in average power output, RSI, and RSR declined, suggesting a reduction in central nervous system efficiency. Additionally, increasing the drop height to 40 cm or above significantly reduced jump height and RFD, and increased Kleg. However, no interactive effects between MF and drop height were observed. creator: Zilong Wang creator: Ziqi Feng creator: Mengya Lu creator: Jing Sun creator: Tao Liu creator: Qiuxia Zhang creator: Xiangdong Wang uri: https://doi.org/10.7717/peerj.20574 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wang et al. title: Serum total testosterone and the prognosis of patients with advanced liver disease: a systemic review and meta-analysis link: https://peerj.com/articles/20571 last-modified: 2026-01-13 description: BackgroundAdvanced liver disease (ALD) is associated with significant morbidity and mortality worldwide. Emerging evidence suggests that sex hormonal imbalances, particularly low serum total testosterone (TT) levels, may influence the prognosis of patients with ALD. This meta-analysis aimed to evaluate the association between serum TT levels and the prognosis of patients with ALD.MethodsComprehensive searches of PubMed, Embase, and Web of Science were performed from the inception of the searched databases up to November 13, 2025, to identify observational studies assessing the association between serum TT levels and the risk of all-cause mortality or liver transplant (LT) among patients with ALD. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model to account for the potential influence of heterogeneity. This systematic review was registered in PROSPERO (CRD42024578870).ResultsEight cohort studies encompassing 1,989 patients were included in the analysis. Findings demonstrated that low serum TT levels were significantly associated with an increased risk of all-cause mortality or LT during follow-up (RR: 1.87, 95% CI [1.57–2.23], p < 0.001; I2 = 0%). Sensitivity analyses, including those limited to male patients, confirmed the stability of these results. Subgroup analyses revealed consistent associations across various study designs, geographic regions, patient ages, TT cutoff values, follow-up durations, and quality assessments (p for subgroup difference, all > 0.05).ConclusionLower serum TT levels are significantly associated with a higher risk of all-cause death or LT in patients with ALD, indicating their potential utility as prognostic biomarkers. creator: Xiao-Yu Zhang creator: Heng-Han Xu creator: Jian-Hui Ma creator: Yang Liu creator: Han Li creator: Hao-Qian Tan creator: Jun-Ying Liu uri: https://doi.org/10.7717/peerj.20571 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Zhang et al. title: Effect of planting density and harvesting date on yield and quality of Artemisia argyi link: https://peerj.com/articles/20565 last-modified: 2026-01-13 description: BackgroundField investigations revealed that during the production of Artemisia argyi Lévl. et Vant. excessive planting density and untimely harvesting lead to desiccation and abscission of leaves in the middle and lower plant sections. The height of these withered leaves (dead leaf height) accounted for over 50% of the plant height, significantly reducing both the yield and quality of the medicinal herb A. argyi leaves.MethodsThis study employed field experiments using Nanyang A. argyi as the test material. Agronomic traits (including plant height, canopy width, number of effective leaves on the main stem, dead leaf height, stem diameter, internode length, and yield) and quality indicators (including volatile oil content, moxa yield rate, eucalyptol content, borneol content, and total flavonoid content) were measured under different planting density treatments and at different harvest times.ResultsThe results demonstrated that reducing planting density promoted sturdier plant growth, increased the number of effective leaves on the main stem, decreased the dead leaf height, and increased the dry matter ratio of the A. argyi leaves. As the harvest time was delayed, the number of effective leaves on the main stem, dead leaf height, and yield all gradually increased. The volatile oil content, eucalyptol content, and borneol content in A. argyi leaves increased gradually with decreasing planting density. These same components initially increased and then decreased as the harvest time was extended. Conversely, the combustion calorific value of A. argyi down, total flavonoid content, polysaccharide content, and polyphenol content generally decreased gradually with reduced density. The combustion calorific value, total flavonoid content, and polyphenol content also exhibited an initial increase followed by a decrease with prolonged harvest time.ConclusionsComprehensive analysis of essential oil content, down yield rate, eucalyptol content, borneol content, dry matter ratio, and yield across different densities and harvest periods indicated that for spring-planted A. argyi, a planting spacing of 20 cm × 40 cm combined with harvesting one week after the Dragon Boat Festival resulted in superior overall quality and higher yield. creator: Haiyan He creator: Dandan Yang creator: Lixin Zhang creator: He Zhang creator: Chaoze Wang creator: Nayuan Yao creator: Yanyan Liu creator: Zhimin Li creator: Hongrui Zhang uri: https://doi.org/10.7717/peerj.20565 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 He et al. title: Application of the Ballroom Aerobic Test protocol for assessing performance in standard-style dancesport athletes link: https://peerj.com/articles/20556 last-modified: 2026-01-13 description: BackgroundAlthough the existing field-based tests to assess functional capacity in dancesport have been developed, most of them have been applied to ballet or contemporary dancesport athletes at the individual level, while little evidence is available for dancesport couples in standard dance disciplines. Therefore, the main purpose of this study was to examine the test-retest reliability and usefulness of the progressive Ballroom Aerobic Test (BAT) protocol for assessing aerobic performance.MethodsThirteen standard dancesport athletes (six pairs and one individual male participant; age: 20.1 ± 3.8 years; height: 175.0 ± 8.2 cm; weight: 64.3 ± 9.7 kg; males; age: 19.9 ± 3.7 years; height: 180.0 ± 4.7 cm; weight: 70.2 ± 8.7 kg; body mass index: 21.5 ± 1.8 kg/m2 training experience: 8.6 ± 5.1 years; females; age: 20.3 ± 4.0 years; height: 168.5 ± 6.5 cm; weight: 57.5 ± 5.5 kg; body mass index: 20.2 ± 1.3 kg/m2; training experience: 8.5 ± 3.4 years) took part in the study. All participants were members of certified dancesport clubs who competed at national and international levels. The BAT protocol consisted of five stages, each corresponding to one of five standard dancesport disciplines (English Waltz, Slow Foxtrot, Tango, Viennese Waltz, and Quickstep). A test-retest design, with one week between trials, was used to examine the reliability measures. Ventilatory and metabolic parameters were derived from MetaMax® 3B, a reliable and valid portable gas analyzer. Reliability measures included Cohen D effect size (ES), intra-class correlation coefficient (ICC), coefficient of variation (CV), typical error (TE) and smallest worthwhile change (SWC).ResultsNo significant differences were observed between test and retest sessions (P > 0.05). ESs ranged from trivial to small (0.00–0.47) with ‘very good’ to ‘excellent’ reliability (ICC = 0.80–0.99; CV = 1.63–4.85%). The usefulness of the BAT protocol was generally rated as ‘ok’ to ‘good’ for speed (TE = 2.76; SWC = 3.20; <), absolute VO2 (TE = 0.14; SWC = 0.15; <), respiratory exchange ratio (RER; TE = 0.02; SWC = 0.02; =), tidal volume (VT = 0.06; SWC = 0.06; =), and dead space to tidal volume ratio (VD/VT; TE = 0.01; SWC = 0.01; =).ConclusionCurrent findings suggest that the BAT protocol is a reliable and useful tool for assessing aerobic capacity in standard-style dancesport athletes. Moreover, the BAT protocol can accurately detect meaningful individual changes, particularly for speed (3.20 bpm), absolute VO2 (0.15 L*min−1), and VE (4.87 L). These results may assist athletes and strength and conditioning coaches in monitoring and tracking ‘real’ time changes to optimize the training process. creator: Tamara Despot creator: Davor Plavec uri: https://doi.org/10.7717/peerj.20556 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Despot and Plavec title: Precision mapping of mandibular canal dimensions: cone beam computed tomography insights link: https://peerj.com/articles/20553 last-modified: 2026-01-13 description: BackgroundThe purpose of this study was to provide detailed anatomical localization of the inferior alveolar canal (IAC) in the mandible area using cone beam computed tomography (CBCT) in the Saudi population, with particular considerations including buccal cortex thickness (BCT), IAC diameter, mental foramen position (MF), and buccal shift patterns of the IAC.MethodsThis retrospective split-mouth study analyzed 126 CBCT scans of 63 males and 63 females between the age group of 18 to 65 years from the faculty of Dentistry, Taibah University, Saudi Arabia. Measurements included BCT at nine points between the first premolar and third molar area, IAC diameter, the closest point of IAC to the mandibular lower border, MF position in relation to premolar apices and mandibular border, and the location of buccal shifting of the IAC. Statistics were calculated with Student’s t-test and paired t-test with the level of significance at p ≤ 0.05.ResultsBCT showed a progressive increase from anterior to posterior regions in both genders, with the thickest measurements at the second and third molar regions (maximum: 6.05 ± 1.34 mm in females). The MF position showed considerable individual variation, with 10% of female subjects exhibiting a coronal position relative to premolar apices. The IAC diameter ranged from 2.43 to 3.80 mm. The closest position of the IAC to the lower border was mostly in the second molar area, with the shortest distances being 2.50–3.40 mm. The canal primarily exhibited a buccal shift in the second molar region in 60–81.8% of the subjects.ConclusionThis study provides comprehensive anatomical mapping of the mandibular region, highlighting considerable individual variation in key anatomical parameters. The findings have significant clinical implications for various dental and maxillofacial procedures. creator: Mohamed Omar Elboraey creator: Emad El Said Fahim Essa creator: Mostafa Ibrahim Fayad creator: Albraa Badr Alolayan creator: Ahmed Mohamed Kabli creator: Abdullah Alqhtani creator: Nahla Gamaleldin Elhelbawy creator: Tarek Mohamed Ibrahim uri: https://doi.org/10.7717/peerj.20553 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Elboraey et al. title: Spatial and host-specific structuring in symbiont community composition of an endemic Hawaiian octocoral, Sarcothelia edmondsoni (Verrill 1928) link: https://peerj.com/articles/20549 last-modified: 2026-01-13 description: Coral reefs are increasingly threatened by climate-induced bleaching, yet some taxa—like the Hawaiian endemic octocoral Sarcothelia edmondsoni—exhibit notable stress tolerance. This study investigates whether distinct color morphotypes (blue and brown) of S. edmondsoni maintain stable or flexible symbiont associations that might underlie this resilience. Using high-throughput ITS2 sequencing and SymPortal analyses, we characterized Symbiodiniaceae communities across morphotypes on three Hawaiian Islands. Assemblages were overwhelmingly dominated (>99%) by Symbiodinium (Clade A), particularly S. tridacnidorum (ITS2 type A3), with blue morphotypes consistently hosting more diverse symbiont profiles. Dinoflagellate community composition varied significantly by morphotype and location, with no ITS2 profile shared across all morphotype–island combinations. Bray–Curtis analyses revealed strong ecological structuring, while UniFrac (a measure of evolutionary relatedness) indicated phylogenetic similarity, suggesting intragenomic or ecotypic divergence within a conserved lineage. Morphotype-specific associations may reflect environmental adaptation or host–symbiont specificity. The greater symbiont diversity in blue morphotypes, coupled with the lack of profile overlap among sites, points to fine-scale host–symbiont structuring shaped by local environmental conditions. These results demonstrate that Sarcothelia edmondsoni hosts morphotype- and location-specific Symbiodiniaceae communities within a conserved lineage, revealing fine-scale ecological structuring and potential symbiont ecotypes that may contribute to this species’ resilience across variable reef environments. This study supports previous findings that symbiont community structure is shaped by the combined influence of host specificity and local environmental conditions. creator: Erika M. Cabell creator: Cynthia L. Hunter uri: https://doi.org/10.7717/peerj.20549 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Cabell and Hunter title: Mapping quality of life in Norway: psychometric evaluation and network analysis of 15,148 responses from a public health study link: https://peerj.com/articles/20529 last-modified: 2026-01-13 description: BackgroundThe Norwegian Quality of Life Study (NQoLS) was established to inform public health policy by assessing self-reported health (SRH) and quality of life (QoL) outcomes across the general population, identifying factors that influence these outcomes, and highlighting vulnerable groups. In this study, we assessed the psychometric properties of the NQoLS measures and applied network analysis to explore the structural relationships among outcome variables.MethodsThe 2022 NQoLS is a cross-sectional study that included 15,148 adults from the general adult Norwegian population. No exclusion criteria were specified beyond the requirement that participants have a registered address, email, and/or phone number. The study assessed SRH and QoL through single- and multi-item measures across physical, psychological, and social domains. The psychometric evaluation included descriptive statistics, reliability testing, confirmatory factor analysis, and correlation analysis, followed by a network analysis to map how outcomes connect and cluster.ResultsMeasures generally demonstrated acceptable reliability and validity. Model fit for multi-item scales was generally adequate following minor modifications. Network analysis identified a central cluster, including the Satisfaction with life scale, Hopkins Symptom Checklist-5, and Satisfaction with psychological health. These indicators were highly connected and structurally central. In contrast, physical health variables, including Satisfaction with physical health, Pain and discomfort, and General health, were more weakly connected and positioned at the network periphery. The sensitivity analysis, stratified by language preference, yielded results consistent with those of the entire sample.ConclusionsThe NQoLS provides a foundation for mapping SRH and QoL. Most measures worked well, though a few could be fine-tuned for a better fit and sensitivity. Based on our assessment and the structure revealed by the network analysis, physical health appears to be relatively underrepresented in the current survey, suggesting a potential area for future enhancement. creator: John Roger Andersen creator: Tone Nygaard Flølo creator: Kari Hanne Gjeilo creator: Käthe Meyer creator: Tone Merete Norekvål creator: Gudrun Rohde uri: https://doi.org/10.7717/peerj.20529 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Andersen et al. title: Efficacy and safety of pyrotinib-based regimens in patients with HER2-positive stage III/IV breast cancer: a real-world retrospective study in China link: https://peerj.com/articles/20524 last-modified: 2026-01-13 description: BackgroundData from multiple clinical trials have shown that pyrotinib has demonstrated significant efficacy and acceptable tolerability in patients with HER2-positive advanced breast cancer (BC). However, the short time to market in China limits our comprehensive understanding of the drug’s long-term efficacy and potential adverse events (AEs) from the drug. Therefore, this study analyzed the clinical efficacy and safety of pyrotinib-based regimens in a real-world database.Materials and MethodsThis study retrospectively analyzed patients with HER2-positive stage III/IV BC who were treated with pyrotinib-based regimens from October 2018 to October 2022 at the Affiliated Tumor Hospital of Guangxi Medical University. Tumor assessments were based on RECIST 1.1, and AEs were assessed and graded according to NCI-CTCAE 5.0. Long-term efficacy was evaluated by calculating median progression-free survival (mPFS, defined as the time from treatment initiation until disease progression or death).ResultsOf the 37 included patients, the objective response rate (ORR) was 62.2%, the disease control rate (DCR) was 94.6%, and the median progression-free survival length was 12.0 months (95% CI [5.8 ∼18.2] months). A subgroups comparison found that significant differences were observed in patients who had not used lapatinib (P = 0.016), had a number of metastatic sites ≤ 2 (P = 0.011), were intolerant to trastuzumab (P = 0.004), and were on first-line pyrotinib treatment (P = 0.036), with these patients having median progression-free survival lengths of 13.0 months, 15.9 months, 23.5 months, and 23.5 months, respectively. Pyrotinib was also effective in patients with advanced brain metastases after multiple lines of complex therapy, with these patients having a median progression-free survival length of 5.0 months. Diarrhea was the most common adverse event (97.3%), with no grade 4 AEs observed. This study was the first to compare the relationship between different degrees of diarrhea and mPFS, and no significant differences in mPFS were observed (P = 0.291). In addition, a rare positive fecal occult blood profile (5.4%) was observed.ConclusionPyrotinib-based regimens have shown satisfactory clinical efficacy in HER2-positive stage III/IV BC patients, and pyrotinib is well tolerated with manageable adverse events. creator: Limin Zhi creator: Lei Huang creator: Xiaohong Pang creator: Qiong Wu creator: Yu Lei uri: https://doi.org/10.7717/peerj.20524 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Zhi et al. title: A non-invasive secreted protein-based gene signature for prognostic stratification and tumor microenvironment assessment in gastric cancer link: https://peerj.com/articles/20517 last-modified: 2026-01-13 description: BackgroundGastric cancer (GC) is a highly heterogeneous malignancy with poor prognosis. Current prognostic models for GC rely on invasive tissue-based high-throughput sequencing. Secreted proteins, detectable non-invasively and involved in tumor microenvironment (TME) remodeling, offer promising biomarkers. We aimed to develop a non-invasive prognostic signature based on secreted protein-coding genes (SPCGs) to stratify GC patients and predict TME characteristics.MethodsWe obtained RNA sequencing data and clinical information from 375 GC and 32 paracancerous tissue samples from The Cancer Genome Atlas Stomach Adenocarcinoma (TCGA-STAD). Differentially expressed SPCGs were identified by intersecting differentially expressed genes with 731 Human Protein Atlas (HPA) secreted protein genes. An 8-SPCG signature was constructed using univariate Cox regression and least absolute shrinkage and selection operator (LASSO) regression analyses. The model’s predictive performance was validated through Kaplan–Meier survival curves, time-dependent receiver operating characteristic (ROC) analysis, and multivariable Cox regression. A nomogram integrating risk scores and clinical parameters was developed and validated using calibration curves. Functional annotation was conducted through Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA). Tumor mutational burden (TMB) profiles and immune cell infiltration were compared between risk subgroups. The biological properties and clinical significance of SERPINE1 were validated through in vitro experiments and clinical data from our center.ResultsAn 8-SPCG signature (SERPINE1, C6, GRP, GCG, IL1F10, IGFBP1, ITIH2, and APOD) was identified and validated to predict overall survival in GC patients. The risk score derived from this signature was significantly associated with TME characteristics, including TME scores, immune cell infiltration, and immune checkpoint expression. High-risk patients exhibited an immunosuppressive microenvironment and lower TMB. Functional enrichment analysis indicated that the high-risk group was enriched in extracellular matrix-related pathways, while the low-risk group was associated with cellular metabolism and gene expression pathways. SERPINE1 was overexpressed in GC tissues, peripheral blood, and malignant effusions, and its high expression correlated with poor prognosis. In vitro experiments demonstrated that SERPINE1 promoted GC cell proliferation and invasion, and its expression was enhanced by cancer-associated fibroblasts (CAFs) through the EGF-ERBB signaling pathway.ConclusionsWe established a non-invasive 8-SPCG signature that may serve as a potential predictor for GC prognosis and TME features. SERPINE1 was identified as a promising mediator linking GC progression to CAFs interactions, supporting its further investigation as a therapeutic target. creator: Qiuxia Liu creator: Haofeng Yin creator: Ziming Wang creator: Qianlong Shen creator: Jianguo Zhao creator: Xianhe Xie uri: https://doi.org/10.7717/peerj.20517 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Liu et al. title: Snow cover mapping with Meteosat third generation FCI: initial evaluation of the European Organisation for the Exploitation of Meteorological Satellites H SAF H43 snow mask product link: https://peerj.com/articles/20495 last-modified: 2026-01-13 description: This study presents the results of the initial validation of the EUMETSAT H SAF H43 snow cover product, the first operational snow product derived from the Flexible Combined Imager (FCI) onboard Meteosat Third Generation (MTG). The evaluation, covering the period from December 2024 to February 2025, includes a direct comparison with the earlier H34 product, generated from SEVIRI observations onboard Meteosat Second Generation (MSG). Analyses were conducted over three mountainous regions—the Alps, Turkey, and Georgia—using MODIS-based reference snow cover maps and in-situ snow-depth measurements from WMO synoptic stations. As snow cover in mountainous terrain plays a critical role in hydrology and water resources management, special attention was given to high-elevation zones (above 1,000 m), where snow is seasonally persistent and detection accuracy most relevant. The evaluation employed standard accuracy metrics—Probability of Detection (POD), False Alarm Ratio (FAR), and Overall Accuracy (ACC)—to assess performance across elevation, aspect, and land-cover classes. Results indicate that H43 provides consistent yet moderate improvements over H34, with miss-rate reductions of up to 40% above 2,000 m elevation and FAR values remaining below 30% across land-cover types. These improvements are supported by the enhanced radiometric performance and 10-min temporal resolution of the FCI sensor, which enable more effective cloud detection and frequent scene refresh. Combined with its near-real-time availability, these features make H43 a promising tool for operational snow monitoring, hydrological forecasting, and early-warning applications across topographically complex regions. creator: Semih Kuter creator: Cagri Hasan Karaman creator: Mustafa Berkay Akpinar creator: Zuhal Akyurek uri: https://doi.org/10.7717/peerj.20495 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Kuter et al. title: Risk factors for systemic lupus erythematosus complicated with tuberculosis infection: meta-analyses and systematic reviews link: https://peerj.com/articles/20448 last-modified: 2026-01-13 description: BackgroundTo unravel the risk factors of systemic lupus erythematosus (SLE) complicated with tuberculosis (TB) infection through a systematic review and meta-analysis.MethodsPubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant research articles on systemic lupus erythematosus with TB infection from inception to June 12, 2024. Analyses of the data were performed with Stata 15.0.ResultsThe analysis incorporated 19 articles, comprising nine case-control and 10 cohort studies. In these studies, 1,292 patients with SLE complicated with TB infection and 5,703 SLE patients without TB infection were evaluated. The meta-analysis findings elucidated several pivotal risk factors with statistical significance: male (odds ratio (OR) = 1.32, 95% confidence interval (CI) [1.06–1.64], probability value (P) = 0.011), lymphocytopenia (OR = 2.65, 95% CI [1.98–3.55], P = 0.000), anemia (OR = 2.53, 95% CI [1.11–5.77], P = 0.001), hypoalbuminemia (OR = 3.46, 95% CI [1.26–9.50], P = 0.016), diabetes (OR = 3.05, 95% CI [1.63–5.71], P = 0.000). Results of multivariate analysis identified lymphocytopenia (OR = 2.90, 95% CI [1.89–4.45], P = 0.000), cumulative glucocorticoids dosage (OR = 4.88, 95% CI [1.85–12.91], P = 0.001), and a history of TB exposure (OR = 3.38, 95% CI [1.16–9.86], P = 0.026) as risk factors for SLE complicated with TB infection.ConclusionBased on available evidence, males, lymphocytopenia, anemia, hypoalbuminemia, diabetes, cumulative glucocorticoids dosage, and the TB exposure history are risk factors for SLE complicated with TB infection.PROSPERO registry numberCRD42024583278. creator: Xiaoyi Zhang creator: Hai Zheng creator: Peng Zhou creator: Wenfeng Hu creator: Yuxin Si creator: Xianhui Wu creator: Chen Shen uri: https://doi.org/10.7717/peerj.20448 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Zhang et al. title: Determination of the biological parameters of Nabis pseudoferus orientarius Remane, 1962 (Hemiptera: Nabidae) under laboratory conditions link: https://peerj.com/articles/20267 last-modified: 2026-01-13 description: Cotton is an important industrial crop that is used in the textile and oil industries, in animal husbandry, and has economic value. Many insect species cause damage in cotton production areas. Nabis species are important predatory insects that feed on many soft-bodied insects, larvae, and eggs found in cotton fields. In this study, some biological parameters of Nabis pseudoferus orientarius were examined under laboratory conditions with 25 ± 1 °C temperature, 65 ± 5% humidity, and 16:8 L: D conditions. In the results of working, the average egg hatching time of N. pseudoferus orientarius was found with 9.83 days, the average preadult development time was 26.85 days, and the average adult life was 62.6 days. The average preoviposition, oviposition, and postoviposition periods of N. pseudoferus orientarius were determined as 9, 58.3, and 4.8 days, respectively. A female lays an average of 446.1 (267–576) eggs throughout her life. In the study, hereditary reproductive ability (r) was determined as 9.15, the increase rate limit (λ) was 1.10, the net reproductive rate (R0) was 193.13, and the average reproductive duration (T) was 57.50. The age-specific survival rate (lx) was calculated as 4.35, the age- and period-specific survival rate (Sxj) was calculated as 80.30, and the age-specific reproduction rate (mx) was calculated as 14. creator: Muhlis Sezgin creator: Selime Olmez Bayhan creator: Erol Bayhan uri: https://doi.org/10.7717/peerj.20267 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Sezgin et al. title: Past and present genetic structure of the tropical rainforest palm Astrocaryum mexicanum: effects of anthropogenic fragmentation link: https://peerj.com/articles/19784 last-modified: 2026-01-13 description: To assess whether fragmentation of the lowland rainforest of Los Tuxtlas natural reserve has altered the genetic structure of understory palm Astrocaryum mexicanum, we analyzed populations from undisturbed forest and forest fragments. The questions that this study addressed were: Has habitat fragmentation reduced gene flow and within-population genetic variation (allele loss)? Has this process, in turn, increased population genetic differentiation of populations in fragments? We expected that reduced population sizes and gene flow, in fragments, has increased the effects of genetic drift, thus affecting genetic structure. The design of the study allows control for pre-fragmentation genetic structure, a common criticism against fragmentation studies, and addresses this question for a community-level important palm tree species of the tropical rain forests of southern Mexico. We sampled two cohorts (i.e., pre- and post-fragmentation palms) in each of eight populations (thirty individuals per cohort or generation, and a separation of four to nine km between populations), one composed by adult palms (80–140 years old), and the other of seedlings <3 years old. We estimated RST, inbreeding coefficient, number of alleles, heterozygosity, linkage disequilibrium, and number of migrants per generation, using variation at eight novel microsatellite loci, developed ex profeso for this study. Results indicate lack of differentiation between population pairs, and most genetic variation exists within subpopulations, implying high historical connectivity. Fragments were not genetically distinct from continuous forest populations. Simulations suggest a severe effective population size reduction at the outset of the Last Glacial Maximum 26,000 YBP, after which the area was recolonized by individuals from Central America. It is possible that the number of reproductive events that have passed since the onset of fragmentation has been insufficient to detect an effect on genetic variation, or that the extant number of palm trees in fragments is high enough to maintain the genetic diversity; bottleneck simulations agree with the first explanation. Notwithstanding, evidence suggests that populations in fragments face harsher environmental conditions, selecting against homozygotes, a situation that can jeopardize their persistence in fragments if population size is too small. creator: Jorge O. Juárez-Ramírez creator: Juan Núñez-Farfán uri: https://doi.org/10.7717/peerj.19784 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Juárez-Ramírez and Núñez-Farfán title: Determinants of subclinical leprosy among household contacts in Indonesia: serological and socio-demographic factors link: https://peerj.com/articles/20631 last-modified: 2026-01-12 description: BackgroundLeprosy remains a public health challenge in Indonesia, which ranks third globally after India and Brazil. Subclinical infection among household contacts contributes to ongoing transmission, as individuals infected with Mycobacterium leprae (M. leprae) without symptoms may serve as undetected reservoirs. This study investigated serological and sociodemographic determinants associated with subclinical M. leprae infection among household contacts of leprosy patients in Tangerang, Indonesia.MethodsA cross-sectional study was conducted in 2020 among 320 household contacts of confirmed leprosy index cases recruited through purposive sampling. Anti-Phenolic Glycolipid-1 (PGL-1) IgM antibodies were detected using an in-house enzyme-linked immunosorbent assay (ELISA). Bivariate analysis using Chi-square and t-tests assessed preliminary associations, and multivariate logistic regression was applied to identify independent predictors of seropositivity, adjusting for potential confounders.ResultsOverall, 43.8% of household contacts were seropositive for anti-PGL-1 IgM antibodies. Multivariate analysis revealed that a history of Bacille Calmette-Guerin (BCG) vaccination was associated with significantly lower odds of seropositivity (adjusted OR = 0.514; 95% CI [0.291–0.907]; p = 0.018), while the presence of a visible BCG scar was associated with nearly twofold higher odds (adjusted OR = 1.953; 95% CI [1.117–3.415]; p = 0.024). No significant associations were found between sociodemographic factors such as age, sex, or contact duration, and seropositivity.ConclusionBCG vaccination status and visible BCG scars were key determinants of anti-PGL-1 seropositivity, suggesting complex interactions between vaccination, immune response, and exposure to M. leprae. The study highlights the protective role of BCG-induced immunity while emphasizing the need for standardized scar assessment and continuous surveillance of household contacts. Although limited by its cross-sectional and purposive design, the integration of immunological and epidemiological data represents a strength, providing evidence to support Indonesia’s Zero Leprosy 2030 control strategy. creator: Khariri Khariri creator: Sunarno Sunarno creator: Novaria Sari Dewi Panjaitan creator: Putu Yuliandari creator: Sarwo Handayani creator: Rita Marleta Dewi creator: Nastiti Intan Permata Sari creator: Fitriana Fitriana creator: Agriani Dini Pasiana creator: Ina Kusrini creator: Edwin Nugroho Njoto uri: https://doi.org/10.7717/peerj.20631 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Khariri et al. title: Serum osmolarity as a predictor of mortality in ICU COVID-19 patients: a retrospective analysis link: https://peerj.com/articles/20590 last-modified: 2026-01-12 description: BackgroundSerum osmolarity, reflecting fluid and electrolyte balance, may serve as a prognostic marker in critically ill patients, but its role in COVID-19 is not well established. This study evaluated the association between admission serum osmolarity and in-hospital mortality in critically ill COVID-19 patients.MethodsWe conducted a retrospective study including 267 critically ill COVID-19 patients admitted from the ED to the ICU of a tertiary-care hospital between March 2020 and April 2022. Data on demographics, thoracic computed tomography (CT) findings, vasopressor use, ventilation support, laboratory values, and in-hospital mortality were obtained. Serum osmolarity was calculated using the formula. The primary outcome was in-hospital mortality; secondary outcomes included vasopressor use, endotracheal intubation (ETI), and laboratory parameters. Statistical analyses included Mann–Whitney U and chi-square tests, logistic regression, and receiver operating characteristic (ROC) curve analysis.ResultsOf 267 patients, 203 were non-survivors and 64 survivors (mortality 76%); mean age was 53.8 ± 12.3 years, 59.6% male. Survivors had higher median serum osmolarity (288.37 vs. 285.75 mOsm/L, p = 0.034) and sodium (Na) (135 vs. 133 mEq/L, p = 0.004). Sodium demonstrated slightly superior discrimination (AUC = 0.620) compared to osmolarity (area under the curve (AUC) = 0.588). In multivariate logistic regression, serum sodium (OR = 0.89, 95% CI 0.82–0.97), inotropic agent use (OR = 3.73, 95% CI [1.65–8.42]), and endotracheal intubation (OR = 5.20, 95% CI [2.11–12.84]) were independent predictors of mortality. The model’s c-statistic was 0.713 (95% CI [0.654–0.771]) with 70.4% sensitivity and 65.8% specificity.ConclusionsLower admission serum osmolarity and hyponatremia were independently associated with increased in-hospital mortality in critically ill COVID-19 patients. Although Na slightly outperformed calculated osmolarity, the latter remains a practical, integrative prognostic tool for early risk stratification. Prospective studies should evaluate whether timely correction of hypo-osmolar or hyponatremic states improves outcomes. creator: Mehmet Toptas creator: Özlem Dikme creator: Ozgur Dikme creator: Abdurrahman Tünay creator: Mensure Yilmaz Cakirgoz creator: İbrahim Akkoç uri: https://doi.org/10.7717/peerj.20590 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Toptas et al. title: A new defoliating threat to eucalyptus plantations: biology and foliar consumption of Physocleora dukinfeldia (Lepidoptera: Geometridae) link: https://peerj.com/articles/20589 last-modified: 2026-01-12 description: The defoliator Physocleora dukinfeldia Schaus 1897 (Lepidoptera: Geometridae) was recently reported attacking Eucalyptus urograndis (Myrtaceae) plantations in Brazil, raising concerns about its potential impact on commercial forestry. In this context, early characterization of pest biology plays a critical role in understanding host-use patterns and forecasting potential impacts on forest ecosystems. This study aimed to characterize the biology and foliar consumption of P. dukinfeldia on E. urograndis and its native host, Schinus terebinthifolia (Anacardiaceae), by recording molting, mortality, pupation, and emergence of imago, measuring larval head capsule width, pupal weight, and size, and calculating stage duration and viability under controlled conditions. The insect completed its life cycle on both host plants, with significantly longer development time and reduced pupal viability observed on E. urograndis. Although larval survival was low on both host species, nearly one-third of the individuals successfully reached adulthood. No significant differences in leaf consumption were detected between the two eucalyptus species evaluated in this study. These findings indicate that P. dukinfeldia has the biological capacity to adapt to eucalyptus and should be closely monitored in forest production areas. This is the first report to detail the life cycle and feeding behavior of this species on eucalyptus, providing critical baseline information for future pest management strategies. creator: Paula Gregorini Silva creator: Aline Marques Pinheiro creator: Thais Lohaine Braga Santos creator: Laura Vilas Bôas Gianezi creator: Daniel Somma Araújo creator: Bruna Ferreira Anjos creator: Carlos Gilberto Raetano creator: Carlos Frederico Wilcken uri: https://doi.org/10.7717/peerj.20589 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Silva et al. title: Human landscape disturbance and wildlife gut microbiota: global knowledge gaps link: https://peerj.com/articles/20545 last-modified: 2026-01-12 description: Wildlife gut microbiota (GM) comprises a dynamic microbial community that plays a key role in host adaptation, ecological interactions and health. Human landscape disturbances (e.g., habitat loss and fragmentation) may alter the diversity and composition of wildlife GM. Therefore, it is important to understand whether these changes are driven by habitat loss, fragmentation per se, or a combination of fragmentation and additional disturbances (e.g., human activities, interaction with domestic animals). We reviewed recent literature (2013–2023) concerning the effects of human landscape disturbance on wildlife GM alpha diversity, focusing on studies employing quantitative or qualitative landscape metrics. Of 119 reviewed studies, 62.2% (n = 74) used some type of landscape metrics, 58% (n = 69) incorporated landscape disturbance as a variable in their analyses, and 49.5% (n = 59) reported significant differences in at least one alpha diversity index. Among studies on free-ranging wildlife that found significant differences in any alpha diversity index (n = 52), 69.2% (n = 36) employed landscape metrics, and 55.8% (n = 29) explicitly described the type of disturbance associated with changes in GM alpha diversity index, with higher values in less disturbed landscapes compared to more disturbed landscapes (binomial sign test; p = 0.04). With respect to host species exhibiting significant variations in their GM alpha diversity index due to human landscape disturbance, there is an overrepresentation of species classified as “Least Concern” and an underrepresentation of species from certain regions, particularly South America. Despite growing research interest in this field, the available studies remain insufficiently extensive to establish clear overall patterns and trends, both globally and across different taxonomic groups. This review identifies methodological and geographical biases and emphasizes the need for more comprehensive studies in this field, considering host species ecology and quantitative landscape metrics as a substantial contribution for predicting ecosystem-level responses and informing effective conservation efforts. creator: Rocío Paleo-López creator: Carolina S. Ugarte creator: Camila J. Stuardo creator: Andrea X. Silva creator: Constanza Napolitano uri: https://doi.org/10.7717/peerj.20545 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Paleo-López et al. title: Dental caries risk assessment using caries management by risk assessment (CAMBRA) tool in Yanbu city, Saudi Arabia—a cross sectional study link: https://peerj.com/articles/20540 last-modified: 2026-01-12 description: IntroductionDental caries affects billions of people globally with complications leading to a reduced quality of life. Investigating dental caries risk factors is of the utmost importance to prevent future carious lesions. To date, most oral health research focused on measuring the prevalence of the disease at the expense of investigating the caries risk. This study aims to establish a baseline record on the level of dental caries risk in Yanbu city and to explore the factors associated with an increased risk in permanent dentition.MethodsContact information was obtained from all Ministry of Health facilities across Yanbu city. Participants aged ≥18 years with permanent dentition were included via simple random sampling. Clinical examinations were conducted to collect potential risk and protective factors using CAMBRA tool. In addition, other factors including demographic characteristics, dental attendance, smoking history, dental anxiety, and the presence of comorbidities, were collected. Descriptive, chi2 test, and multivariate linear regression analyses were performed to determine major potential risk factors and the level of caries risk.ResultsA total of 141 participants were included in the study. The most prevalent risk factor was the presence of heavy plaque (51.1%), 97.2% of the participants presented with cavitated teeth. Factors such as the use of fluoridated toothpaste once/twice daily and a chlorhexidine gluconate mouth rinse were associated with a decreased risk of caries (p-value < 0.05). Conversely, frequent snacking, medications-induced hyposalivation, the presence of heavy plaque, deep pits and fissures, exposed tooth roots, white spot lesions, new non-cavitated lesions in enamel and existing restorations were associated with an increased risk for dental caries (p-value < 0.05).ConclusionThis study represents a foundational assessment of caries risk via the CAMBRA protocol among an underreported population in Saudi Arabia. This work addresses a critical gap and highlights important key factors that can be utilized in managing dental caries clinically and in the implementation of larger-scale caries preventive programs in the region. creator: Wallaa Albishi creator: Sumyia Mehrin creator: Mai Kadi creator: Ghadah Althubyani creator: Abdulelah Alblawi creator: Ghadeer Baqais creator: Nouf Alnazawi uri: https://doi.org/10.7717/peerj.20540 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Albishi et al. title: Multifractal analysis of vegetation regulation on ecohydrological processes in a small watershed link: https://peerj.com/articles/20496 last-modified: 2026-01-12 description: BackgroundRunoff from small catchments facilitate water movement and a hydrologic balance across an area. In the watershed hydrological cycle, precipitation serves as the primary source of runoff, while runoff represents a delayed response to precipitation. Vegetation plays a crucial regulatory role in the relationship between precipitation and runoff through multiple ecohydrological mechanisms, including interception, infiltration regulation, and evapotranspiration. In different small watersheds, the dominant coupling mechanisms between precipitation and runoff exhibit clear temporal-scale dependence due to the variability of meteorological conditions and vegetation dynamics. Moreover, these interactions are strongly influenced by topographic features, vegetation cover, and soil composition, resulting in considerable uncertainty in the interrelationships among precipitation, runoff, and vegetation.MethodsWe investigated the nonlinear relationship between precipitation and runoff at various time scales, drawing on long-term observational data (2017–2022) from the Quxi River catchment in China. We used the ensemble empirical mode decomposition (EEMD) and multifractal detrended cross-correlation analysis (MF-DCCA) to explore scale-dependent dynamics. The multifractal parameter was applied to reveal how water retention in the Quxi River small watershed varies across scales. To explore seasonal vegetation effects, we further conducted sliding window and Pearson correlation analyses.ResultsEEMD, detrended fluctuation analysis (DFA), and MF-DCCA analyses were applied to runoff, precipitation, and vegetation cover data in the Quxi River watershed, China. EEMD revealed that high-frequency modes of precipitation and runoff, with a ∼2-week cycle, explained significant data variance. DFA showed precipitation as a random process, while runoff exhibited long-term persistence. MF-DCCA confirmed multifractal characteristics in precipitation-runoff coupling, with the multifractal parameter quantifying hydrological responses. Correlation coefficients between the multifractal parameter and fractional vegetation cover (FVC) were −0.07 (spring), 0.54 (summer), 0.34 (autumn), and 0.42 (winter), indicating vegetation’s moderating effect, especially in summer. Although both spring and summer have substantial precipitation exceeding 1,100 mm, the effects of vegetation dynamics on the watershed’s water retention capacity differ significantly between the two seasons. This is attributed to the vegetation type characteristics of the small watershed. This novel approach, integrating remote sensing and multifractal analysis, quantified vegetation’s regulation of watershed hydrology, offering a robust method to assess water retention capacity. It supports ecological restoration, forest management, and sustainable development in small watersheds, adaptable to regions with large hydraulic projects, enhancing ecosystem stability and biodiversity. creator: Kai Shi creator: Bin Hu creator: Qiang Xiao creator: Songlin Tan uri: https://doi.org/10.7717/peerj.20496 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Shi et al. title: MRS2 and mitochondrial gene networks in endometrial cancer: mechanisms, biomarkers, and therapeutic implications link: https://peerj.com/articles/20409 last-modified: 2026-01-12 description: Magnesium ions and their transport proteins are increasingly recognized for their critical roles in tumor progression. However, their specific mechanisms in endometrial cancer (EC) remain poorly understood. This study investigated the role of Mitochondrial RNA Splicing 2 protein (MRS2), a key mitochondrial magnesium transporter, and its associated genes, in regulating mitochondrial function and the invasive and metastatic capabilities of EC cells. Using a combination of experimental approaches including lactate detection, flow cytometry, immunofluorescence, CCK8 assays, and Transwell migration assays, along with bioinformatics analysis, we investigated the relationship between lactate levels and MRS2 expression in endometrial cancer cells (KLE). Our findings suggest that elevated lactate levels are associated with increased MRS2 expression in mitochondria. This correlation was further linked to enhanced reactive oxygen species (ROS) production and altered expression of mitochondrial-related genes. Notably, MRS2 knockdown resulted in reduced proliferation of KLE cells, supporting a potential functional role of MRS2 in endometrial cancer progression. These findings provide new insights into the molecular mechanisms underlying EC progression and highlight MRS2 as a potential therapeutic target. creator: Leyi Huang creator: Yafang Kang creator: Wenyu Lin creator: Jiaxi Chen creator: Yuxuan Huang creator: Yan Zhang creator: Yihan Shen creator: Zeyu Wu creator: Sihao Chen creator: Shaoqing Zheng creator: Yiyang Wang creator: Renxi Lin creator: Yuanlin Qi uri: https://doi.org/10.7717/peerj.20409 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Huang et al. title: Individual and population variation in isotopic niche between two sympatric cormorant species link: https://peerj.com/articles/20384 last-modified: 2026-01-12 description: Coexistence among sympatric, functionally similar species often hinges on niche differentiation, especially as resource competition intensifies during the breeding season. Individual specialisation (IS) can promote coexistence by narrowing individual niches or increasing divergence among individuals. In colonial seabirds, aggregation at limited breeding sites and central-place foraging amplify both intra- and interspecific competition. Here, we assess seasonal shifts in individual and population isotopic niche widths in two sympatric cormorant species to elucidate the mechanisms underlying their coexistence. We analysed isotopic composition (δ13C and δ15N) in multiple-tissues to produce repeated measures within 111 individuals of red-legged cormorant (Poikilocarbo gaimardi) and imperial shag (Leucocarbo atriceps) captured on the Pirén Islet (Los Lagos, Chile) during breeding and non-breeding seasons. Multivariate generalised linear mixed models estimated isotopic niche components: total niche width (TNW), within-individual component (WIC), and between-individual component (BIC). We estimated IS (i.e., the extent to which individuals exploit a narrower subset of the population niche) as BIC/TNW. L. atriceps exhibited 2.2-fold greater TNW than P. gaimardi during non-breeding and 2-fold greater during breeding. IS differed markedly between species: L. atriceps showed a higher IS during non-breeding (0.541 vs 0.213 in P. gaimardi), but decreased by 79.3% during breeding, whereas P. gaimardi increased IS by 52.1%. Niche width overlap was asymmetric and seasonally variable: P. gaimardi exhibited high overlap with L. atriceps (95.7% non-breeding, 89.6% breeding), whilst L. atriceps showed lower overlap (48.3% non-breeding, 43.7% breeding). Competition indices increased substantially during breeding in both species (305% in L. atriceps, 221% in P. gaimardi). Results suggest that coexistence relies on multiple mechanisms, including subtle population niche differentiation, contrasting IS between species, and divergent resource-use strategies. The high niche width overlap and narrower niche of P. gaimardi suggest greater competitive vulnerability for this Near Threatened species. Conservation of foraging habitat heterogeneity and prey availability is crucial for maintaining ecological opportunities that sustain these coexistence mechanisms. creator: Gabriela Piriz creator: Edwin J. Niklitschek creator: Valentina Mansilla Gamín creator: Karin Maldonado uri: https://doi.org/10.7717/peerj.20384 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Piriz et al. title: The Appalbees menu: a multiyear, multilocus metagenetic assessment of pollen foraging by Appalachian Bombus affinis workers link: https://peerj.com/articles/20284 last-modified: 2026-01-12 description: BackgroundDetailed studies of foraging behavior are needed for scientific management of the endangered rusty-patched bumblebee (Bombus affinis) in the disjunct and ecologically differentiated habitats it presently occupies. Current knowledge gaps hinder recovery planning but are challenging to redress through direct observation of rare interactions in the field.MethodsWe used genetic metabarcoding to characterize the taxonomic composition of pollen collected by B. affinis workers in the Appalachian mountains of Virginia and West Virginia from 2021–2023. We developed a custom sequence database of the regional flora and compared results for two independent genetic loci, internal transcribed spacer 1 and internal transcribed spacer 2 (ITS1 and ITS2).ResultsWhile ITS2 consistently detected more plant diversity, results from the two loci were broadly concordant with a few notable exceptions. The plant genera Hydrangea, Actaea, Rhododendron, Tilia, and (unexpectedly) Laportea were prominent in midsummer samples, with Rubus a consistent contributor in late spring and early summer. Pea flowers (family Fabaceae) were relatively infrequent but the genera Securigera and Trifolium were detected before the Hydrangea bloom and again in late summer afterwards. The diversity of forage plants was highest in late summer, driven primarily by various genera of Asteraceae. Comparing the current data with previous work indicates regional differentiation in forage plants between Appalachia and the upper Midwest, but also allows ‘consensus’ forage sources that are supported by multiple lines of evidence and shared between regions to be tabulated. These results should help managers focus survey efforts for this endangered species and plan habitat enhancements. creator: Robert S. Cornman creator: Mark J. Hepner creator: Clint R.V. Otto uri: https://doi.org/10.7717/peerj.20284 license: https://creativecommons.org/publicdomain/zero/1.0/ rights: ©2026 Cornman et al. title: Association between WeChat-based remote care guidance and diabetic foot ulcer healing: a retrospective cohort study link: https://peerj.com/articles/20624 last-modified: 2026-01-09 description: ObjectiveThe aim of this study was to evaluate the effectiveness of WeChat-based remote care guidance as a supplement to standard care for patients with diabetic foot ulcers. Our specific objectives were to compare healing rates, self-management behaviors, and patient satisfaction between the two groups, with a focus on identifying patient subgroups that might benefit most from this approach.MethodsA retrospective cohort study was conducted at Fujian Maternity and Child Health Hospital between June 2021 and December 2022, with follow-up until December 2024. Among 131 eligible patients with diabetic foot ulcers (Wagner grades 1–4), 59 received WeChat -based guidance (intervention) while 72 received standard care (control). Primary outcomes included wound healing rate and time-to-healing. Quality of life (WHOQOL-BREF) and treatment satisfaction (DTSQs) were assessed at baseline, 3, 6, 12, and 24 months. Analyses were adjusted for demographic characteristics, clinical parameters, and disease severity indicators.ResultsThe intervention group showed significantly higher healing rates (88.1% vs 63.9%, P = 0.001) and faster healing time (HR = 2.27, 95% CI [1.35–3.82], P = 0.002). The effect was particularly pronounced in Wagner grade 2–3 ulcers (HR = 14.3–34.2, P < 0.001) and patients receiving interventional procedures (HR = 3.4, 95% CI [1.8–6.3], P <0.001). At 24 months, the intervention group demonstrated greater improvements in quality of life (mean difference = 7.87, P < 0.001) and treatment satisfaction (mean difference = 6.70, P < 0.001).ConclusionWeChat-based remote care guidance was associated with better diabetic foot ulcer healing outcomes, particularly for moderate-severity ulcers and patients undergoing interventional procedures. Our findings also suggest associations between this approach and improvements in quality of life and treatment satisfaction. creator: De Qin Chen creator: Chao Yun Jiang creator: Tian Hong Cai creator: Rong Zhang creator: Teng Hui Zhan uri: https://doi.org/10.7717/peerj.20624 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Chen et al. title: Improving exercise motivation and physical fitness in college students through a long-term mindfulness-enhanced Tai Chi Chuan program: a randomized controlled trial link: https://peerj.com/articles/20602 last-modified: 2026-01-09 description: BackgroundWhile Tai Chi Chuan (TCC) is widely recognized for its physical and mental health benefits, its mindful components are often overlooked in traditional training. Mindfulness-enhanced Tai Chi Chuan (MTCC) has been proposed to address this limitation, yet little research has explored its long-term impact on exercise motivation and physical fitness. This study extends previous findings by investigating the sustained effects of a 24-week MTCC intervention in improving physical and mental health outcomes among college students, with a focus on long-term sustainability and motivation maintenance that distinguishes it from our prior short-term research.MethodsA randomized controlled trial was conducted with 80 college students assigned to either an MTCC group or a traditional TCC group. Seventy-one participants completed the allocated intervention, while nine participants dropped out for personal reasons. No serious adverse events (SAEs) were reported. The MTCC program was delivered in two stages over 24 weekly sessions. The first stage introduced participants to mindfulness-enhanced Taiyi Mirrored-heart Chuan, emphasizing foundational postures and mindfulness principles. The second stage involved traditional TCC training to consolidate the skills and motivation gained during the first stage. Outcome measures, including exercise motivation, physical fitness, mindfulness and subjective well-being, were assessed pre- and post-intervention.ResultsRepeated measures analysis of variance (ANOVA) indicated that participants in the MTCC group demonstrated significantly greater improvements in all measured outcomes compared to the traditional TCC group. Specifically, the 24-week intervention showed larger effect sizes in physical fitness (η2p = 0.224) compared to our prior study (η2p = 0.033–0.210), highlighting the value of long-term intervention.ConclusionThese findings highlight the long-term benefits of integrating mindfulness into TCC practice, particularly in fostering intrinsic motivation for physical activity and enhancing overall well-being. The study underscores the potential of MTCC as a sustainable intervention for promoting holistic health in college students and its applicability in educational and wellness settings.Clinical review registrationhttps://www.chictr.org.cn/, identifier ChiCTR2200058449. creator: Ping Qu creator: Xiaoqing Zhu creator: Ting Zhu creator: Hui Zhou creator: Minghua Huang creator: Feng Pan creator: Xiaoyan Wang creator: Jingsi Wen creator: Yang Liu creator: Yu Zhang creator: Fangbin Li creator: Yuyin Wang uri: https://doi.org/10.7717/peerj.20602 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Qu et al. title: Beneath the canopy, beneath the ground: how surface microhabitats shape cave communities link: https://peerj.com/articles/20593 last-modified: 2026-01-09 description: Ecosystem dynamics are shaped by spatial and temporal fluctuations in resource availability and species composition across the landscape. Caves exemplify this interconnectedness, as they rely on allochthonous inputs and surface climatic conditions, fostering communities composed of viable populations from both surface and subterranean habitats. Consequently, effective management and conservation of subterranean environments require the protection of adjacent surface ecosystems, a particularly urgent need in the Amazonian ferruginous hills, where mineral exploitation poses a significant threat. In this context, we investigated how vegetation cover and environmental variables influence the distribution of surface and subterranean fauna, and which factors should guide conservation strategies. We sampled six caves and ten epigean transects around each, encompassing both ombrophilous forest and canga (savanna over ferruginous crusts). Environmental structure variables were recorded for all transects. Significant differences were detected between forest and canga in terms of vegetation structure, microclimate, species richness, and community composition. Species most similar to those found in caves were associated with forest leaf litter, particularly in transects closest to cave entrances. Leaf litter depth emerged as a key factor facilitating faunal overlap between surface and subterranean habitats, likely by providing microhabitats with stable temperature and humidity. In contrast, faunal similarity in canga occurred only under specific conditions, namely, milder temperatures, deeper litter layers, and increased canopy cover. Our findings demonstrate that cave-dwelling species in Amazonian ferruginous systems also inhabit adjacent forest environments, which should be prioritized for conservation. creator: Marcus P. A. Oliveira creator: Rodrigo L. Ferreira uri: https://doi.org/10.7717/peerj.20593 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Oliveira and Ferreira title: Integrating cerebrovascular morphology and radiomics features for predicting stroke prognosis: a retrospective study link: https://peerj.com/articles/20588 last-modified: 2026-01-09 description: Accurately predicting 90-day Modified Rankin Scale (mRS) scores for acute ischemic stroke (AIS) patients is crucial for guiding treatment strategies. However, many existing mRS prediction methods rely on clinicians to manually evaluate relevant features, and the accuracy of feature quantification and model reproducibility still need to be further improved. This study proposes a machine learning framework that combines multimodal imaging features in order to predict 90-day mRS outcomes. A retrospective analysis was conducted on 86 AIS cases. Morphological features of the intracranial arterial and venous system were extracted from computed tomography angiography (CTA) images. Additionally, radiomics features were obtained from the ischemic lesion on diffusion-weighted imaging (DWI). Recognizing the significance of the peri-infarct penumbra in stroke prognosis, radiomics features were also extracted from the annular region surrounding the ischemic lesion. Redundant features were eliminated using a sparse representation method, and a sparse representation-based classifier was developed to predict mRS outcomes. Model performance was validated using cross-validation and independent test. A total of 1,066 features, including 40 vascular morphological features and 1,026 radiomics features, were extracted. Both feature types demonstrated statistical significance (P < 0.05). Ultimately, 26 features were selected to construct the classification model. The proposed model achieved robust performance on the independent test set, with a classification accuracy of 0.828, an area under the curve (AUC) of 0.942, sensitivity of 0.789, specificity of 0.900, positive predictive value of 0.937, and negative predictive value of 0.692. By integrating vascular morphological features with radiomics features from the ischemic lesion and peri-ischemic lesion regions in DWI, the proposed machine learning model provides accurate predictions of 90-day clinical outcomes for AIS, offering valuable insights for personalized stroke management. creator: Suying Pu creator: Shunjun Li creator: Jing Shao creator: Jixian Lin creator: Huanyin Li creator: Jinjiang Shen creator: Hui Zheng uri: https://doi.org/10.7717/peerj.20588 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Pu et al. title: Perceived social support as a mediator between left-behind experience and subjective well-being in Chinese college students link: https://peerj.com/articles/20567 last-modified: 2026-01-09 description: BackgroundLeft-behind experience (LBE), where children are separated from one or both parents due to parental migration for work, has been shown to negatively affect college students’ psychological well-being. This study explores the relationship between LBE and subjective well-being (SWB) among college students and investigates whether perceived social support (PSS) mediates this relationship.MethodsA cross-sectional survey was conducted with 1,228 undergraduate students across four Chinese universities. Participants completed the Perceived Social Support Scale (PSSS) and the Subjective Well-Being Scale (SWB). Statistical analyses, including independent t-tests, Pearson correlations, and mediation analysis (using SPSS PROCESS), were performed to test the hypotheses.ResultsStudents with LBE reported lower levels of both PSS and SWB compared to their non-LBE peers. PSS was found to fully mediate the relationship between LBE and SWB. Specifically, LBE negatively affected PSS, which in turn positively influenced SWB. The direct effect of LBE on SWB was non-significant, highlighting the importance of PSS in this relationship.ConclusionsThe study emphasizes that LBE itself does not directly dictate developmental outcomes. Instead, it influences college students through the reduction of perceived social support. These findings suggest that enhancing social support systems in universities and communities can significantly improve the well-being of college students with LBE, and this approach has potential implications beyond the Chinese context. creator: Biwei Zhou creator: Lei Zhang uri: https://doi.org/10.7717/peerj.20567 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Zhou and Zhang title: Comparison of the safety and efficacy of remimazolam for sedation during bronchoscopy: a meta-analysis of randomized controlled trials link: https://peerj.com/articles/20552 last-modified: 2026-01-09 description: ObjectiveTo evaluate the comparative efficacy and safety of remimazolam vs. established sedatives (dexmedetomidine, propofol, midazolam) for sedation during bronchoscopy.MethodsA systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted according to PRISMA guidelines and Cochrane Handbook recommendations (PROSPERO CRD420251071986). Databases (EMBASE, PubMed, Scopus, Cochrane Central, Web of Science) were searched from inception to May 14, 2025. Included studies were RCTs comparing intravenous remimazolam to comparator sedatives in adults (≥18 years) undergoing bronchoscopy. Primary outcome was procedural success rate (completion without rescue sedation). Secondary outcomes included onset time, wake-up time, procedure duration, patient satisfaction, and adverse events (hypotension, hypoxemia, tachycardia, bradycardia, hypertension). Risk of bias was assessed using RoB 2. Data were pooled using random-effects models, reporting mean differences (MD) or odds ratios (OR) with 95% confidence intervals (CI).Results13 RCTs (n = 2,002 patients) were included. Remimazolam demonstrated: Procedural success: Significantly higher success rates vs. dexmedetomidine (OR 2.87, 95% CI [1.13–7.29], P = 0.03; I2 = 62%) and vs. midazolam (OR 3.65, 95% CI [1.40–9.49], P = 0.008; absolute rates 77.1% vs. 3.6%). Comparable success rates to propofol (OR 0.55, 95% CI [0.11–2.61], P = 0.45; rates ~98% each). Onset/Recovery: Faster onset vs. dexmedetomidine (MD −2.01 min, 95% CI [−2.08 to −1.93], P < 0.001; I2 = 0%). Shorter wake-up time vs. dexmedetomidine (MD −1.84 min, 95% CI [−3.31 to −0.37], P = 0.01) and vs. midazolam (MD −4.72 min, 95% CI [−8.05 to −1.39], P = 0.005). Comparisons with propofol were inconclusive due to heterogeneity. Safety: Significantly lower risk of hypotension vs. propofol (OR 0.35, 95% CI [0.23–0.55], P < 0.00001) and hypoxemia vs. dexmedetomidine (OR 0.41, 95% CI [0.18–0.96], P = 0.04). Significantly higher risk of tachycardia vs. dexmedetomidine (OR 3.01, 95% CI [1.37–6.60], P = 0.006). No significant safety differences vs. midazolam. Patient satisfaction was equivalent to propofol.ConclusionRemimazolam is a highly effective and safe sedative for bronchoscopy. It offers superior procedural success and faster recovery compared to dexmedetomidine and midazolam, while matching the high success rate of propofol. Its key safety advantage is significantly reduced hypotension risk compared to propofol, making it particularly suitable for vulnerable patients. Remimazolam represents a valuable addition to sedation options for this procedure. creator: Yupei Yuan creator: Chunlei Chang creator: Jing Zhang creator: Liang Liang uri: https://doi.org/10.7717/peerj.20552 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Yuan et al. title: Comparative analysis of transvaginal and transabdominal sliding sign for predicting intra-abdominal adhesions prior to repeat cesarean section: a single center study link: https://peerj.com/articles/20551 last-modified: 2026-01-09 description: BackgroundCaesarean section plays a crucial role in ensuring the health of both mother and newborn, especially when complications arise or are anticipated. However, the increasing global prevalence of caesarean section brings along significant postoperative challenges, notably pelvic adhesions, which can impact subsequent pregnancies and surgeries. Non-invasive preoperative assessment methods, such as ultrasonography, offer promise in enhancing surgical planning and patient outcomes.ObjectiveThis study aims to evaluate the accuracy of transabdominal and transvaginal sliding sign in detecting intraabdominal adhesions in third-trimester pregnant women with a history of caesarean section.MethodThis diagnostic study recruited 35 third-trimester pregnant women with a history of cesarean section undergoing scheduled repeat cesarean at a tertiary referral hospital. All participants underwent both via transvaginal (TV) and transabdominal (TA) ultrasound before surgery. The presence of a positive or negative sliding sign was recorded for each modality. Intra-abdominal adhesions were confirmed intraoperatively and used as the gold standard. Diagnostic accuracy was calculated for each modality. Comparative analysis was conducted across patient characteristics and outcomes.ResultAll 35 patients underwent both TA and TV ultrasound evaluations (within-subject design). The majority of participants were aged between 31 and 40 years (68.6%), were multigravida (65.7%), and had undergone two caesarean sections (51.4%). The sliding sign was negative in 18 (51.4%) and 17 (48.6%) patients using TA and TV approaches, respectively. Both modalities showed high sensitivity (93.75%) and specificity (84.21%) in detecting adhesions. There was no statistically significant difference between TA and TV sliding signs in relation to age or obstetric status. Comparative analysis of both modalities showed equivalent diagnostic performance.ConclusionBoth transabdominal and transvaginal sliding sign evaluations demonstrate high accuracy in detecting intra-abdominal adhesions in women undergoing repeat cesarean section. The within-subject comparison suggests either modality may be reliably used depending on clinical and logistic factors. creator: Peby Maulina Lestari creator: Imas Kartika Dewi E creator: Abarham Martadiansyah creator: Theodorus Theodorus creator: Nuswil Bernolian creator: Putri Mirani creator: Muhammad Al Farisi Sutrisno creator: Bella Stevanny uri: https://doi.org/10.7717/peerj.20551 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Lestari et al. title: New insights into lactylation in respiratory diseases: progress and perspectives link: https://peerj.com/articles/20548 last-modified: 2026-01-09 description: Lactate is conventionally regarded as a metabolic byproduct and generated through diverse pathophysiological pathways. However, a growing body of evidence supports its regulatory roles in energy metabolism and signal transduction, boosting extensive research into lactate-mediated lactylation as a newly discovered post-translational modification (PTM). Lactylation can occur on both histone and non-histone proteins, thereby modulating gene transcription and protein function. By influencing various biological processes, lactylation has been shown to intricately participate in the onset and progression of respiratory diseases that are closely related to metabolic abnormalities and remodeling, including asthma, lung cancer, pulmonary fibrosis, silicosis, pulmonary hypertension (PH), and acute lung injury (ALI). In this review, we summarize the current progress in this field, underscoring the multifaceted regulatory and functional mechanisms underlying lactylation, the pivotal role of lactylation in different respiratory diseases, as well with its potential as a therapeutic target. This comprehensive understanding offers novel insights into the pathogenesis of respiratory diseases and opens new avenues for therapeutic approach. creator: Longmin Chen creator: Yuan Zou creator: Qianqian Xu creator: Jing Zhang uri: https://doi.org/10.7717/peerj.20548 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Chen et al. title: A narrow therapeutic window of platelet P2Y12 reactivity in high-risk Chinese percutaneous coronary intervention patients link: https://peerj.com/articles/20536 last-modified: 2026-01-09 description: BackgroundMuch evidence has been provided that a therapeutic window of P2Y12receptor inhibition exists, which is highly significantly associated with ischemic and bleeding events. The therapeutic window for high-risk stratification after percutaneous coronary intervention (PCI) is lacking. We aimed to investigate the therapeutic window of P2Y12receptor inhibition in high-risk Chinese PCI patients.MethodsIn this observational study, we analyzed 860 high-risk patients who were undergoing PCI. The primary endpoint was the correlation between vasodilator-stimulated phosphoprotein platelet reactivity index (VASP-PRI) values with bleeding and ischemic components in high-risk patients. The secondary endpoint was a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, urgent revascularization, and stroke at 12 months after the index procedure.ResultsAmong high-risk patients, VASP-PRI could significantly discriminate between PCI patients with and without ischemic events (area under the curve (AUC): 0.77; 95% CI [0.72–0.82]; P < 0.001). A VASP-PRI ≥ 0.45 was the optimal cutoff point to predict ischemic events (sensitivity: 86.6%; specificity: 63.6%). Similarly, VASP-PRI could also significantly discriminate between PCI patients with and without bleeding events ((AUC): 0.77; 95% CI [0.73–0.81]; P < 0.001). A VASP-PRI ≤ 0.24 was the optimal cutoff point to predict bleeding events (sensitivity: 72.1%; specificity: 70.3%). Multivariate analysis showed that VASP-PRI was an independent predictor of the risk of major adverse cardiovascular events (odds ratio: 10.67, 95% CI [3.78–30.08]).ConclusionOur results suggest that high-risk Chinese PCI patients have a narrow therapeutic window. Within this window, high-risk patients are at lower risk for both ischemic and bleeding events. Platelet reactivity may have significant implications for personalized antiplatelet therapy in high-risk patients. creator: Liying Gong creator: Yaxin Liu creator: Jingle Li creator: Shiming Tan creator: Chengxian Guo creator: Zhengmei Wang creator: Huiling Song creator: Yun Kuang creator: Yu Cao creator: Guoping Yang uri: https://doi.org/10.7717/peerj.20536 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Gong et al. title: Mountains of diversity: a systematic revision of the Andean rodent genus Oreoryzomys (Cricetidae: Sigmodontinae) link: https://peerj.com/articles/20515 last-modified: 2026-01-09 description: The until recently monotypic cricetid genus Oreoryzomys inhabits piedmont and cloud forests, primarily in eastern Ecuador and northwestern Peru. Erected following the taxonomic revision of a polytypic Oryzomys complex two decades ago, Oreoryzomys has remained poorly understood, with most references limited to the original descriptions of its type species (O. balneator) and a subspecies (O. b. hesperus). Here, we present an integrative taxonomic revision of the genus, based on new field collections and comprehensive museum-based analyses. Phylogenetic reconstructions from mitochondrial and nuclear gene sequences, combined with morphometric and qualitative morphological data, support the recognition of three species: (1) a redescribed O. balneator from central-eastern Ecuador; (2) O. hesperus, elevated to full species rank based on topotypic material; and (3) a new species from populations of the Quijos River Valley, northeastern Ecuador. This revision triples the known species diversity of Oreoryzomys and highlights the genus as a notable radiation of small-bodied oryzomyines adapted to Andean environments. Our findings emphasize the need for systematic revisions of other poorly known Andean rodents to better reveal the hidden diversity of cricetids and the role of the Andes in shaping Neotropical biodiversity. creator: Jorge Brito creator: Rocío Vargas creator: Nicolás Tinoco creator: Rubí García creator: Julio C. Carrión-Olmedo creator: Claudia Koch creator: Ricarda Wistuba creator: Carlos Nivelo-Villavicencio creator: Ulyses F.J. Pardiñas uri: https://doi.org/10.7717/peerj.20515 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Brito et al. title: Elucidating the invasion history of introduced bullfrogs in New Mexico using population genetic approaches link: https://peerj.com/articles/20491 last-modified: 2026-01-09 description: The American Bullfrog, Rana (Aquarana) catesbeiana, is an extremely successful invader that has spread globally in the last century, impacting vulnerable ecosystems. In the western U.S., bullfrogs were intentionally introduced in the early 1900s, but little is known about their subsequent colonization into the state of New Mexico. We evaluated a single mitochondrial gene region, cytochrome b, using population genetic approaches to investigate the invasion history of bullfrogs across their introduced range. Specifically, our objectives were to (1) assess the level of genetic diversity and identify haplotypes within bullfrog populations in New Mexico, (2) compare the genetic diversity of native and invasive bullfrog populations, (3) infer the number of introductions into New Mexico, and (4) identify potential native source populations. Using haplotype and nucleotide diversity estimates, we found moderate genetic variation within New Mexico (Hd = 0.648, π = 0.0036) with higher diversity at sites with increased human activity. However, there was significantly lower genetic diversity in introduced populations compared to native populations, consistent with expectations of recent colonization. Based on haplotype diversity estimates and BLAST results, we found a total of eight haplotypes across New Mexico, of which six haplotypes were found across the native and other introduced ranges. Pairwise ΦST revealed minimal differentiation between New Mexico sites, consistent with introduction from a single source population. Lastly, the analysis of molecular variance (AMOVA) conveyed that bullfrogs from the Northwest (Northwest: 0%, P = 0.6411) and Southwest (Southwest: 0%, P = 0.5124) invasive regions showed no significant differences compared to New Mexico populations, suggesting either recent connectivity or similar origins. This study reinforces the importance of managing the movement of invasive species and demonstrates how evaluating the genetic composition of an invasive species can reveal key points of its invasion history. creator: Celina M. Eberle creator: Daniele L.F. Wiley creator: Chris X. McDaniels creator: J. Tomasz Giermakowski creator: Lisa N. Barrow uri: https://doi.org/10.7717/peerj.20491 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Eberle et al. title: Endophytic fungi and their secondary metabolites in Qin medicine plants: a comprehensive review of diversity, function, and application link: https://peerj.com/articles/20487 last-modified: 2026-01-09 description: Qin medicine represents the premier local traditional Chinese medicinal herbs in Shaanxi province (China) and its neighboring areas. Endophytic fungi, an essential element of the internal ecosystem of medicinal plants, have attracted considerable attention for their roles in enhancing plant resistance to pests and diseases, increasing the concentration of bioactive compounds, and stimulating plant growth and development. This paper presents the first comprehensive review of endophytic fungi in Qin medicinal plants, summarizing their diversity, effects on plant growth and medicinal quality, as well as novelty and bioactivity of their secondary metabolites. It also highlights their potential applications in promoting plant growth. Furthermore, this study explores the current opportunities and challenges in the research of endophytic fungi within Qin medicinal plants, with the objective of offering a unique perspective for the advancement and development of Qin medicinal plants. creator: Bo-Yang Chen creator: Tong Li creator: Wen-Pu Shi creator: Juan-Juan Yang creator: Yang Bai creator: Qi-Meng Xue creator: Chen-Li Jiao creator: Pei-Feng Wei creator: Liang-Liang Chen uri: https://doi.org/10.7717/peerj.20487 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Chen et al. title: A highly diverse Pennsylvanian tetrapod ichnoassemblage from the Semily Formation (Krkonoše Piedmont Basin, Czechia) link: https://peerj.com/articles/20437 last-modified: 2026-01-09 description: The Krkonoše Piedmont Basin (KPB) is one of the Late Paleozoic continental basins in Bohemia, Czechia, comprising a sedimentary sequence from the Late Pennsylvanian to the early Cisuralian. The Pennsylvanian in the KPB consists of alluvial-fluvial to lacustrine deposits with a relatively rich fossil record, comprising mainly ray-finned fishes, freshwater sharks, and invertebrates. Although no skeletal remains of terrestrial vertebrates have been discovered in the Late Pennsylvanian deposits of the KPB, recent studies of tetrapod footprints provide the first direct evidence of pre-Permian terrestrial tetrapod diversity within this basin. A diverse ichnofossil assemblage is represented by six ichnogenera, Amphisauropus, Batrachichnus, Dimetropus, Dromopus, Ichniotherium and Limnopus, including five known ichnospecies, Amphisauropus kablikae, Batrachichnus salamandroides, Dromopus lacertoides, Ichniotherium cottae, and Limnopus heterodactylus, and two unknown ichnospecies, Dimetropus isp. and Limnopus isp. This tetrapod ichnoassemblage is among the most diverse in the Pennsylvanian. Moreover, the Amphisauropus tracks from the KPB represent the first undisputed occurrence of this ichnotaxon in the Gzhelian. Furthermore, the Ichniotherium cottae tracks described here complement the still rare Pennsylvanian occurrences of this ichnospecies in the European part of Pangaea. The ichnofauna studied herein is associated with alluvial-plain to lacustrine nearshore deposits, highlighting the ecological importance of the lacustrine environment and its adjacent areas for the presence of terrestrial vertebrates and the preservation of their footprints. creator: Gabriela Calábková creator: Jakub Březina creator: Roland Nádaskay uri: https://doi.org/10.7717/peerj.20437 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Calábková et al. title: Abundance in secret: a review of the genus Leptobrachium (Anura, Megophryidae) in India, with descriptions of two new species link: https://peerj.com/articles/20397 last-modified: 2026-01-09 description: Of the 39 currently recognized species in the Slender Armed Frog genus Leptobrachium, four are reported from India, Leptobrachium aryatium, L. bompu, L. smithi, and L. sylheticum. Based on new collections, we review these reported species by integrating molecular, morphological, and behavioral data. Our comparative analyses of external and internal morphology as well as molecular data and acoustic properties reveal two new species-level lineages from the Lower Dibang Valley and Shi Yomi districts of Arunachal Pradesh, India, which we describe here as new species. Phylogenetically, Leptobrachium mechukasp. nov. and Leptobrachium somanisp. nov. are members of the L. bompu species group, but they are distinct from L. bompu sensu stricto by DNA sequence divergence in the 16S mitochondrial rRNA gene of 3.6–4.2% and 4.5–4.7%, respectively. A population previously identified as L. cf. bompu from Medog County, China, is also assignable to Leptobrachium mechukasp. nov. Each new species is distinguished from congeners by a combination of diagnostic morphological characters, including in the case of Leptobrachium somanisp. nov., a unique advertisement call comprising two distinct call types; unicolored silvery white iris; moderately large webbing between toes; and ventral coloration. Leptobrachium mechukasp. nov. on the other hand, is distinguishable by its head length equal to width; nostril equidistant from the snout tip and the eye; internarial distance equal to the distances from nostril to eye and from nostril to snout tip; distance from the tip of inner metatarsal tubercle to the tip of first toe shorter than the length of inner metatarsal tubercle itself; and frontoparietals separated at the midline by a moderate fontanelle. Analyses of multiple new populations representing members of the L. smithi group reveal that L. smithi is absent from the Indian fauna; all previous records attributed to this species from India instead represent L. aryatium or L. sylheticum. These discoveries highlight the prevalence of taxonomic misidentifications in the absence of detailed systematic studies as well as the underestimation of diversity in the genus Leptobrachium, not only from India but across its known range. Our results underscore the need for dedicated surveys that document amphibian diversity in underexplored regions of Northeast India. creator: A.N. Dikshit Akalabya Sarmah creator: Sonali Garg creator: Tage Tajo creator: Radhakrishna Upadhyaya K. creator: James Hanken creator: S.D. Biju uri: https://doi.org/10.7717/peerj.20397 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Sarmah et al. title: Fungal-specific IgG responses in allergic conjunctivitis: comparison with IgE and immunological implications link: https://peerj.com/articles/20625 last-modified: 2026-01-08 description: BackgroundImmunoglobulin G (IgG) is the most abundant antibody class in the bloodstream and is characterized by a long half-life compared to other immunoglobulins. While IgG plays a key role in host defense against infections, it is also known to be elevated in chronic inflammatory conditions. This study aimed to evaluate serum levels of fungus-specific Immunoglobulin E (IgE) and IgG antibodies in patients with allergic conjunctivitis and to investigate their associations with disease severity and sensitization status.MethodsA total of 40 patients with allergic conjunctivitis and 20 healthy controls were enrolled. Serum levels of specific IgE and IgG antibodies against four common fungi—Alternaria, Aspergillus, Cladosporium, and Penicillium—were measured. These values were compared with skin prick test (SPT) results and clinical severity scores for allergic conjunctivitis (0–30 scale).ResultsPatients with allergic conjunctivitis exhibited significantly higher positivity rates and serum titers of both IgE and IgG against all four fungal antigens compared to controls (p < 0.05). Notably, IgG titers were significantly higher than IgE titers across all fungal antigens (p < 0.05). IgG levels demonstrated stronger correlations with SPT positivity (correlation coefficients r = 0.95–0.97 vs. r = 0.60–0.89 for IgE) and allergic conjunctivitis severity scores (r = 0.35–0.60 vs. r = 0.23–0.43 for IgE, p < 0.001).ConclusionsSerum fungus-specific IgG antibodies may serve as useful biomarkers reflecting the severity of allergic conjunctivitis. Given that mucosal barrier dysfunction has been implicated in allergic inflammation, the findings suggest that hypersensitivity reactions to fungal elements due to impaired barrier function may contribute to disease pathogenesis. creator: Tatsuya Mimura uri: https://doi.org/10.7717/peerj.20625 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Mimura title: Effect of acute exercise on the dynamics of testosterone levels: a systematic review of randomized controlled trials link: https://peerj.com/articles/20615 last-modified: 2026-01-08 description: PurposeAlthough acute exercise has been demonstrated to modulate endogenous testosterone levels, existing studies have reached conflicting conclusions regarding the pattern of response of testosterone levels after exercise. The objective of this study was to examine the dynamic effects of acute exercise on testosterone levels and to analyze the differences in the role of factors such as exercise mode, intensity, sample source, and gender.MethodsA comprehensive search of articles published up to March 2025 was conducted in five database systems, including PubMed and Web of Science, in accordance with the PRISMA guidelines. A total of 15 randomized controlled trials assessing the effect of acute exercise on testosterone levels were included, with a total sample size of 251 participants.Results(1) Testosterone levels demonstrate a greater increase following resistance training, with a delayed return to baseline levels; in contrast, testosterone levels typically recover within 1 h after aerobic exercise. (2) Moderate to high-intensity exercise stimulates the hypothalamic-pituitary-gonadal axis (HPG), leading to a transient rise in testosterone, but extended high-intensity exercise causes testosterone suppression during recovery due to cortisol antagonism for up to 72 h. The testosterone concentration during the active phase exceeds that during the recovery period. (3) A significant disparity in baseline testosterone levels exists between males and females, with males exhibiting higher levels. Additionally, males demonstrate a more pronounced response to exercise compared to females. (4) Blood tests exhibit greater sensitivity than saliva tests, although the latter is more reactive to high-intensity exercise; (5) The response is more pronounced in younger males compared to older adults, with negligible response observed in adolescents.ConclusionVariations in testosterone level modulation due to acute exercise are predominantly influenced by exercise mode, intensity, sample source, and subject characteristics (gender and age). While resistance training and high-intensity exercise might temporarily increase testosterone levels, it is essential to consider the potential for hormonal imbalance after recovery; age and sex variations, along with assay standardization, are critical areas for further investigation. This review was registered PROSPERO with registration number CRD420251007222. creator: Qianxin Tu creator: Gen Li creator: Songtao Wang uri: https://doi.org/10.7717/peerj.20615 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Tu et al. title: Characterizing core muscle morphometry in postpartum women with pelvic girdle pain and asymptomatic subjects: a comparative cross-sectional study link: https://peerj.com/articles/20601 last-modified: 2026-01-08 description: BackgroundThis study aimed to examine the differences in core muscle morphometry and contraction changes between postpartum individuals with and without pelvic girdle pain (PGP). Understanding the observed changes in muscle thickness and contraction characteristics is crucial for tailoring effective core muscle rehabilitation strategies that promote optimal postpartum recovery.MethodsA cross-sectional study was conducted involving 150 postpartum women with PGP and 50 asymptomatic individuals as matched controls. Real-time musculoskeletal ultrasound was used to measure core muscle morphometry and assess changes in muscle thickness and percentage change during various tasks.ResultsCompared with asymptomatic women, individuals with PGP exhibited substantially reduced diaphragm excursion and thinner muscle thickness of the transverse abdominal muscle (TrA) during active straight leg raise (ASLR) tests with abdominal muscle contractions (P < 0.05). The TrA respiratory contraction rate and preferential activation ratio during abdominal breathing were also lower in the PGP group (PGP = 0.46 (0.13 to 1.41); asymptomatic women = 0.98 (0.05 to 2.05), P = 0.01). In addition, postpartum women with PGP showed increased activation of the internal oblique muscle during ASLR tests with abdominal muscle contractions compared to controls (PGP: 47%; asymptomatic women: 45%, P < 0.05). Furthermore, the bilateral lumbar multifidus muscle was smaller and thinner on the right side in the PGP group than the asymptomatic group (P < 0.001).ConclusionPostpartum women with PGP exhibited thinner muscle thickness on core muscle morphometry and less muscle change during abdominal breathing and the ASLR test. creator: Ziling Lin creator: Bo Chen creator: Ruoling Chen creator: Xueling Chen creator: Yanjun Hou creator: Yanping Liu creator: Lili Lin creator: Zhiwei Lin creator: Xiangbin Wang creator: Cheng Zeng uri: https://doi.org/10.7717/peerj.20601 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Lin et al. title: Non-targeted metabolomic profiling of Cremastra appendiculata providing insights for phytochemical analyses link: https://peerj.com/articles/20592 last-modified: 2026-01-08 description: BackgroundCremastra appendiculata (D. Don) Makino, known as “Shan Cigu” in China, is a valuable medicinal plant historically employed for its antibacterial and anti-inflammatory properties. However, its comprehensive metabolome remains underexplored, hindering the establishment of standardized quality control.MethodsIn this study, a non-targeted metabolomics approach based on the Thermo Fisher Orbitrap Exploris 120 LC-MS (Liquid Chromatography-Mass Spectrometry) platform was employed to systematically profile the metabolites of C. appendiculata.ResultsA total of 174 compounds were annotated through a dual-validation workflow integrating Compound Discoverer 3.3 and manual tandem mass spectrometry spectral verification. Orthogonal partial least squares discriminant analysis prioritized 30 candidate quality markers, of which, six were further validated through network pharmacology-based bioactivity screening. Hierarchical clustering analysis revealed distinct metabolic patterns across the different tissues (roots, pseudobulbs, and leaves), establishing a tissue-specific chemical atlas. The integration of chemometric, network pharmacological, and chemotaxonomic analyses resulted in a robust, molecularly guided quality control framework, providing novel insights for phytochemical research and medical applications of C. appendiculata. creator: Rui Guan creator: Yuxin Shan creator: Hamizah Shahirah Hamezah creator: Somnuk Bunsupa creator: Hong To Quyen Duong creator: Yadong Zhou creator: Rongchun Han creator: Xiaohui Tong uri: https://doi.org/10.7717/peerj.20592 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Guan et al. title: Analysis of clinical parameters of different types of α-thalassemia children in Hainan region, China link: https://peerj.com/articles/20586 last-modified: 2026-01-08 description: BackgroundThalassemia, a hereditary hemoglobinopathy characterized by impaired hemoglobin production, results in the premature destruction of erythrocytes and consequent anemia. However, the distinct hematological parameters and phenotypic expressions associated with different α-thalassemia genotypes in the pediatric population remain inadequately characterized. Therefore, this study was designed to perform a comparative analysis of clinical parameters between pediatric patients with α-thalassemia and healthy controls, to elucidate genotype-specific disease manifestations, and to inform optimized management strategies.MethodsThis retrospective cross-sectional study enrolled 160 children with genetically confirmed α-thalassemia and 105 healthy controls in Hainan. Participants were categorized into silent carrier, mild, Hb H disease, and control groups. Comprehensive assessments included hematological parameters, biochemical profiles, coagulation function, growth Z-scores, and serum ferritin. Group comparisons were performed across genotypes and age strata (1–5, 6–11, 12–18 years) using appropriate statistical methods.ResultsChildren diagnosed with Hb H disease exhibited the most severe hematological impairments, including growth retardation, elevated bilirubin levels, increased ferritin concentrations, and altered coagulation parameters. Among the genotypes studied, non-deletional types (--SEA/αQSα, --SEA/αCSα) demonstrated the most pronounced deficits. Growth Z-scores, encompassing weight-for-age (WAZ), height-for-age (HAZ), and body mass index-for-age (BAZ), were significantly reduced in the Hb H disease cohort, with deterioration observed as age increased. Notably, even silent carriers of the disease exhibited developmental delays during later childhood. Furthermore, iron overload and subclinical organ involvement were evident in older children affected by Hb H disease.ConclusionsThe clinical phenotype of pediatric α-thalassemia is significantly influenced by both genotype and age, with non-deletional Hb H disease presenting the highest risk for systemic complications. These findings emphasize the necessity for genotype-specific monitoring, early nutritional and iron-chelation interventions, and a multidisciplinary follow-up approach to enhance long-term outcomes. creator: Ge Gao creator: Zhengnan Sun creator: Junhong Chen creator: Jinyu Kang creator: Fei Sun creator: Qi Li creator: Limei Fu creator: Yi Gong creator: Linna Ma creator: Qiuling Jie creator: Yanlin Ma uri: https://doi.org/10.7717/peerj.20586 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Gao et al. title: Species diversity patterns in Tagetes minuta-invaded plant communities along an elevational gradient in Southeastern Xizang link: https://peerj.com/articles/20573 last-modified: 2026-01-08 description: Tagetes minuta, a herbaceous plant native to South America, has shown a significant trend of invasion along the section from Nyingchi to Shannan, situated along the Yarlung Zangbo River in southeastern Xizang in recent years. In this study, we conducted field surveys of T. minuta plant communities at elevations ranging from 2,925 to 3,553 m. By establishing 31 quadrats, we systematically analyzed the species composition, diversity characteristics of the invaded communities of T. minuta, and their relationships with elevation gradients and habitat types. The study results revealed that a total of 78 plant species, belonging to 28 families and 69 genera, were recorded in the T. minuta-invaded plant communities. Among them, the families Asteraceae, Poaceae, and Rosaceae were dominant, with herbaceous plants being in an absolute majority. The diversity analysis showed that the Shannon–Wiener index, Simpson index, and Pielou’s evenness index of were significantly higher in the community group mainly composed of Eragrotis pilosa and Plantago depressa (Cluster Group II) compared to the groups dominated by Poa annua plus Plantago depressa (Cluster Group I) and Poa annua and Digitaria cruciata (Cluster group III) (P < 0.05), while no significant differences were found in species richness. This suggests that the invasion of T. minuta primarily affects the evenness of species distribution rather than species richness. In addition, the species diversity indices of the T. minuta-invaded plant communities showed no significant correlation with elevation, indicating that elevation is not a major factor influencing species diversity in the invaded communities. The height of T. minuta was significantly positively correlated with elevation (P < 0.01), while its cover showed no significant correlation with elevation. Under different habitat types, the height and cover of T. minuta showed significant differences, with stronger invasion ability in habitats with greater human disturbance. This study highlights the invasion characteristics of T. minuta and its relationship with elevation in southeastern Xizang, offering valuable data for the ecological management of invasive plant species in plateau regions. creator: Norzin Tso creator: Ngawang Norbu creator: Wei Li creator: Xin Tan creator: Zhefei Zeng creator: La Qiong creator: Junwei Wang uri: https://doi.org/10.7717/peerj.20573 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Tso et al. title: Spatial and temporal patterns of vegetation carbon sources/sinks and driving factors in southeastern Xizang from 2000 to 2020 link: https://peerj.com/articles/20572 last-modified: 2026-01-08 description: Net ecosystem productivity (NEP) is a crucial measurement for understanding ecosystem function and carbon cycling. On the basis of Moderate Resolution Imaging Spectroradiometer (MODIS) data, meteorological data, and topographic data, combined with the enhanced Carnegie Ames Stanford Approach (CASA) model, we analyzed the spatiotemporal trends and changes in the vegetation NEP in southeastern Xizang from 2000 to 2020. Additionally, we employed the GeoDetector model to identify the driving factors influencing the vegetation NEP. The results indicated that: (1) from 2000 to 2020, the annual vegetation NEP in southeastern Xizang exhibited a fluctuating increasing trend. The multiyear average vegetation NEP was 519.06 gC m−2 a−1, ranging from 11.23 to 1,333.40 gC m−2 a−1. The minimum and maximum values occurred in 2010 and 2015, respectively. (2) The spatial distribution pattern of the vegetation NEP revealed an overall trend of higher values in southern areas and lower values in northern areas, with higher values in eastern areas compared to western areas. The average area of the carbon source regions (NEP < 0) was approximately 70,119 km2, whereas the average area of the carbon sink regions (NEP > 0) was approximately 82,017 km2. Overall, the region exhibited a carbon sink characteristic. (3) Altitude, precipitation, and temperature were the primary drivers influencing the vegetation NEP. In regions at lower elevations and in the southern and eastern parts of the study area—where thermal and moisture conditions are relatively favorable—NEP values were generally higher. In contrast, NEP was markedly lower in the northern and high-elevation areas characterized by low temperatures and limited water availability. The interactions between any two of these factors had a greater impact on the vegetation NEP than the independent effect of any single factor did, highlighting a synergistic dual-factor enhancement effect. creator: Jiahua Han creator: Xiyue Meng creator: Li Lin creator: Jie Lu uri: https://doi.org/10.7717/peerj.20572 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Han et al. title: Identification and analysis of exosome-associated signatures in pediatric sepsis by integrated bioinformatics analysis and machine learning link: https://peerj.com/articles/20555 last-modified: 2026-01-08 description: BackgroundPediatric sepsis (PS) is a critical condition characterized by life-threatening organ dysfunction and immune dysregulation, including exosome-mediated immune modulation, often linked to infections. Investigating the role of exosome-related genes (ERGs) in the pathogenesis of PS is essential for identifying significant diagnostic and therapeutic targets.MethodsFour datasets, namely GSE66099 (training set) and GSE13904, GSE26378, and GSE26440 (validation sets), were retrieved from the Gene Expression Omnibus (GEO). The differential expression of 56 ERGs was analyzed, followed by consensus clustering to identify distinct exosome-related patterns in PS. Weighted gene co-expression network analysis (WGCNA) was utilized to identify PS-related genes (SRGs). Additionally, the immune microenvironment was assessed, and diagnostic models were developed employing specific machine learning algorithms.ResultsThe differential expression analysis identified 21 ERGs that exhibited significant alterations in PS. Consensus clustering revealed two distinct subtypes of PS based on the expression pattern of ERGs. WGCNA identified several hub genes involved in exosome function and PS, with immune-related pathways, including phagocytosis and NF-κB signaling, showing significant enrichment. These genes were leveraged to construct machine learning models, which demonstrated a high diagnostic accuracy, with an area under the curve (AUC) > 0.995. The analysis identified CD177, GYG1, IRAK3, MCEMP1, and TLR5 as key biomarkers. Furthermore, external validation confirmed the superior performance of the constructed model.ConclusionThis study elucidated the role of ERGs in PS, and highlights the significance of immune dysregulation in the pathogenesis of the disease. The developed diagnostic models represent promising tools for the early detection and prognosis prognostic of PS. creator: Junming Huang creator: Lichuan Lai creator: Jinji Chen creator: Xiaotao Su uri: https://doi.org/10.7717/peerj.20555 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Huang et al. title: The effects of biological sex on fatigue during and recovery from resistance exercise link: https://peerj.com/articles/20542 last-modified: 2026-01-08 description: BackgroundGuidelines for resistance training prescription do not often consider sex as it relates to exercise prescription, despite its potential influence on responses to and adaptations following resistance training. If there are sex differences in the rate at which males and females fatigue during a resistance training session, or the rate at which they recover from resistance training between sessions, optimal resistance training volume may differ between the sexes. The purpose of this study was to investigate sex differences in fatigability and recovery from dynamic resistance exercise.MethodsMale and female subjects with at least one year of bench press experience (N = 21 males and 21 females) performed a fatigue protocol consisting of barbell bench press with 75% 1RM loads for sets of five repetitions, with 90 seconds between sets, until the point of concentric failure. Recovery was monitored for the subsequent 72 hours using subjective ratings of soreness for the pectoral muscles, triceps, and anterior deltoids, and estimated 1RM strength derived from load-velocity profiles.ResultsThe female subjects completed more reps during the fatigue protocol (females: 58.3 ± 27.3; males: 29.6 ± 10.6; p = 0.0001), but post-training soreness and recovery of estimated 1RM strength did not significantly differ between sexes (p > 0.05).ConclusionOur results suggest that females fatigue slower than males during multiple sets of bench press yet appear to recover from training at the same rate in spite of completing a higher relative workload. Furthermore, the difference in performance during the fatigue protocol appears to be attributable to the female subjects recovering more quickly during the rest intervals, rather than fatiguing more slowly while performing each set. creator: Gregory Lee Nuckols creator: Chase Alexander Overpeck creator: Erik Daniel Hanson creator: Claudio Luiz Battaglini uri: https://doi.org/10.7717/peerj.20542 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Nuckols et al. title: Searching for the neural correlates of emotional intelligence: a systematic review link: https://peerj.com/articles/20539 last-modified: 2026-01-08 description: The concept of emotional intelligence (EI) has gained significant interest in the scientific community in recent years. Despite its demonstrated impact on social and personal functioning, the neural bases underlying EI remain poorly understood. This study aimed to conduct a comprehensive systematic review of the existing literature on the neural correlates of EI. The search was conducted in Web of Science, Scopus, PsycINFO, and PubMed databases. A total of 849 studies were initially identified (after duplicates were removed), of which 34 met the inclusion criteria and were selected for the final synthesis. These studies employed various brain mapping techniques, including lesion studies, grey and white matter structural magnetic resonance imaging (MRI), task-based functional magnetic resonance imaging (fMRI), resting-state fMRI, and electroencephalogram (EEG). The findings of this review suggest that EI is supported by a complex and widespread brain network primarily implicated in the integration of cognitive and emotional processes, with significant involvement of structures commonly linked to social cognition. The literature mainly emphasized the role of the insula, ventromedial prefrontal cortex, orbitofrontal cortex, cingulate cortex, and amygdala in conjunction with brain networks comprising these areas, such as the somatic marker circuitry and the social cognition network. Other brain regions, including the dorsolateral prefrontal cortex, cuneus, precuneus, fusiform gyrus, superior temporal gyrus, cerebellum, parahippocampal gyrus, inferior frontal gyrus, frontopolar gyrus, superior parietal lobule, and superior longitudinal fasciculus (SLF) were also frequently mentioned. However, further research is needed to clarify the roles of some of these regions in EI. Limitations and future lines of research are discussed. creator: Víctor Martín-Aguiar creator: Pablo Fernández-Berrocal creator: Alberto Megías-Robles uri: https://doi.org/10.7717/peerj.20539 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Martín-Aguiar et al. title: Impact of osteosarcopenia in older people on prognosis following major surgery: a scoping review link: https://peerj.com/articles/20527 last-modified: 2026-01-08 description: PurposeThis review aims to map the existing literature on the prevalence, diagnostic criteria, and impact of osteosarcopenia on postoperative clinical outcomes in older adults.MethodsThe search for this scoping review followed the PRISMA extension guidelines across five databases (Medline, Scopus, Web of Science, Scielo, and PEDro) from their inception until August 2025. Eligible studies included older adults with osteosarcopenia who underwent major surgeries and reported clinical outcomes. Additionally, data extraction covered three themes: study and population characteristics; prevalence and impact of osteosarcopenia on post-major surgery clinical outcomes; and diagnostic criteria for osteosarcopenia.ResultsA total of 164 studies were identified, of which 18 met the inclusion criteria, involving 3,235 participants aged between 60.7 and 83 years. The impact of osteosarcopenia varies depending on the type of procedure: (1) in oncological surgeries, the prevalence ranged from 12% to 44%, with reported complications including prolonged surgical time and reduced survival; (2) in orthopedic surgeries, prevalence ranged from 28% to 100%, with issues such as delayed recovery and increased mortality; and (3) in cardiovascular and gastrointestinal surgeries, the prevalence of osteosarcopenia ranged from 6.5% to 38.5%, associated with delayed wound healing and higher infection rates. Diagnostic approaches to osteosarcopenia showed substantial heterogeneity, most frequently relying on skeletal muscle mass index and bone mineral density, but applying different cutoff values.ConclusionsThe prevalence of osteosarcopenia differs across populations and surgical contexts. This syndrome represents an important risk factor for adverse postoperative outcomes in older adults undergoing major surgery. Furthermore, considerable variability persists in the diagnostic criteria employed, underscoring the need for standardized definitions to improve clinical applicability and comparability across studies. creator: Yshoner Antonio Silva-Diaz creator: Cintya Odar-Rojas creator: Wilson Pasten-Hidalgo creator: Eduardo Gallegos-Chavez creator: Cristian Barros-Osorio creator: Walter Sepúlveda-Loyola uri: https://doi.org/10.7717/peerj.20527 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Silva-Diaz et al. title: Comparative analysis of length-weight relationships and condition factors of two congeneric rockcod species from the shores of King George Island, Antarctica link: https://peerj.com/articles/20513 last-modified: 2026-01-08 description: Length-weight relationships (LWR) and Fulton’s condition factors (K) of two notothenioid species, Notothenia rossii and Notothenia coriiceps, were assessed using 295 and 148 specimens, respectively. Fish samples were collected from two different locations: the wharf of the King Sejong Station and Chotdaebawi in Maxwell Bay, King George Island, from January to February 2023. The coefficient of determination (R2) of linear regressions on LWR ranged from 0.935 to 0.970, and the b values ranged from 3.05 to 3.27. Only N. coriiceps caught in the wharf exhibited positive allometric growth, while N. coriiceps from Chotdaebawi and N. rossii from both locations demonstrated isometric growth. The estimated condition factors (K) indicated that all groups of N. rossii and N. coriiceps exhibited favorable growth conditions in their respective biotopes. These findings enhance our understanding of the similarities and differences in fundamental biological characteristics, ecological aspects, and growth conditions of two important congeneric Antarctic fish species. creator: Seungyeon Lee creator: Mi-Hyun Park creator: Sachithra Amarin Hettiarachchi creator: Jihun Kim creator: Yong-Woo Lee creator: Jin-Hyoung Kim uri: https://doi.org/10.7717/peerj.20513 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Lee et al. title: Biodegradation of plastic waste by yellow mealworms (Tenebrio molitor larvae) link: https://peerj.com/articles/20429 last-modified: 2026-01-08 description: BackgroundPlastics are very widely used worldwide, and most of these are not degradable, resulting in global environmental concerns. Plastic usage is growing faster than it did in the past, especially during the COVID-19 outbreak. Global plastic waste associated solely with this pandemic was estimated to be 8.4 ± 1.4 million tons in 2021, exacerbating the existing global burden of plastic, estimated at 9 billion tons produced up to 2017. Some insects can break down plastic polymers, and their intestinal microorganisms play an important role in the process. The purpose of this study was to investigate the biodegradation of several types of plastics by yellow mealworms (Tenebrio molitor larvae) and identify the intestinal bacteria engaged in the process.MethodsIn this study, a total of 140 g of mealworms (±1,050 individuals) were divided into seven groups consisting of approximately 150 larvae, and assigned to different plastic feeding conditions, i.e. polyvinyl chloride (PVC), polyethylene (PE), polystyrene (PS), polypropylene (PP), and polyethylene terephthalate (PET) for 30 days. The consumption rate of plastic, mealworm total live biomass retention, and the life cycle of mealworms were observed. The gut microorganisms of mealworms with the highest rate of plastic consumption were isolated and identified using 16S rRNA gene sequencing. Their potential for plastic degradation was assessed by testing their capability to grow in a minimal medium with PVC film serving as the sole carbon source.ResultsAfter a month, PVC was consumed by mealworms more than other plastic sources, as evidenced by their regular life cycle and total live biomass retention (94.8702 ± 2.4278%). A bacterial strain (MG06) with potential PVC-degrading capability was isolated from the guts of the mealworms and was identified as Enterobacter xiangfangensis based on 16S rRNA gene sequencing and phylogenetic analysis. The strain demonstrated PVC-dependent growth and survival, indicating its potential to utilize PVC as a carbon source. To the best of our knowledge, no information regarding E. xiangfangensis concerning plastic degradation has been disclosed. This work reports the first evidence suggesting that this bacterium species may contribute to the biodegradation of PVC. creator: Wissarut Srisakvarangkool creator: Panjamaphon Chanthasena creator: A’liyatur Rosyidah creator: Phongsakorn Ganta creator: Supavadee Kerdtoob creator: Nawarat Nantapong uri: https://doi.org/10.7717/peerj.20429 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Srisakvarangkool et al. title: Effects of unilateral neck muscle vibration on tilt direction and variability of subjective postural vertical in the frontal plane during seated posture in healthy adults link: https://peerj.com/articles/20579 last-modified: 2026-01-07 description: BackgroundUnilateral neck muscle vibration (NMV) activates the primary endings of muscle spindles and modulates both subjective visual vertical and subjective straight-ahead perception. However, its effects on subjective postural vertical (SPV), crucial for postural balance, remain poorly understood. We aimed to investigate the effects of unilateral NMV-induced proprioceptive stimulation on SPV tilt direction and intraindividual variability in the frontal plane in healthy participants.MethodsWe included 48 healthy adults (29 males, 19 females; age 22.5 ± 1.1 years; height 167.7 ± 7.4 cm; weight 58.7 ± 8.4 kg), randomly divided into four groups: vibrations to the left (L-Vib) and right sides (R-Vib), as well as sham stimulations to the left (L-Sham) and right (R-Sham). Vibration was applied for 10 min at 80 Hz with an amplitude of 0.8 mm. SPV was measured using a motorized vertical-tilting chair equipped with a backrest and lateral supports. Participants were seated without ground contact, with their trunk fixed and arms crossed; the ir head and legs re mained unrestrained. The experimenter tilted the chair from an initial position of 15° or 20° in the frontal plane toward the vertical at a speed of 1.5°/s. A digital inclinometer recorded the tilt angle when participants reported their body felt upright. Each session comprised eight trials with pseudorandom starting directions and angles. The mean tilt direction and standard deviation across trials were calculated. SPV was assessed before, during, and after stimulation. A two-way analysis of variance was conducted to analyze the effect s of unilateral NMV on SPV outcomes.ResultsThere were no significant demographic differences across groups. For SPV tilt direction, there was no statistically significant interaction between group and time. However, for SPV variability, significant effects were observed for time (F1,44 = 9.591, p = 0.003, partial η2 = 0.179) and the interaction between group and time (F6,44 = 2.325, p = 0.039, partial η2 = 0.137). Participants in the L-Vib group exhibited significantly reduced variability both during and after stimulation compared with those in the L-Sham (p = 0.004) and R-Sham (p < 0.001) groups. Similarly, participants in the R-Vib group showed significantly lower variability than those in the R-Sham group (p = 0.02).DiscussionThese findings highlight the role of sensorimotor integration in body orientation and suggest that unilateral NMV may enhance the precision of verticality estimation. Based on this preliminary study, NMV could be a promising intervention for individuals with SPV abnormalities. creator: Yuji Fujino creator: Kazu Amimoto creator: Tadamitsu Matsuda creator: Daisuke Sekine creator: Toshiyuki Fujiwara uri: https://doi.org/10.7717/peerj.20579 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Fujino et al. title: Assessment of knowledge, attitudes, and practices regarding sun exposure and sun protection among female students living in high-altitude areas, Abha, Saudi Arabia: a cross-sectional study link: https://peerj.com/articles/20576 last-modified: 2026-01-07 description: BackgroundUltraviolet (UV) rays are more intense at high-altitude regions. Exposure to intense UV rays is a major risk factor for skin damage and skin cancer. The university students (young adults) have limited awareness of sun protection measures, leading to persistent gaps in their knowledge, attitudes, and practices (KAP). This study evaluates the KAP of sun exposure and protection measures among female students at King Khalid University in Abha, Saudi Arabia.ObjectivesTo assess students’ understanding of sun exposure risks and protective measures, to identify students’ attitudes toward sun safety, and to determine students’ sun exposure and protection practices.MethodsA descriptive cross-sectional study was conducted on 328 female students from various academic programs using a stratified random sampling method. Data were collected using a validated questionnaire assessing sociodemographic details, knowledge, attitudes, and practices toward sun exposure and sun protective measures at high altitudes. Statistical analysis was conducted using SPSS V.27, with descriptive statistics determining frequency and percentages, and inferential statistics assessing relationships between KAP variables.ResultsThe majority of participants (77.1%) were aware of the stronger sun rays at high altitudes, and 72.9% recognized high UV intensity. However, misconceptions persisted, with 55.2% believing sunscreen use before age 30 causes skin darkening. While 66.5% reported using sun protection, inconsistencies in sunscreen use and other protective behaviors were observed. Statistically significant relationships were found between academic year and sun-related knowledge (p < 0.001), as well as between knowledge, attitudes, and practices.ConclusionDespite good awareness and positive attitudes toward sun protection, practical application remains inconsistent. Targeted educational campaigns and culturally appropriate interventions are essential to bridging the gap between knowledge and practice. Future studies should focus on evaluating intervention effectiveness and long-term behavioral changes. creator: Maha Ali creator: Bayapa Reddy Narapureddy uri: https://doi.org/10.7717/peerj.20576 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Ali and Narapureddy title: The effects of the heavy metals cadmium and lead on six metabolic and immune-related enzymes in the loach (Misgurnus anguillicaudatus) link: https://peerj.com/articles/20547 last-modified: 2026-01-07 description: BackgroundCadmium (Cd2+) and lead (Pb2+) are two common heavy metal pollutants in rivers and lakes that have multiple toxic effects on organisms. However, their toxic mechanisms are not fully understood. The loach (Misgurnus anguillicaudatus), belonging to the genus Misgurnus (Cypriniformes, Cobitidae), is an important benthic fish species whose physiological activities are highly susceptible to heavy metal pollutants. Such exposure can adversely affect its growth, development, and reproduction, leading to disease occurrence and significant economic losses in the M. anguillicaudatus farming industry.MethodsAfter M. anguillicaudatus was exposed to Cd2+ (3.625 mg L−1, 7.25 mg L−1, and 14.5 mg L−1) and Pb2+ (47.5 mg L−1, 95 mg L−1, and 190 mg L−1) for 96 h, frozen sections of their visceral organs (heart, hepatopancreas, gills, kidneys, stomach, and intestine) were prepared. The activities of six metabolic and immune-related enzymes in these organs were assessed using enzyme histochemical staining and optical density quantitative analysis technology.ResultsThe distribution of the six metabolic and immune-related enzymes exhibited significant tissue specificity. Acid phosphatase (ACP) was mainly distributed in the stomach, intestine, and gills; alkaline phosphatase (ALP) exhibited high activity in the stomach and intestine; and adenosine triphosphatase (ATPase) displayed greater activity in the heart, hepatopancreas, and stomach. In addition, non-specific esterase (NSE) was abundant in the hepatopancreas, stomach, gills, and kidney; peroxidase (POX) activity was prominent in the kidney, gills, and heart; and succinate dehydrogenase (SDH) activity was enriched in the heart and hepatopancreas. Exposure to Cd2 + markedly inhibited ACP activity in all six organs, significantly inhibiting ALP activity in the hepatopancreas, gills, and stomach, ATPase activity in all six organs, NSE activity in the hepatopancreas and stomach, POX activity in the heart, gills, and kidney, and SDH activity in the heart, hepatopancreas, and stomach. Similarly, Pb2 + exposure significantly inhibited ACP and ATPase activities in all organs except the kidney and stomach, the ALP and NSE activities of the hepatopancreas, gills, and stomach, the POX activities of the heart, gills, and kidney, and the SDH activities of the heart, hepatopancreas, and stomach.ConclusionsCompared with Pb2+, Cd2+ exerted a broader toxic effect across the six organs. Both heavy metal ions disrupted the blood circulation of M. anguillicaudatus by inhibiting enzymatic activity, impairing detoxification and respiration, and reducing the digestion and absorption of nutrients. creator: Qin Wang creator: Jiejie Su creator: Zhiruo Fu creator: Yujia Hu creator: Junlong Wei creator: Tao Pan creator: Shengzhou Zhang uri: https://doi.org/10.7717/peerj.20547 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wang et al. title: AVOKE: an open-source toolbox for audiovisual web experiments in jsPsych link: https://peerj.com/articles/20544 last-modified: 2026-01-07 description: As web-based experiments become increasingly popular, the need for advanced, accessible research methods is greater than ever. Existing solutions for designing and building an experiment are often closed source and proprietary, which limits configurability, affordability, and testability. Moreover, inconsistent terminologies, domain-specific coding and documentation, and practices such as open-washing impair the ease of adoption and effective use of these tools by novice researchers and practitioners. To address these shortcomings, we release AVOKE—a collection of free and open source tools for web-based behavioural experiments. AVOKE extends the functionalities of the widely adopted jsPsych library, matching community standards for code reusability and comprehensive documentation. The current release of AVOKE supports temporally-precise presentation of audiovisual media (including generated animations, preloaded files, and external sources like YouTube), as well as the collection of behavioural responses, like keypresses and video capture (e.g., for recording face videos of participants). This paper elaborates on the functionalities, implementation, and usage of the included plugins and extensions in AVOKE. These extensions and plugins have been validated with simulation testing and utilised in previous and ongoing studies. AVOKE is openly available at https://www.github.com/beatlab-mcmaster/AVOKE and archived on Zenodo. We welcome contributions to AVOKE and discuss potential future additions to ease the development of advanced web-based experiments for all users. creator: Shreshth Saxena creator: Jackson Shi creator: Lauren Fink uri: https://doi.org/10.7717/peerj.20544 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Saxena et al. title: Zmpste24 deficiency contributes to intervertebral disc degeneration by undermining the stability of the nuclear membrane of nucleus pulposus cells link: https://peerj.com/articles/20534 last-modified: 2026-01-07 description: Intervertebral disc degeneration (IVDD) is often accompanied by the senescence of nucleus pulposus (NP) cells and narrowed intervertebral disc space. Zinc metalloproteinase STE24 (Zmpste24), a common anti-aging gene, has been studied in several diseases but remains understudied in IVDD. This study aimed to investigate the relationship between IVDD and alterations in Zmpste24 expression. Immunohistochemical staining revealed that reduced Zmpste24 expression in patients with IVDD. In vitro experiments using rat NP cells revealed that Zmpste24 inhibition induced nuclear instability and cellular senescence. In addition, the phenotype and immunohistochemical staining of Zmpste24 knockout (KO) mice confirmed that Zmpste24 plays a protective role against IVDD. Collectively, these findings suggest that reduced Zmpste24 expression in NP cells may contribute to IVDD pathogenesis. creator: Chen Han creator: Shaotian Fu creator: Hanyi Wang creator: Kai Zhang creator: Jie Zhao uri: https://doi.org/10.7717/peerj.20534 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Han et al. title: Comparative genomics and phylogenetic analysis of seven Ficus species based on chloroplast genomes link: https://peerj.com/articles/20531 last-modified: 2026-01-07 description: BackgroundThe genus Ficus (Moraceae) is a large and ecologically important group, known for its intricate fig-wasp pollination mutualism and role as a keystone resource in tropical ecosystems. Despite its significance, the phylogenetic relationships within Ficus remain partially unresolved, necessitating more comprehensive genomic data. Chloroplast (cp) genomes are valuable resources for plant phylogenetic and comparative genomic studies. Here, we sequenced, assembled, and comparatively analyzed the complete chloroplast genomes of seven Ficus species, including Ficus esquiroliana, Ficus pandurata, Ficus formosana, Ficus erecta, Ficus carica, Ficus hirta, and Ficus stenophylla.ResultsThe complete cp genomes were successfully assembled, ranging in size from 160,340 bp to 160,669 bp, and exhibited a typical quadripartite structure with highly conserved gene content and arrangement. Critically, while some of these species have previously published plastomes, our assemblies consistently encoded 130 genes, contrasting with reported gene counts (e.g., 129 for F. formosana (NC_059898), 119 for F. carica (KY635880), 131 for F. erecta (MT093220)) in earlier studies. Numerous repeat sequences and simple sequence repeats (SSRs) were identified, predominantly in non-coding regions, which serve as valuable resources for developing novel genetic markers. Analysis of codon usage revealed a strong bias towards A/T endings, a common feature in plant cp genomes. While inverted repeat (IR) boundary regions were largely conserved, minor variations, including partial gene duplications (rps19, rpl2), were observed. Comparative genome alignment and nucleotide diversity analysis showed high sequence conservation, with most variations concentrated in single-copy and non-coding regions. We identified three hypervariable regions (ccsA, ccsA - ndhD, and rpoB - trnC-GCA) with elevated nucleotide diversity (Pi > 0.012, ccsA up to 0.0141), suggesting their utility as candidate DNA barcodes for Ficus. Phylogenetic analysis using 79 protein-coding genes from 26 species robustly supported the monophyly of Ficus and resolved the seven newly sequenced species into two well-supported clades, consistent with previous classifications.ConclusionsOur study provides new, consistently assembled and rigorously annotated chloroplast genome data for Ficus, including clarified data for previously studied species with notable gene content discrepancies. These data identify candidate molecular markers with potential applications for systematics and population genetics, and offer robust insights into relationships among sampled taxa. These data will facilitate future studies of Ficus evolution and conservation when complemented by broader taxon sampling and nuclear/mitochondrial data. creator: SuQing Bao creator: Lili Deng creator: YanCai Shi creator: Na Duan uri: https://doi.org/10.7717/peerj.20531 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Bao et al. title: Research progress on exercise fatigue from the perspective of fatigue biomarkers link: https://peerj.com/articles/20424 last-modified: 2026-01-07 description: Exercise-induced fatigue refers to the physiological processes of body functions that cannot be sustained at a specific level during exercise or the inability of the organs to maintain a predetermined level of intensity. Exercise-induced fatigue is a comprehensive physiological process, which is mainly reflected in the body’s neuromuscular system and cardiovascular system. The study of fatigue-related physiological responses related to exercise-induced fatigue provides crucial insights into the underlying mechanisms, enables the assessment of fatigue levels, and aids in the formulation of effective recovery strategies. This review summarized the latest advancements in the research of biomarkers associated with exercise-induced fatigue, exploring the mechanisms of various biomarkers, detection methods, and their applications in sports medicine. Studies have shown that energy substances, metabolites, blood bioindicators, central neurotransmitters, free radicals, urine, saliva, etc., are related to exercise-induced fatigue-related biomarkers in human body. Among them, energy-related substances were the first fatigue markers studied, and metabolites in blood or urine were gradually used as biomarkers as research was deepened and testing methods were refined. The presence of central neurotransmitters gradually increased, and researchers gradually emphasized the important role of neurotransmitters in exercise-induced fatigue. Through a comprehensive analysis of relevant literature, this paper aimed to offer guidance for future research directions and promote a more scientific approach to managing exercise-induced fatigue. creator: Xin Liu creator: Juan Liu uri: https://doi.org/10.7717/peerj.20424 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Liu and Liu title: A systematic review and meta-analysis of the effects of mind-body exercise on depressed and anxious individuals link: https://peerj.com/articles/20570 last-modified: 2026-01-06 description: BackgroundThis systematic review evaluates the effectiveness of mind-body exercise in alleviating symptoms of depression and anxiety. It further compares the effects of different types of mind-body exercise and examines whether intervention cycle, session length, or frequency exhibit dose-response relationships.MethodsThis study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and systematically searched seven prominent databases—Web of Science, PubMed, Cochrane Library, Embase, CNKI, WANFANG DATA, and the VIP database—from their inception through July 6, 2024. Only randomized controlled trials (RCTs) examining the impact of mind-body exercise interventions on depression and anxiety were included in the analysis. All experimental groups engaged only in mind-body exercise, and control groups received no intervention. Meta-analysis, subgroup analysis, sensitivity analysis, and assessment of publication bias were performed using Stata 17.0 software. Evidence quality was assessed using the GRADE tool.ResultsA total of 15 studies that encompassed 1,351 participants were included in this review. The meta-analysis demonstrated that mind-body exercise significantly alleviated symptoms of depression (Hedges’ g = −0.86, 95% CI [−1.24 to −0.48], P < 0.001) and anxiety (Hedges’ g = −0.38, 95% CI [−0.53 to −0.23], P < 0.001). Five subgroup variables were examined in this study: exercise type, session duration (minutes), intervention period (weeks), frequency (sessions per week), and baseline depression severity. In the analysis of depression outcomes, exercise type, session duration, frequency, and baseline depression severity were identified as significant moderators. The most effective intervention characteristics for reducing depressive symptoms were: Qigong as the exercise type, sessions lasting 31–60 min, a frequency of three sessions per week, an intervention period of 9–12 weeks, and high baseline levels of depression. In contrast, none of these variables were found to be significant moderators in the analysis of anxiety outcomes. However, the most effective intervention characteristics for alleviating anxiety symptoms were tai chi as the exercise type, sessions lasting 31–60 min, a frequency of four or more sessions per week, an intervention period of 8 weeks or less, and normal baseline anxiety levels.DiscussionThere was robust evidence that mind-body exercise significantly reduces symptoms of depression and anxiety.OtherThis study adhered to PRISMA guidelines to ensure rigorous transparency and methodological accuracy. Furthermore, it was formally registered on the PROSPERO international systematic review platform (https://www.crd.york.ac.uk/prospero/) under registration number CRD42024613769. creator: Zheng Ye creator: Zhihui Xu creator: Xing Wang uri: https://doi.org/10.7717/peerj.20570 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Ye et al. title: Microbial allies: shaping growth, physiology, and rhizosphere dynamics of onion (Allium cepa L.) link: https://peerj.com/articles/20566 last-modified: 2026-01-06 description: The present study investigates the dual impact of microbial biofertilizers on the phenotypic performance and rhizosphere microbiome composition in an onion crop. A pot experiment was conducted with seven treatments of microbial inoculants, such as Azotobacter, Azospirillum, Piriformospora indica, phosphate solubilizing bacteria (PSB), and control treatments with and without chemical fertilizers. The growth, physiological, and biochemical traits of onion were assessed alongside rhizospheric soil microbiome profiling using 16S rRNA metagenomic sequencing. Significant enhancement in plant height, leaf number, leaf area, chlorophyll content, photosynthetic rate, and antioxidant enzyme activity with low leaf temperature was observed in plants inoculated with Azotobacter and Azospirillum. Notably, the Azotobacter treatment yielded a significant enhancement in the bulb phenol content. Rhizosphere metagenomic analysis revealed 17 dominant phyla, with Actinobacteria (25.3%), Proteobacteria (22.2%), Firmicutes (12.8%), and Chloroflexi (11.02%) comprising over 70% of the total microbiome. Alpha and beta diversity metrics indicated that microbial inoculation, especially with Azospirillum and PSB, enriched the soil microbial community structure. Distinct clustering and correlations with specific microbial taxa such as Candidatus Nitrososphaera and Pseudomonas were observed in response to individual biofertilizer treatments. This study highlights the potential of biofertilizers not only in enhancing onion growth and development but also in modulating beneficial rhizosphere microbial communities. Integrating biofertilizers into onion production systems could reduce the dependency on chemical fertilizers and promote sustainable crop management. creator: Pranjali A. Gedam creator: Kiran Khandagale creator: Vitthal T. Barvkar creator: Snehal Bhandari creator: Sucheta Patil creator: Sagar Wayal creator: Indira Bhangare creator: Kiran P. Bhagat creator: Kiran Landage creator: Rajiv Kale creator: Vivek Bhoite creator: Sanket More creator: Vijay Mahajan creator: Suresh Gawande uri: https://doi.org/10.7717/peerj.20566 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Gedam et al. title: An improved tortuosity measurement method combining curvature-based, breadth-first search and Euclidean distance for retinal image analysis link: https://peerj.com/articles/20561 last-modified: 2026-01-06 description: Retinal vascular tortuosity is a clinically relevant biomarker linked to systemic and ocular diseases; however, its quantitative assessment particularly the distinction between arteries and veins remains underexplored in both healthy and pathological conditions. This study investigates tortuosity behavior using three publicly available retinal fundus image datasets: Digital Retinal Images for Vessel Extraction (DRIVE), High-Resolution Fundus (HRF), and Labelled Eye fundus Segmentation-Artery Vein (LES-AV). A standardized analytical pipeline combining curvature-based metrics, breadth-first search (BFS) and Euclidean distance was applied following vessel segmentation, artery-vein separation, skeletonization, and optic disc-based tracing. BFS algorithm was utilized for vessel path tracing, chosen for its robustness and suitability in navigating complex vascular structures with high reproducibility. Five comparative analyses were performed: artery vs. vein tortuosity; healthy vs. diseased eyes (glaucoma and diabetic retinopathy); and cross-dataset comparisons under both healthy and pathological conditions. Across all datasets, veins consistently exhibited higher tortuosity than arteries in healthy eyes, confirmed by large effect sizes (Cohen’s d), despite weak correlation between the two vessel types. Diabetic retinopathy cases showed an amplified artery-vein separation, suggesting disease-induced vascular changes. Glaucomatous eyes exhibited mixed patterns, with HRF artery-vein differences maintained and LES-AV showing diminished separation, partly due to non-normal data distribution. A key finding highlights the significant influence of imaging characteristics especially field of view (FOV) on tortuosity measurement. Datasets with a wider field of view, such as DRIVE and HRF (45° FOV, optical disc (OD) positioned nasally), captured more peripheral, tortuous vessels and reported higher tortuosity values. In contrast, the LES-AV dataset with a narrower 30° FOV and centered optic disc, resulted in lower tortuosity measurements and weaker artery-vein differentiation. These anatomical and technical differences emphasize the need to handle FOV and orientation settings when designing or comparing tortuosity-based diagnostic studies. In conclusion, retinal vascular tortuosity appears to be a vessel-specific feature which is robust and capable of capturing both pathological and variations in dataset. The findings support its integration into automated diagnostic frameworks and highlight the importance of standardizing imaging parameters particularly FOV and anatomical orientation in future retinal biomarker research. creator: Nur Asyiqin Amir Hamzah creator: Wan Mimi Diyana Wan Zaki creator: Aziah Ali uri: https://doi.org/10.7717/peerj.20561 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Amir Hamzah et al. title: Comparative anatomy of the thoracic muscles of bees (Hymenoptera: Apoidea) link: https://peerj.com/articles/20532 last-modified: 2026-01-06 description: Bees exhibit a remarkable anatomical diversity, with phenotypic traits that reflect broad evolutionary patterns and specific adaptations. Understanding these patterns requires examining key anatomical features, such as thoracic musculature, which drives morpho-functional variation and underscores their extensive phenotypic diversity. The thorax (or ‘mesosoma,’ as it can be referred to in the context of bees and other apocritan Hymenoptera) serves as a power core, housing muscles responsible for leg, wing, and also head and metasomal articulation movements. Despite the role of the thoracic musculature in the flight mechanics of bees, detailed studies are limited to accounts of individual species or small subsets of muscles, with truly comparative analyses being scarce, leaving gaps in understanding muscular variation and phylogenetic significance. To address this, we conducted detailed dissections of 13 species, representing six bee families (Andrenidae, Apidae, Colletidae, Halictidae, Megachilidae, and Melittidae) and three additional apoid wasp taxa (Bembicidae, Crabronidae, Philanthidae), selected to capture a broad range of morphological and phylogenetic diversity. Our results revealed high conservation in mesosomal musculature, with only 16 of 58 muscle groups showing significant variation, primarily in origin points, suggesting a balance between functional constraints and evolutionary flexibility in muscle attachment. Phylogenetically relevant changes were investigated by coding 17 morphological characters, revealing potential synapomorphies for bees or certain lineages. These include the dorsomedial origin of Idlm1 (M. prophragma-occipitalis) in Meliponini, as evident in species such as Melipona quadrifasciata and Tetragonisca fiebrigi, suggesting a shared derived trait for this tribe. Additionally, the extended origin of IIIscm2 is observed in Andrenidae, Colletidae, and Halictidae, indicating closer evolutionary relationships among these families. Bee-specific modifications, including the non-separation of IItpm7b and IItpm7c by the mesepisternal ridge, distinguished bees from most apoid wasps, interpreted here as a potential synapomorphy for bees. Additional variations, such as the ventral origin of Ivlm3 in select lineages and the branched morphology of IIpcm4, suggest independent evolutionary shifts potentially linked to biomechanical demands. These findings underscore the evolutionary stability and phylogenetic value of bee mesosomal musculature, revealing a conserved framework punctuated by lineage-specific adaptations that may correlate with ecological traits. creator: Odair M. Meira creator: Eduardo A.B. Almeida uri: https://doi.org/10.7717/peerj.20532 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Meira and Almeida title: Platelet-lymphocyte ratio and its dynamic changes predict mortality in septic acute kidney injury patients: a retrospective multi-center study using U.S. database and Chinese hospital data link: https://peerj.com/articles/20522 last-modified: 2026-01-06 description: BackgroundThe platelet-to-lymphocyte ratio (PLR), a readily available marker that integrates systemic inflammatory burden and immune competence, has emerged as a cost-effective prognostic biomarker in critical care medicine. Elevated PLR has been linked to adverse outcomes across a spectrum of critical illnesses, yet its utility in predicting prognosis among patients with septic acute kidney injury (AKI) remains undefined. Moreover, little is known about how in-hospital trajectories of PLR influence survival outcomes.MethodThis retrospective study employed data from the Medical Information Mart for Intensive Care IV and West China Hospital of Sichuan University. The primary endpoints were 28-day and 90-day all-cause mortality. The association between baseline PLR/changes in PLR (ΔPLR) and 28-day and 90-day mortality was investigated by survival analysis and Cox proportional hazards models. ΔPLR was calculated as PLR at discharge minus PLR at admission. Patients were stratified based on optimal PLR cut-off values determined from the training cohort, and results were validated internally and externally. Predefined subgroup analyses probed for effect modification across key clinical populations, and mediation analysis was conducted to quantify intermediate variables linking PLR/ΔPLR dynamics to patient outcomes.ResultA total of 1,478 patients were included in the baseline-PLR cohort and 982 in the ΔPLR cohort. In the training set, an elevated baseline PLR (≥335.44) was associated with significantly higher 28-day mortality (26.56% vs. 18.66%, P = 0.009) and 90-day mortality (46.48% vs. 35.61%, P = 0.003). These findings were confirmed in both the internal validation cohort and an external cohort, and remained robust after adjustment for demographic, clinical and laboratory confounders. Conversely, lower ΔPLR also predicted the 28-day (14.81% vs. 6.94%, P = 0.007; HR = 2.261, P = 0.005) and 90-day mortality (24.07% vs. 15.41%, P = 0.029; HR = 1.702, P = 0.017), as well as prolonged hospital stay (28.64 vs. 21.64 days, P = 0.004). The associations between PLR or ΔPLR and mortality remained robust after adjusting for confounding factors. Subgroup analyses indicated that the prognostic value of PLR was particularly pronounced in non-urinary tract infection patients, and a low baseline PLR conferred a significant survival benefit in male patients. Mediation analysis revealed that changes in white blood cell count (ΔWBC) mediated 27.99% of the association between ΔPLR and 28-day mortality.ConclusionBoth baseline PLR and its dynamic change during hospitalization may serve as significant predictors of mortality in septic AKI. PLR-based indices could aid in risk stratification and early identification of high-risk patients. creator: Caihong Liu creator: Xue Tang creator: Wei Wei creator: Yongxiu Huang creator: Mingjing Guan creator: Jinglei Ren creator: Binyu Yang creator: Ping Fu creator: Ling Zhang creator: Yuliang Zhao uri: https://doi.org/10.7717/peerj.20522 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Liu et al. title: Extracorporeal shockwave therapy versus sham extracorporeal shockwave therapy for chronic Achilles tendinopathy: a meta-analysis of randomized controlled trials link: https://peerj.com/articles/20506 last-modified: 2026-01-06 description: BackgroundChronic Achilles tendinopathy is a persistent and debilitating condition. Extracorporeal shockwave therapy (ESWT) is widely used, but its true effectiveness and safety for chronic Achilles tendinopathy remains debated. This study aimed to compare the effectiveness and safety of ESWT and sham ESWT for chronic Achilles tendinopathy.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, EMBASE, Cochrane Library, and Web of Science were systematically searched for randomized controlled trials (RCTs) comparing ESWT with sham ESWT in chronic Achilles tendinopathy. Primary outcomes included pain reduction (change in Visual Analog Scale (ΔVAS), minimal clinically important difference (MCID) 1.1/10) and functional improvement (change in Victorian Institute of Sports Assessment-Achilles (ΔVISA-A), MCID 8/100; change in American Orthopaedic Foot and Ankle Society (ΔAOFAS), MCID 12/100). Secondary outcomes encompassed adverse events. Risk of bias was assessed via Risk of Bias 2 (RoB2). Meta-analysis used RevMan 5.4.1, with weighted mean differences (WMD) and odds ratios (ORs) for continuous and dichotomous outcomes, respectively. Hypothesis-generating subgroup analyses explored ESWT type, tendinopathy classification, and symptom duration.ResultsEight RCTs (458 participants) were included. No significant differences were observed between ESWT and sham groups in ΔVAS or ΔVISA-A, ΔAOFAS across follow-ups all P > 0.05). Adverse events were higher with ESWT (4.5% vs. 1.2%), though non-significant (P = 0.12). Subgroup analysis found that ESWT led to significant VAS reduction in patients with symptom duration < 12 months at 1-month (WMD: −0.76, P = 0.03) and 3-month (WMD: −1.23, P = 0.001) follow-ups than Sham ESWT.ConclusionsESWT showed no clear overall benefits compared to sham ESWT for chronic Achilles tendinopathy, but exploratory analyses hint at possible short-term pain relief for patients with symptoms lasting less than 12 months. More high-quality evidence is needed. creator: Tingting Ni creator: Yanmin Zhao creator: Long Pang creator: Weili Fu uri: https://doi.org/10.7717/peerj.20506 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Ni et al. title: Analysis of molecular subtypes and prognostic signature of senescence-associated secretory phenotype in pancreatic cancer link: https://peerj.com/articles/20476 last-modified: 2026-01-06 description: BackgroundPancreatic cancer (PC) exhibits an extremely poor prognosis due to its high heterogeneity. The senescence-associated secretory phenotype (SASP), a distinct secretory profile displayed by senescent cells, has been increasingly studied. However, the role of SASP in PC prognosis and treatment remains unclear.MethodsTranscriptomic sequencing data from PC patients were analyzed using consensus clustering based on SASP genes. A prognostic signature was subsequently constructed via Least Absolute Shrinkage and Selection Operator (LASSO) regression using survival-related SASP genes. Pathway enrichment analysis for distinct subgroups was performed using Gene Set Variation Analysis (GSVA). Comprehensive analyses of mutational landscapes and tumor immune microenvironments were conducted across risk-stratified PC samples.ResultsConsensus clustering based on SASP genes identified two SASP-associated clusters (SASPclusters), with cluster B demonstrating significantly worse prognosis than cluster A. Thirty-three SASP genes showed significant associations with PC prognosis, and a 7-gene SASP-based prognostic signature was established. High-risk patients exhibited significantly higher mutation rates. Distinct immune cell infiltration patterns, immune functions, checkpoint expression levels, and chemosensitivity profiles were observed between risk groups. Besides, we found that ANGPTL4 could promote PC cell proliferation, migration, and invasion.ConclusionMolecular subtyping and risk stratification based on SASP genes effectively predict PC prognosis and reveal heterogeneity in mutational burden, immune microenvironment, and therapeutic sensitivity. These computational findings deepen our understanding of potential role of SASP in PC and provide a theoretical foundation for personalized treatment strategies. creator: Yuewen Kuang creator: Mingkun Jia creator: Yuming Zhu creator: Zhiyong Xiang uri: https://doi.org/10.7717/peerj.20476 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Kuang et al. title: A new species of aposematic grasshopper of the genus Pseudoutanacris (Acrididae: Gomphocerinae) from the Andean cloud forest of the Ecuadorian Amazon basin link: https://peerj.com/articles/20376 last-modified: 2026-01-06 description: We have identified a new grasshopper species belonging to the genus Pseudoutanacris Jago, 1971, in the montane forests of the eastern Andes in Ecuador. This discovery expands the known distribution of the genus, previously limited to a single species in the Bolivian tropics, by over 2,000 kilometers. For the first time, a female of the genus is described, and notes on the ecology and natural history of the species are presented. We also provide the first barcodes of the genus Pseudoutanacris Jago, 1971. The males of a newly described species, Pseudoutanacris grilla sp. nov. shares a striking coloration pattern with their Bolivian congener, Pseudoutanacris chromobapta Jago, 1971, setting them apart from other members of the tribe Amblytropidiini. However, the females maintain a cryptic coloration pattern, similar to that of the tribe members, and display different behavior from the males. During our study, we also observed Ps. grilla sp. nov. on the same plant as Megacheilacris graminicola (Descamps & Amédégnato, 1971) (Bactrophorinae: Romaleidae), a species with similar chromatic characteristics. This finding also marks the first formal documentation of the new geographical records of M. graminicola (Descamps & Amédégnato, 1971) in Ecuador. creator: Felipe Campos-Yánez creator: Ana B. García-Ruilova creator: Diego J. Inclán uri: https://doi.org/10.7717/peerj.20376 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Campos-Yánez et al. title: Cholesterol and steroid synthesis pathways may be involved in the inhibition of osteosarcoma cell viability by calcium-sensing receptor antagonism link: https://peerj.com/articles/20546 last-modified: 2026-01-05 description: BackgroundThis study examined the effect of calcium-sensing receptor (CaSR) antagonism on human osteosarcoma cells and investigated the underlying molecular mechanisms of this effect through transcriptome sequencing.MethodsHuman osteosarcoma cell lines MG-63 and Saos-2 were treated with different concentrations (0.1–10 µM) of the CaSR antagonist NPS-2143. Cell Counting Kit-8 (CCK-8) assays were used to detect the effect of CaSR antagonism on the viability of the cells. RNA sequencing was performed on cells treated with five µM NPS-2143 for 24 hours, followed by bioinformatic analysis to identify differentially expressed genes and enriched pathways. qRT-PCR was conducted to validate key genes.ResultsCCK-8 assays showed that at low concentrations (0.1 and one µM), NPS-2143 had no significant effect on MG-63 and Saos-2 cell viability. At higher concentrations (five µM and 10 µM), the viability of MG-63 and Saos-2 cells was significantly reduced. Five µM was therefore selected for subsequent experiments. RNA sequencing revealed distinct gene expression profiles in NPS-2143–treated cells compared to controls. A total of 927 differentially expressed genes (DEGs) were identified in Saos-2 cells (378 upregulated, 549 downregulated), and 59 DEGs were identified in MG-63 cells (33 upregulated, 26 downregulated). Reactome and KEGG pathway enrichment analyses indicated significant enrichment of cholesterol and steroid biosynthesis–related pathways. Transcriptome sequencing showed that NPS-2143 modulated the expression of genes in cholesterol and steroid synthesis pathways. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) confirmed that NPS-2143 promoted the expression of the cholesterol and steroid synthesis pathway genes, CYP51A1, DHCR24, LSS, and MSMO1 in MG-63 and Saos-2 cells.DiscussionThe inhibitory effect of NPS-2143 on MG-63 and Saos-2 osteosarcoma tumor cell viability was confirmed. CaSR antagonism significantly up-regulated genes involved in cholesterol and steroid biosynthesis, including CYP51A1, DHCR24, LSS, and MSMO1. These genes encode key enzymes in the cholesterol synthesis pathway, and their upregulation may lead to cholesterol overproduction. This may, in turn, lead to the formation of oxysterols, which are known to induce inflammation and cytotoxicity. These findings suggest a potential metabolic mechanism through which CaSR antagonists influence osteosarcoma cell viability. Although further validation is warranted, our results provide preliminary evidence implicating cholesterol biosynthesis as a mechanistic target in osteosarcoma and underscore the exploratory value of CaSR antagonists as metabolic regulators in cancer research. creator: Luchuan Wang creator: Jianfa Wang creator: Xinjie Chu creator: Yao Liu creator: Yanping Fan creator: Xunzhong Qi creator: Jin Guo creator: Shuqiu Wang uri: https://doi.org/10.7717/peerj.20546 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Wang et al. title: The impact of physical activity on social anxiety among college students: an analysis of the chain mediation effect of family support and self-efficacy link: https://peerj.com/articles/20511 last-modified: 2026-01-05 description: BackgroundThis study aimed to explore the mechanisms through which physical activity affects social anxiety in college students, with a specific focus on the sequential mediating roles of family support and self-efficacy.MethodsA total of 391 valid responses were analyzed using the Physical Activity Rating Scale (PARS-3), the Interaction Anxiousness Scale (IAS). Family Support Scale (PSS-Fa), and the General Self-Efficacy Scale (GSES). Mediation analyses were conducted with structural equation modeling (SEM) and bootstrapping procedures (5,000 resamples).ResultsPhysical activity significantly predicted lower social anxiety (β =  − 0.187, p < .001). Both family support (β =  − 0.309, p < .001) and self-efficacy (β =  − 0.390, p < .001) mediated this association, with the sequential pathway (β =  − 0.073, p < .001) accounting for 13.35% of the total effect.ConclusionPhysical activity was associated with lower social anxiety indirectly via higher family support and self-efficacy, while the direct effect was not statistically significant in the full mediation model. These findings provide empirical support for incorporating physical activity into university-based mental health strategies aimed at alleviating social anxiety. creator: Baiyi Yang creator: Xiaodi Yang creator: Zhengyang Fan creator: Chang Liu creator: Zhanfei Zheng uri: https://doi.org/10.7717/peerj.20511 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Yang et al. title: Development and validation of a risk prediction model for overall survival in cervical cancer patients under 50: a prospective cohort study in southwest China link: https://peerj.com/articles/20509 last-modified: 2026-01-05 description: ObjectiveAccurately predicting the prognosis of cervical cancer in younger patients is increasingly important due to the rising incidence of the disease in China and the growing number of cases among individuals under 50. This study aimed to develop a nomogram to predict overall survival (OS) in cervical cancer patients under 50 in southwest China.MethodsClinicopathological and follow-up data for cervical cancer patients under 50 were prospectively collected as part of an ongoing longitudinal cohort study at Chongqing University Cancer Hospital between January 1, 2015, and May 31, 2019. A training cohort (n = 703) and a validation cohort (n = 301) were randomly selected. Variables associated with OS were assessed using a Cox regression model. Multivariate analysis was used to construct the nomogram and identify independent prognostic factors. The model’s performance was evaluated using decision curve analysis (DCA), calibration curves, area under the receiver operating characteristic curve (AUC-ROC), and the concordance index.ResultsThe final model identified pathology, International Federation of Gynecology and Obstetrics (FIGO) staging, treatment, β2-microglobulin, neutrophil-lymphocyte ratio (NLR), and albumin as independent risk factors for OS in patients under 50. The concordance index for OS was 0.818 in the training cohort and 0.747 in the validation cohort. Calibration curves in both cohorts showed strong agreement between predicted and observed survival probabilities. In the training cohort, AUCs for 1-, 3-, and 5-year OS were 0.851, 0.847, and 0.816, respectively; in the validation cohort, they were 0.810, 0.733, and 0.730. Compared to the FIGO staging system, the nomogram demonstrated superior predictive accuracy and net benefit, as shown by the net reclassification index (NRI) and DCA.ConclusionThe nomogram provides a reliable tool for predicting overall survival in cervical cancer patients under 50, supporting more personalized treatment planning. creator: Li Yuan creator: Baogang Wen creator: Xiuying Li creator: Fangrong Liu creator: Haike Lei creator: Qi Zhou uri: https://doi.org/10.7717/peerj.20509 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Yuan et al. title: Improving taxonomic resolution, biomass and abundance assessments of aquatic invertebrates by combining imaging and DNA megabarcoding link: https://peerj.com/articles/20501 last-modified: 2026-01-05 description: Understanding biodiversity change requires a comprehensive assessment of not only the identity of species inhabiting an ecosystem but also their biomass and abundance. However, assessing biodiversity on the species level with precise biomass information is a time-consuming process and thus rarely applied. While DNA-based approaches like DNA barcoding offer precise species identification, they lack information on specimen size and biomass. In contrast, high-throughput imaging techniques enable rapid measurements of a specimen’s size and morphological features but may have low taxonomic resolution. In this study, we combined DNA megabarcoding, i.e., high-throughput barcoding of single specimens, with semi-automated imaging and deep neural networks to produce accurate taxonomic identifications, abundance, and biomass estimations for insects. In a multiple stressor field experiment, we collected a dataset of 743 specimens from 14 species of the orders Ephemeroptera, Plecoptera, and Trichoptera (EPT), which are routinely used as aquatic biological quality indicator taxa. Each specimen was imaged, weighed, and megabarcoded using the COI barcode gene. From the images captured using the semi-automated imaging device BIODISCOVER, we curated a final dataset of 146,439 images taken from two perpendicular cameras. We trained convolutional neural networks (CNNs) with these pictures for species identification and biomass estimation and evaluated their performance. In addition, we investigated whether models pre-trained for species identification perform better on the biomass estimation task, compared to models trained solely for biomass estimation, thus potentially reducing the need for extensive labelled data in future studies. Our findings demonstrate that combining DNA megabarcoding with automated imaging and deep neural networks enables fast, reliable, but also comprehensive assessment of species composition and biomass on the specimen level, contributing to the urgently needed methods in conservation biology, ecology, and evolution. creator: Philipp M. Rehsen creator: Mia S. Honka creator: Mikko Impiö creator: Iris Madge Pimentel creator: Florian Leese creator: Arne J. Beermann uri: https://doi.org/10.7717/peerj.20501 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Rehsen et al. title: The petrosal and bony labyrinth of extinct horses (Perissodactyla, Equidae) and their implications for perissodactyl evolution link: https://peerj.com/articles/20484 last-modified: 2026-01-05 description: Perissodactyla, or odd-toed ungulates, are represented today by 16 species of rhinoceroses, tapirs, and horses. Perissodactyls were much more diverse in the past, having a rich fossil record spanning from the earliest Eocene (~56 Ma) to recent, including a myriad of extinct lineages. Despite over a century of study, the inter-relationships of some extinct perissodactyl families remain poorly resolved. New morphological characters are needed to help solve this issue. Recent studies suggest that the ear region, i.e., the petrosal and the bony labyrinth of the inner ear, is a valuable source of morphological characters for mammalian phylogenetic analyses. The petrosal is the bony structure protecting the inner ear, the organs of hearing and balance in mammals. However, perissodactyl petrosals are poorly documented and have not been used in such a phylogenetic framework. In this study, we describe the petrosals and inner ears of five European fossil equid taxa and perform a preliminary phylogenetic analysis. Despite its small sample size, our phylogenetic analysis recovers important groupings, which suggests the petrosal is phylogenetically informative in equids. This study supports the relevance of the ear region for phylogenetic inference and its potential to better resolve long-contentious relationships within Perissodactyla. creator: Owen Axel Goodchild creator: Sydney Nicole Rosen creator: Bastien Mennecart creator: Jin Meng creator: Jérémy Tissier uri: https://doi.org/10.7717/peerj.20484 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Goodchild et al. title: Feeding ecology of scolopendromorphs: integrating a global literature review with Japanese citizen-sourced data link: https://peerj.com/articles/20482 last-modified: 2026-01-05 description: Knowledge of food habits is essential for ecological research, yet those are often assessed based on general assumptions rather than evidence, especially in secretive animals that are difficult to observe in the wild, such as centipedes. This leads to underestimation and mischaracterisation of their ecological roles. To address this problem, the present study evaluates the trophic interactions of scolopendromorphs by a dual approach, which integrates a global literature review with analysis of Japanese citizen-sourced data to examine the diets of scolopendromorphs. A total of 76 publications were systematically reviewed, and 102 reported predation events were analysed to assess publication trends and predator–prey size ratios. Concurrently, 8,684 entries from social media and citizen science platforms were mined, yielding 1,130 predation records that were used to construct a detailed prey inventory for Japanese scolopendromorphs. The literature review revealed that scolopendromorphs consume small prey when targeting mammals and amphibians but are capable of preying on large reptiles comparable to themselves, at least regarding body length. Despite the increase in recent publications, it is highly probable that available reports are biased towards vertebrate prey. In contrast, although the citizen-sourced data lacked quantitative metrics such as body size, they encompassed a much broader array of trophic interactions, including the consumption of animals, both alive and dead, and plant material, many of which are not covered in the literature. The citizen-sourced data revealed ecologically notable interactions including cross predation, foraging on spider webs, and ingestion of venomous animals. Collectively, these findings highlight the remarkably broad foraging versatility of scolopendromorphs and ascertain a potential risk of drawing ecological inferences from unverified assumptions or a biased subset of evidence. By integrating a traditional literature review with analysis of citizen-sourced data, the present study not only provides a more comprehensive portrayal of the feeding ecology of scolopendromorphs but also illustrates a promising methodology for uncovering the structure of food webs for secretive animals, for which observations depend on chance encounters. creator: Ryosuke Uno uri: https://doi.org/10.7717/peerj.20482 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Uno title: Bacterial diversity in the jelly of shark Ampullae of Lorenzini: a holobiont perspective link: https://peerj.com/articles/20461 last-modified: 2026-01-05 description: The Ampullae of Lorenzini (AoL) are specialized electrosensory organs found in sharks and other chondrichthyans. They allow the detection of electric fields, temperature changes, and salinity variations. These organs contain a jelly composed of mucopolysaccharides, proteins, and ions, whose microbiota had not been previously characterized. In this study, we investigated and described the presence of bacteria associated with the AoL jelly in seven shark species from the Mexican coast, including three species from the family Sphyrnidae and four from the family Carcharhinidae. Bacteria present in the AoL jelly were cultured on selective media and characterized through 16S rRNA gene sequencing and phylogenetic analysis. We identified bacterial species belonging to the families Staphylococcaceae, Micrococcaceae, Bacillaceae, Vibrionaceae, Aeromonadaceae, and Microbacteriaceae. Additionally, we performed whole-genome sequencing of a subset of these bacterial isolates using the Illumina platform to identify genes related to AoL colonization and potential biological functions. We propose that the bacteria found in the jelly may be regular inhabitants of the AoL, as it provides the nutrients necessary for their persistence. This study represents the first report of bacteria associated with the AoL jelly in sharks, offering new insights into the microbiota of these organs and their potential influence on electrosensory function. creator: Nataly Bolaño-Martínez creator: Benjamín Cristian Corona-Comunidad creator: Oscar Uriel Mendoza-Vargas creator: Luis E. Eguiarte creator: Valeria Souza uri: https://doi.org/10.7717/peerj.20461 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Bolaño-Martínez et al. title: Evaluating portable EEG: a comparison between two wireless systems (EPOC Flex and LiveAmp) and the wired BrainAmp system link: https://peerj.com/articles/20416 last-modified: 2026-01-05 description: BackgroundRecent advances in equipment miniaturization have led to low-cost, portable electroencephalography (EEG) systems that facilitate data collection in real-world settings and with larger samples. Although wireless EEG systems were originally developed for non-research applications, recent studies have provided valuable information to help researchers make informed choices, particularly about participant comfort, mobility during recordings, and data validity. This study aimed to assess the impact of portability by comparing the performance of portable consumer- and research-grade systems (EPOC Saline Flex, EM; LiveAmp, LA) with fixed research-grade systems (BrainAmp, BA).MethodContinuous EEG was recorded with each system in healthy adults performing five benchmark tasks in fundamental and clinical cognitive neuroscience. Mental states (alpha power variations in open/closed eyes) and unconscious perception (steady-state visual evoked potential, SSVEP) were analyzed through time/frequency methods, while active (N200 and P300 components during active listening and N170 component during face recognition) and passive cognitive processes (Mismatch negativity, MMN component during passive listening) were examined using time/amplitude analyses (event-related potential, ERPs). Our analyses compared system efficiency at native and equalized sampling rates and examined 100%, 75%, and 50% of the datasets to determine the required trial number for satisfactory signal quality.ResultsDespite the smaller amount of signal retained for EM, all systems recorded the expected resting state alpha power decrease and SSVEP responses, with EM showing lower spectral effects ([EM < (LA≈BA)]). ERPs for active (N170, N200, P300) and passive (MMN) processes emerged across all systems, with EM and LA showing lower amplitudes only for N170 compared to BA. Furthermore, the dataset reduction resulted in a decreased N170 at P7 only for EM ([EM < LA < BA]). EM also exhibited shorter latencies for all ERPs except for MMN.ConclusionThis study provides concrete guidance for designing EEG experiments in real-world settings, with significant potential for investigating children and vulnerable populations. The efficiency of the three EEG systems is more influenced by task duration than sampling rates. A wireless EEG device, such as the EM, can effectively support both time/frequency and time/amplitude analyses in cognitive science, provided that the number of trials is sufficient and latencies are controlled. creator: Justine Epinat-Duclos creator: Antoine Rossignon creator: Jérôme Prado creator: Jean-Baptiste Van der Henst creator: Yves Paulignan creator: Maude Beaudoin-Gobert creator: Françoise Lecaignard creator: Nathalie Bedoin uri: https://doi.org/10.7717/peerj.20416 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Epinat-Duclos et al. title: Indonesian parental knowledge, attitudes, and sources of information regarding pediatric space maintainers: a cross-sectional questionnaire-based study link: https://peerj.com/articles/20363 last-modified: 2026-01-05 description: BackgroundSpace maintainers are an important part of pediatric dentistry to prevent malocclusion after premature loss of primary teeth. The use of space maintainers are limited in developing countries such as Indonesia. This survey study was conducted to determine Indonesian parents’ knowledge, attitudes, and informational sources related to paediatric space maintainers and factors influencing awareness and acceptance.MethodsA descriptive cross-sectional survey of 400 Indonesian parents was executed. Respondents completed a questionnaire distributed to them through clinics, schools, and publicly sponsored sites in social media. Descriptive statistics, chi-square tests, t-tests and multivariate logistic regression were conducted to study predictors of knowledge and attitudes.ResultsOnly 25% of parents indicated that they were aware of space maintainers. Urban parents (37.5%) were significantly more likely to be aware than rural parents (6.3%; χ2 = 48.35, p < 0.001). Urban location was an important predictor of the dependent variable of awareness, with urban parents being 8.92 times more likely to report awareness than rural parents (adjusted odds ratio (AOR) = 8.92, p < 0.001). At one point, awareness was related to higher comfort (p = 0.0013) and more favorable attitudes (χ2 = 10.88, p = 0.0043). Dentists were reported as the most common source of information about dental visits for parents living in urban settings (68.75%) while rural parents sourced information from community members and social media. Although awareness and attitude were correlated, for favorable perception about dental visits location was a more robust and independent predictor, (AOR for urban location = 8.27, p < 0.001).ConclusionThere is a marked gap in knowledge about space maintainers, among Indonesian parents, specifically in rural areas. Targeted educational efforts and proactive dental counselling are urgently needed to improve parental awareness and promote preventive orthodontic care. creator: Aishwarya Kumbhar creator: Bhagyashree Thakur creator: Dian Agustin Wahjuningrum creator: Suraj Arora creator: Krishna Prasad Shetty creator: Alexander Maniangat Luke creator: Mohmed Isaqali Karobari creator: Ajinkya M. Pawar uri: https://doi.org/10.7717/peerj.20363 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Kumbhar et al. title: Delayed heart rate recovery and its variability in fitness functional training compared to endurance athletes: a cross-sectional analysis link: https://peerj.com/articles/20335 last-modified: 2026-01-05 description: IntroductionThe present study sought to expand upon prior investigations of the effect of different training modalities on post-exercise heart rate recovery (HRR) and heart rate variability (HRV).ObjectiveTo compare the HRR and HRV in physically active men with endurance and fitness functional training recreational athletes following maximal treadmill exercise testing.MethodWe conducted a cross-sectional study with 53 healthy men split into a control group (CG: n = 15; physically active men), endurance group (EG: n = 16; recreational triathlon athletes), and fitness functional training group (FFG: n = 15; recreational fitness functional training athletes). Short-term (5 min) HRR and HRV indexes (SD1, SD2, and HR/LF) were analyzed in 1-minute segments throughout 5 mins of recovery immediately following maximal treadmill exercise testing. Statistical analysis employed a generalized linear model test with a p-value set at 5%.ResultsFFG showed slower HRR than EG at all post-exercise time points (β =  − 13.74 to −8.83 bpm; p < 0.01–0.02) and lower HRR than CG at the 1st minute of recovery (β =  − 10.47 bpm; p = 0.03). The SD1 (cardiovagal reactivation) was lower in CG than EG at the 1 st (β =  − 0.84 ms; p = 0.02); however, no differences (p > 0.05) existed among all groups throughout the recovery period. The SD2 (overall cardiac autonomic modulation) was lower in FFG than EG at 2nd (β =  − 2.51 ms, p = 0.02) and 3rd (β =  − 3.20 ms, p = 0.03) minutes. FFG and EG showed higher values of HR/LF index (indicative of sympathetic activity) than CG at the 1 st minute (β = 432.38 to 1,104.49; p < 0.01). FFG also showed higher HR/LF activity than CG an EG at the 2nd and 3rd minutes of recovery (β = 60.48 to 205.31, p < 0.01 to 0.05), and at the 4th minute, than EG (β = 29.33; p = 0.05).ConclusionHRR was lower in FFG compared to EG throughout recovery. There were no differences in cardiovagal reactivation between the groups from the second to the fifth minute. FFG showed low cardiac overall modulation and high sympathetic activity throughout recovery compared to other groups. These findings may reflect that the FFG displays a persistent coactivation of both autonomic branches following maximal exercise testing compared to the different training modalities. creator: Freddy Enrique Ramos Guimarães creator: Michelle Teles Morlin creator: Kevin Alves Barreto creator: Luiz Guilherme Grossi Porto creator: Guilherme Eckhardt Molina uri: https://doi.org/10.7717/peerj.20335 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Guimarães et al. title: The critical relationship between vaginal microecology and Ureaplasma urealyticum: a retrospective study link: https://peerj.com/articles/19783 last-modified: 2026-01-05 description: BackgroundVaginal microecology can reveal the health of the female reproductive tract directly. Female vaginal microecology reflects the state of female reproductive tract health. This study aimed to utilize a variety of female vaginal microecological indicators to comprehensively assess the relationship between the level of vaginal microecological health and Ureaplasma urealyticum (UU) infection in women.MethodsA total of 408 participants were included in this study, including 144 UU-positive and 264 UU-negative individuals. Clinical information of the participants was collected, and vaginal microecological indicators (cleanliness, hydrogen peroxide (H2O2), leukocyte esterase (LEU), sialidase (SNA), N-acetyl glucosidase (NAG), and β-glucuronidase (GUS)) were tested. The measurement data were expressed as mean ± standard deviation (x ± s), and the comparison of data between groups was performed using a t-test; count data were expressed as the number of cases (percentage) (n[%]), and the data between groups were compared using the chi-square test. Univariate and multivariate logistic regression model analyses explored the factors modifying infection with UU.ResultsUU-positive patients exhibited higher rates of cleanliness positivity, H2O2 positivity, LEU positivity, SNA positivity, NAG positivity, and GUS compared to UU negative patients (P < 0.05) . The univariate logistic regression model found that cleanliness, H2O2, LEU, SNA, NAG, and GUS were risk factors for UU infection in women (Cleanliness: odds ratio [OR] = 4.30, 95% confidence interval [CI] [2.79–6.63]); H2O2: OR = 9.01, 95% CI [5.33–15.23]; LEU: OR = 1.88, 95% CI [1.22–2.91]; s SNA: OR = 5.53, 95% CI [2.73–11.19]; NAG: OR = 2.41, 95% CI [1.35–4.30]; and GUS: OR = 1.95, 95% CI [1.21–3.15]) . The multivariate logistic regression model found that the independent risk factors for UU infection in patients were cleanliness (OR = 3.00, 95% CI [1.66–5.43]) and H2O2 (OR = 7.24, 95% CI [4.19–12.51]).ConclusionsVaginal cleanliness and H2O2 abnormalities are risk factors for UU infections in women. Therefore, female UU infections can be prevented by maintaining vaginal microecology. creator: YanHong Liu creator: Jie Zheng creator: Junpeng Zhao creator: Yuhong Yao creator: Dongxue Gao creator: Wenjie Qi creator: Yingmei Wang creator: Jinyin Yan uri: https://doi.org/10.7717/peerj.19783 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Liu et al. title: AI-driven de novo design of BRAF inhibitors with enhanced binding affinity and optimized drug-likeness link: https://peerj.com/articles/20541 last-modified: 2026-01-02 description: BackgroundTraditional drug discovery methods, such as high-throughput screening (HTS), are often inefficient and costly, especially in complex areas like oncology. The BRAF V600E mutation is a validated therapeutic target in cancers such as melanoma, thyroid carcinoma, and colorectal cancer. However, existing BRAF inhibitors face challenges like acquired resistance and off-target toxicity. Artificial intelligence (AI) has emerged as a transformative tool for designing novel inhibitors more efficiently.MethodsThis study employed REINVENT 4, an advanced machine learning (ML) framework using recurrent neural networks and transformer architectures, for targeted generation and property optimization of BRAF V600E inhibitors, integrating reinforcement learning (RL) for drug-likeness optimization and transfer learning (TL) for mutation-specific design. Molecular docking and dynamics simulations were used to evaluate binding affinity and stability.ResultsThe AI-driven approach generated 41,721 novel BRAF V600E inhibitor candidates with enhanced drug-likeness (mean Quantitative Estimate of Drug-likeness (QED) score: 0.61 ± 0.17 vs. the training set 0.40 ± 0.13) and predicted inhibitory activity (83.8% with predicted pIC50 > 6). The generated compounds showed a 32% reduction in mean molecular weight (326.8 ± 45.6 g/mol vs. 480.8 ± 84.2 g/mol in the training set) while maintaining inhibitory potency. Pharmacokinetic analysis revealed that 99.7% of generated compounds satisfied Lipinski’s Rule of Five criteria, suggesting favorable absorption and distribution profiles. Molecular docking analysis of selected compounds revealed strong binding affinities, with an average free energy of −8.03 ± 1.12 kcal/mol and top-performing compounds reaching −11.5 kcal/mol. Molecular dynamics simulations conducted over 200 ns confirmed complex stability, demonstrating protein backbone RMSD values of 0.35–0.55 nm and ligand RMSD values of 0.086–0.161 nm. Structural novelty assessment using Tanimoto similarity coefficients showed values below 0.45 when compared with FDA-approved BRAF inhibitors (including Sorafenib and Vemurafenib).DiscussionThis work highlights a reproducible, integrated AI-driven workflow demonstration for targeted inhibitor generation. The generated inhibitors exhibit favorable drug-like properties and inhibitory activity, offering a scalable solution for designing safer cancer therapies. Experimental validation is needed to address potential discrepancies between computational predictions and biological behavior. creator: Zuokun Lu creator: Aili Zhang uri: https://doi.org/10.7717/peerj.20541 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Lu and Zhang title: Quality improvement interventions to prevent late-onset sepsis in premature infants: a systematic review and meta-analysis link: https://peerj.com/articles/20530 last-modified: 2026-01-02 description: BackgroundLate-onset sepsis (LOS) is a life-threatening complication in preterm infants, with reported incidence rates of 1%–30% that vary by clinical and geographical factors. Quality improvement (QI) bundles integrating infection control, nutrition, and device management show promise in reducing LOS, but evidence remains fragmented due to heterogeneous definitions and mixed study populations.MethodsA systematic review and meta-analysis of QI studies was conducted across PubMed, Embase, Cochrane Library, and Web of Science (inception to March 19th, 2025). Studies were included if they reported pre-post QI outcomes for LOS in preterm infants (gestational age < 37 weeks), with effect sizes synthesized as odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity was evaluated using I2, with random-effects models for I2 ≥ 50%. Subgroup analyses explored LOS definition impacts (time windows: ≥48 h, ≥72 h, other) and meta-regression tested covariates (study year, sample size, quality).ResultsOf 9,705 identified studies, 29 (21 for meta-analysis, n = 29,120 infants) met criteria. QI bundles significantly reduced LOS in very low birth weight (VLBW) infants (pooled OR = 0.47, 95% CI [0.38–0.58], I2 = 88.7%) and extremely low birth weight (ELBW) infants (OR = 0.49, 95% CI [0.29–0.83], I2 = 80.6%). Core components included multidisciplinary teams (25/29), hand hygiene (21/29), and central line management (22/29). Subgroup analysis showed varying effects by LOS definition: OR = 0.35 (95% CI [0.19–0.64]) for ≥ 48 h, OR = 0.50 (95% CI [0.39–0.64]) for ≥ 72 h, and OR = 0.71 (95% CI [0.61–0.82]) for ill-defined thresholds. Meta-regression identified no significant modifiers (all p > 0.0), but publication bias was detected in VLBW analyses (Egger’s test, p < 0.0).ConclusionQI bundles significantly reduce LOS in preterm infants, including VLBW and ELBW subgroups, through core components like multidisciplinary teams, hand hygiene, and central line management. Given outcome variations by diagnostic criteria, standardizing LOS definitions is crucial. These bundles should be integrated into routine care globally. Future efforts should prioritize standardized reporting, antibiotic stewardship, and equitable implementation, especially in low-resource settings, by building on existing evidence and broader healthcare principles. creator: Xiangtong Zhang creator: Zhi Wan creator: Kangyan Yuan creator: Genfeng Wu creator: Zhangbin Yu uri: https://doi.org/10.7717/peerj.20530 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2026 Zhang et al. title: The impact of wearable resistance training on strength, speed, and agility: a systematic review and meta-analysis link: https://peerj.com/articles/20519 last-modified: 2026-01-02 description: ObjectiveTo conduct a systematic assessment of the impact of wearable resistance training (WRT) on muscular strength, speed, and agility, while examining the influence of critical training parameters as moderating factors.MethodsA systematic review was undertaken to identify eligible studies. Literature searches were conducted in PubMed, Web of Science, EBSCO databases from inception to October 31st, 2025. This study employed the Cochrane Collaboration tool built into Review Manager 5.4 for literature quality assessment, and utilized Stata version 18.0 for meta-analysis, including pooled effect size calculation, subgroup analysis, and publication bias assessment.ResultsThe Meta-analysis encompassed 19 studies with a total of 233 participants. It is revealed that WRT produced significant improvements in jumping power (standardized mean difference (SMD) = −0.60; 95% CI [−1.07 to −0.14]; p = 0.01), and agility performance (SMD = −0.44, 95% CI [−0.58 to −0.30], p < 0.001). Subgroup analyses demonstrated that the most pronounced jumping power enhancements occurred with training frequencies of three sessions per week (SMD = −0.47, 95% CI [−0.92 to −0.02], p = 0.038). Additionally, external loading protocols utilizing 8–19% of body weight yielded superior improvements (SMD = −0.17, 95% CI [−0.37 to 0.03], p = 0.032). Finally, subgroup analyses revealed no significant moderating effects for wearable device placement, participant age, or study population characteristics (p > 0.05).ConclusionWRT effectively enhances jumping power and agility. Although it contributes to some improvement in speed and maximal strength, the effect is not statistically significant. Further high-quality studies are needed in the future to validate these findings. creator: Shuairan Li creator: Qiwei Wang creator: Yingying Cao creator: Xiaoli Huang creator: Yuanyuan Luo creator: Jing Mi uri: https://doi.org/10.7717/peerj.20519 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Li et al. title: Research progress on glycolytic reprogramming in ophthalmic diseases link: https://peerj.com/articles/20478 last-modified: 2026-01-02 description: The retina is one of the most energy-demanding tissues in the human body. Retinal energy metabolism is primarily dominated by aerobic glycolysis, with more than 80% of the glucose consumed being converted to lactic acid. As a highly energy-consuming tissue, the metabolic characteristics of the retina, especially aerobic glycolysis, are essential for maintaining retinal cell function during normal physiological processes. However, in disease states, this metabolic balance is disrupted, leading to a range of pathological changes. There is currently growing evidence that metabolic reprogramming is a pathological cause of diseases such as retinal degeneration, uveal melanoma, and glaucoma. This article reviews the mechanisms involved in metabolic reprogramming in ocular diseases and describes relevant therapeutic targets. Despite the many advances, the regulatory mechanisms of metabolic reprogramming in ophthalmic diseases still need to be thoroughly investigated, and new therapeutic strategies are expected to be developed based on this in the future. creator: Xiaoqi Gong creator: Jiaojiao Feng creator: Yibo Han creator: Guodong Tang creator: Yixue Yin creator: Jing Li creator: Yuxi Liu creator: Jun Zhang creator: Jike Song creator: Hongsheng Bi uri: https://doi.org/10.7717/peerj.20478 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Gong et al. title: Spatiotemporal distribution and driving factors of atmospheric pollutants in the U-Chang-Shi urban agglomeration, Northwestern China link: https://peerj.com/articles/20430 last-modified: 2026-01-02 description: As a critical core node of the “Belt and Road” Initiative and a representative arid-zone urban agglomeration in Northwest China, the Urumqi-Changji-Shihezi (U-Chang-Shi) region faces severe air pollution, posing significant threats to ecological security and public health. Leveraging the 2000–2022 China High-Resolution Air Quality (CHAP) dataset and multi-source meteorological data, this study systematically investigates the spatiotemporal evolution of PM2.5, PM10, and ozone (O3) alongside their driving mechanisms. Results reveal distinct seasonal patterns: PM2.5 and PM10 concentrations peak in winter due to coal combustion emissions and unfavorable static meteorological conditions, while dropping below 30 µg/m3 in summer as photochemical reactions weaken. The Mann–Kendall (MK) trend test, combined with spatial-temporal analysis methods, elucidates the complex pollution dynamics. The U-Chang-Shi industrial belt acts as a pollution hotspot, with Dabancheng District exhibiting elevated PM10 levels attributed to pollutant transport and terrain effects. O3 pollution intensifies in spring and summer, surging post-2016 across regional cities, with Shihezi showing a 16.7% annual increase. Key drivers include unfavorable static meteorology and sparse vegetation for particulate pollutants, while precipitation (P) wet deposition enhances their removal. O3 production is modulated by potential evapotranspiration (PET) and wind speed (WIND), with high temperatures (T) accelerating photochemical reactions, although counteracted by particulate matter. Hybrid Single-Particle Lagrangian Integrated Trajectory Model (HYSPLIT) simulations indicate that Eurasian mid-latitude winter circulation and cross-border dust contribute to winter PM10 variability. Although the “coal-to-gas” project mitigated particulate pollution, its efficacy is constrained by Shihezi’s lagging industrial restructuring. This study provides critical insights for optimizing air pollution control strategies in ecologically vulnerable regions of Northwest China and arid-zone urban agglomerations under the Belt and Road Initiative, emphasizing the need for region-specific emission reduction measures and cross-border collaboration. creator: Sheng Chen creator: Jinglong Li creator: Qing He creator: Si Chen creator: Gaixia Ding creator: Zihao Dang uri: https://doi.org/10.7717/peerj.20430 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Chen et al. title: Multiple approaches to meso- and macroplastics and the food habitat of the green turtle, Chelonia mydas, in the Ogasawara Islands, Japan link: https://peerj.com/articles/20425 last-modified: 2026-01-02 description: This study integrated genetic, isotopic, and plastic analyses to investigate the diet and plastic ingestion of adult green turtles living in the waters around the Ogasawara Islands. Micro-, meso-, and macroplastics were found in the gut contents of 7 of the 10 individuals examined. A total of 92 meso- and macroplastics were found in six individuals, with an average of 9.2 ± 11.48 items/individual (range: 0–31, n = 10). The average total weight of these items was 15.28 ± 24.76 g (range: 0–70.55, n = 10), and their average percentage of the turtles’ body weight was 0.014 ± 0.021% (range: 0–0.064, n = 8). At the time of capture, the turtles’ main food was macroalgae, and the feeding grounds were estimated from the DNA analysis to be three locations where the seaweeds Ectocarpus crouaniorum, Sargassum muticum, and Lobophora sp. predominate. Stable isotope ratios of carbon and nitrogen in muscle tissue and DNA analysis suggested that the captured individuals may have fed on drifting seaweed and gelatinous plankton on their way south from the Pacific coasts of Japan to the Ogasawara Islands, during which time it can be concluded from the green turtle’s feeding habits that they may have ingested meso- and macroplastics found among large and drifting seaweeds, mistaking them for gelatinous plankton such as jellyfish and salpas. The ingested plastics were estimated to have originated from a larger area than the turtles’ migratory range, indicating that this problem may stem from transboundary pollution. creator: Tenzo Fujitani creator: Shunji Ena creator: Touma Hosoya creator: Seongwon Lee creator: Miyuki Nishijima creator: Akira Iguchi creator: Haruka Nakano creator: Nozomu Iwasaki uri: https://doi.org/10.7717/peerj.20425 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2026 Fujitani et al. title: Significance of neuroendocrine systems and the gut-brain axis (GBA) in the regulation of obesity link: https://peerj.com/articles/20400 last-modified: 2026-01-02 description: Obesity is a major global public health issue due to its high morbidity and mortality rates, with its prevalence increasing annually. According to World Health Organization (WHO) estimates, the global population of individuals with obesity has doubled from 1990 to 2022, with over 650 million adults with obesity experiencing metabolic abnormalities such as dyslipidemia, insulin resistance, diabetes, and cardiovascular diseases. Various approaches have been used to treat or prevent obesity including lifestyle interventions, surgery, and pharmacological therapies aimed at reducing energy absorption and increasing energy expenditure. However, these methods do not significantly reduce energy stored in adipose tissues. The conversion of white adipose tissue (WAT) to brown adipose tissue (BAT) presents a promising therapeutic target for obesity treatment. Notably, there is a substantial loss of BAT in individuals with obesity. Conversely, increased BAT is associated with a lower body mass index (BMI), younger age, lower glucose levels, and a decreased incidence of cardiometabolic diseases. Research indicates that BAT formation is modulated by neuro endocrine systems, suggesting a promising therapeutic strategy for obesity prevention and treatment by targeting these systems. In this review, we first discuss the regulation and signaling pathways of neuroendocrine systems involved in energy balance. We then explore the molecular and cellular mechanisms underlying the onset and pathogenesis of obesity and their relationship with neuroendocrine systems. In particular, we summarize the role of the gut-brain axis (GBA) in obesity. creator: Hanwei Zhao creator: Yaqing Li creator: Ran Cheng creator: Ye Wang creator: Liyuan Ma creator: Wenge Chen uri: https://doi.org/10.7717/peerj.20400 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2026 Zhao et al.