title: PeerJ description: Articles published in PeerJ link: https://peerj.com/articles/index.rss3?journal=peerj&page=167 creator: info@peerj.com PeerJ errorsTo: info@peerj.com PeerJ language: en title: Interspecies differences in the transcriptome response of corals to acute heat stress link: https://peerj.com/articles/18627 last-modified: 2024-12-10 description: Rising sea surface temperatures threaten the survival of corals worldwide, with coral bleaching events becoming more commonplace. However, different coral species are known to exhibit variable levels of susceptibility to thermal stress. To elucidate genetic mechanisms that may underlie these differences, we compared the gene repertoire of four coral species, Favites colemani, Montipora digitata, Acropora digitifera, and Seriatopora caliendrum, that were previously demonstrated to have differing responses to acute thermal stress. We found that more tolerant species, like F. colemani and M. digitata, possess a greater abundance of antioxidant protein families and chaperones. Under acute thermal stress conditions, only S. caliendrum showed a significant bleaching response, which was accompanied by activation of the DNA damage response network and drastic upregulation of stress response genes (SRGs). This suggests that differences in SRG orthologs, as well as the mechanisms that control SRG expression response, contribute to the ability of corals to maintain stability of physiological functions required to survive shifts in seawater temperature. creator: Jeric Da-Anoy creator: Niño Posadas creator: Cecilia Conaco uri: https://doi.org/10.7717/peerj.18627 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2024 Da-Anoy et al. title: Construction and validation of a predictive model for the risk of malnutrition in hospitalized patients over 65 years of age with malignant tumours: a single-centre retrospective cross-sectional study link: https://peerj.com/articles/18685 last-modified: 2024-12-10 description: BackgroundNutritional status is a critical indicator of overall health in individuals suffering from malignant tumours, reflecting the complex interplay of various contributing factors. This research focused on identifying and analysing the factors influencing malnutrition among older patients aged ≥65 with malignant tumours and aimed to develop a comprehensive risk model for predicting malnutrition.MethodsThis study conducted a retrospective analysis of clinical data from 3,387 older inpatients aged ≥65 years with malignant tumours collected at our hospital from July 1, 2021, to December 31, 2023. The dataset was subsequently divided into training and validation sets at an 8:2 ratio. The nutritional status of these patients was evaluated using the Nutritional Risk Screening Tool 2002 (NRS-2002) and the 2018 Global Leadership Initiative on Malnutrition (GLIM) Standards for Clinical Nutrition and Metabolism. Based on these assessments, patients were categorized into either malnutrition or non-malnutrition groups. Subsequently, a risk prediction model was developed and presented through a nomogram for practical application.ResultsThe analysis encompassed 2,715 individuals in the development cohort and 672 in the validation cohort, with a malnutrition prevalence of 40.42%. A significant positive correlation between the incidence of malnutrition and age was observed. Independent risk factors identified included systemic factors, tumour staging (TNM stage), age, Karnofsky Performance Status (KPS) score, history of alcohol consumption, co-infections, presence of ascites or pleural effusion, haemoglobin (HGB) levels, creatinine (Cr), and the neutrophil-to-lymphocyte ratio (NLR). The predictive model exhibited areas under the curve (AUC) of 0.793 (95% confidence interval (CI) [0.776–0.810]) for the development cohort and 0.832 (95% CI [0.801–0.863]) for the validation cohort. Calibration curves indicated Brier scores of 0.186 and 0.190, while the Hosmer–Lemeshow test yielded chi-square values of 5.633 and 2.875, respectively (P > 0.05). Decision curve analysis (DCA) demonstrated the model’s clinical applicability and superiority over the NRS-2002, highlighting its potential for valuable clinical application.ConclusionThis study successfully devised a straightforward and efficient prediction model for malnutrition among older patients aged 65 and above with malignant tumours. The model represents a significant advancement as a clinical tool for identifying individuals at high risk of malnutrition, enabling early intervention with targeted nutritional support and improving patient outcomes. creator: Xuexing Wang creator: Jie Chu creator: Chunmei Wei creator: Jinsong Xu creator: Yuan He creator: Chunmei Chen uri: https://doi.org/10.7717/peerj.18685 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2024 Wang et al. title: Spectrum analysis of inborn errors of metabolism for expanded newborn screening in Xinjiang, China link: https://peerj.com/articles/18173 last-modified: 2024-12-09 description: To determine the disease spectrum and genetic characteristics of inborn errors of metabolism (IEM) in Xinjiang province in the northwest of China, 41,690 newborn babies were screening by tandem mass spectrometry from November 2018 to December 2021. Of these, 57 newborn babies were referred for genetic analysis by next-generation sequencing, which was validated by Sanger sequencing. A total of 36 newborn babies and one relative were diagnosed with IEM, and the overall positive predictive value was 29.03%. The overall incidence of IEM in Xinjiang was 1:1,158 (36/41,690). The incidence of amino acidemias, organic acidemias, and fatty acid oxidation disorder were 1:1,668 (25/41,690), 1:4,632 (9/41,690), and 1:20,845 (2/41,690), respectively. Phenylketonuria and methylmalonic acidemia were the two most common inborn errors of metabolism (IEM), accounting for 83% (30/36) of all confirmed cases. Some hotspot mutations were observed for several IEMs, including PAH gene c.158G > A (p.Arg53His) and c.688G > A (p.Val230Ile) for hyperphenylalaninemia. Four mutation types of the MMACHC gene (e.g., c.609G > A (p.Trp203Ter), c.567dupT (p.Ile190fs)) and six mutation types of the MMUT gene (e.g., c.729_730insT (p.Asp244fs)) were found for methylmalonic acidemia. We also found 11 mutations in six genes: PCCB, IVD, GCDH, MCCC1, SLC22A5, and ACADS in this region. This study combined tandem mass spectrometry and next-generation sequencing technology for the screening and diagnosis of IEM. The study provides effective clinical guidance, and the data provide a basis for expanding newborn screening, genetic screening, and IEM gene consultation in Xinjiang, China. creator: Jingying Zhu creator: Li Han creator: Pingjingwen Yang creator: Ziyi Feng creator: Shuyuan Xue uri: https://doi.org/10.7717/peerj.18173 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2024 Zhu et al. title: Accuracy of augmented reality navigated surgery for placement of zygomatic implants: a human cadaver study link: https://peerj.com/articles/18468 last-modified: 2024-12-09 description: PurposePlacement of zygomatic implants in the most optimal prosthetic position is considered challenging due to limited bone mass of the zygoma, limited visibility, length of the drilling path and proximity to critical anatomical structures. Augmented reality (AR) navigation can eliminate some of the disadvantages of surgical guides and conventional surgical navigation, while potentially improving accuracy. In this human cadaver study, we evaluated a developed AR navigation approach for placement of zygomatic implants after total maxillectomy.MethodsThe developed AR navigation interface connects a commercial navigation system with the Microsoft HoloLens. AR navigated surgery was performed to place 20 zygomatic implants using five human cadaver skulls after total maxillectomy. To determine accuracy, postoperative scans were virtually matched with preoperative three-dimensional virtual surgical planning, and distances in mm from entry-exit points and angular deviations were calculated as outcome measures. Results were compared with a previously conducted study in which zygomatic implants were positioned with 3D printed surgical guides.ResultsThe mean entry point deviation was 2.43 ± 1.33 mm and a 3D angle deviation of 5.80 ± 4.12° (range 1.39–19.16°). The mean exit point deviation was 3.28 mm (±2.17). The abutment height deviation was on average 2.20 ± 1.35 mm. The accuracy of the abutment in the occlusal plane was 4.13 ± 2.53 mm. Surgical guides perform significantly better for the entry-point (P = 0.012) and 3D angle (P = 0.05); however, there is no significant difference in accuracy for the exit-point (P = 0.143) when using 3D printed drill guides or AR navigated surgery.ConclusionDespite the higher precision of surgical guides, AR navigation demonstrated acceptable accuracy, with potential for improvement and specialized applications. The study highlights the feasibility of AR navigation for zygomatic implant placement, offering an alternative to conventional methods. creator: Sander Tabernée Heijtmeijer creator: Haye Glas creator: Nard Janssen creator: Nathalie Vosselman creator: Sebastiaan de Visscher creator: Fred Spijkervet creator: Gerry Raghoebar creator: Remco de Bree creator: Antoine Rosenberg creator: Max Witjes creator: Joep Kraeima uri: https://doi.org/10.7717/peerj.18468 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2024 Tabernée Heijtmeijer et al. title: The role of CD47 in immune escape of colon cancer and its correlation with heterogeneity of tumor immune microenvironment link: https://peerj.com/articles/18579 last-modified: 2024-12-09 description: BackgroundCluster of differentiation 47 (CD47), a transmembrane protein, plays a critical role in regulating cellular functions and maintaining immune homeostasis. Its expression has been shown to influence cancer prognosis. In this study, we investigated the role of CD47 in tumor progression in colon adenocarcinoma (COAD) and evaluated its potential as a target for immunotherapy.Materials and MethodsWe analyzed surgical samples from 96 COAD patients. Immunohistochemical analysis was performed on 90 samples, while the remaining 6 were subjected to multiplex immunofluorescence. To explore the association between CD47 expression and clinicopathological characteristics, we integrated transcriptome data from The Cancer Genome Atlas and the Gene Expression Omnibus using R software. The Tumor Immune Estimation Resource and Kaplan-Meier plotter were utilized to assess the relationship between CD47 expression, patient prognosis, and immune infiltration. Furthermore, the single-cell Tumor Immune System Interaction Database was used to examine the correlation between CD47 expression and the tumor microenvironment (TME). All included patients gave oral and written informed consent. The study was approved by the Ethics Committee of 3201 Hospital (full name: Medical Ethics Committee of 3201 Hospital).ResultsCD47 was found to be overexpressed in various tumors, including COAD. Higher CD47 expression was significantly associated with more advanced tumor stages, including TNM staging, T staging, and N staging (P < 0.05). A robust correlation was observed between CD47 expression and immune cell infiltration in COAD. Patients with elevated CD47 expression tended to have longer disease-free intervals, although this benefit was diminished in cases with high infiltration of M1 macrophages. The immunosuppressive function of CD47 primarily acted through the CD47/SIRPα pathway. Additionally, distinct cellular compositions and distributions were identified between primary and metastatic COAD, underscoring the heterogeneity of the TME. CD47 also influenced the TME by modulating cytokine and cytokine receptor interactions.ConclusionCD47 represents a promising prognostic biomarker and a potential target for immunotherapy in COAD. These findings provide new insights into therapeutic strategies aimed at modulating the TME and improving patient outcomes. creator: Qiu-Si Tian creator: ChunMei Zhang creator: Zhi-Jun Bao creator: ZhiGang Pei uri: https://doi.org/10.7717/peerj.18579 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2024 Tian et al. title: Observation of peri-implant bone loss rates in patients visiting dentist—A retrospective evaluation of patients of a faculty hospital for one year link: https://peerj.com/articles/18643 last-modified: 2024-12-09 description: BackgroundMany studies have been published on the relationship between different parameters with marginal bone loss around implants. The results of these studies vary, but some variables such as smoking or certain systemic conditions are more likely to predispose or exacerbate the resorption around implants. The aim of this study was to determine the rates of implants with radiographically detected marginal bone loss and to determine whether there is a relationship between the severity of destruction and certain risk factors like location of implant, restoration type, systemic condition, age, sex or smoking habits.Materials and MethodsPanoramic radiographs obtained for 1 year were examined. Patients with bone loss around the implant were classified according to the region of implant placement, type of restoration on implants, systemic diseases, and smoking habits. The rate of bone loss around the implants was recorded as the resorption score. Double and multiple comparison tests were applied to observe whether the resorption scores were related to the variables.ResultsOf 17,352 patients, 1,465 had at least one implant, and 1,116 of these had no bone loss. A total of 181 patients (863 implants) included in the study, there was a weak correlation between age (p = 0.017) and resorption rate. Implants supporting bridge restorations had higher resorption scores. Gender, age, and systemic conditions alone are not effective in increasing peri-implant bone loss (p < 0.05); therefore, placing implants in the mandible (p = 0.020) or using implants to support bridge restorations(p = 0.027) may make implants more vulnerable to resorption. creator: Ilkim Karadag creator: Halis Kurnaz creator: Mehmet Murat Akkaya creator: İrem Karadag creator: Zeynep Ilayda Konukçu Kurnaz uri: https://doi.org/10.7717/peerj.18643 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2024 Karadag et al. title: Evaluation of the effect of a communication skills course on medical students’ attitude towards patient-centered care: a prospective study link: https://peerj.com/articles/18676 last-modified: 2024-12-09 description: BackgroundThis study aims to examine whether a communication skills course (Early Clinical Exposure–ECE) might support shaping medical students’ attitudes towards patient-centered care at Taibah University, Saudi Arabia. Attitudes were measured before and after the course using the Patient Practitioner Orientation Scale (PPOS), which assesses students’ orientation towards patient-centeredness.MethodsThis prospective observational study collected data at two points: the start of year two and the start of year four from the same cohort. The PPOS, divided into the sharing subscale (physician shares information, power, and control with the patient) and the caring subscale (physician considers the patient’s emotions, preferences, and expectations), was used to evaluate students’ attitudes. Mean scores were calculated, and independent sample t-tests were employed to assess statistical significance.ResultsOf the students targeted, 153 participated at year two (response rate = 93.5%) and 143 at year four (response rate = 89.5%). Significant progress was observed in the sharing subscale, with scores increasing from 3.23 ± 0.53 to 3.40 ± 0.60 (p = 0.015). However, the caring subscale exhibited a significant decline, with scores dropping from 4.06 ± 0.53 to 3.76 ± 0.68 (p < 0.001). As a result, there was no significant overall change in the total PPOS score (p = 0.282). Female students showed more progress in the sharing subscale than males.ConclusionsThe communication skills course might have had a positive impact on students’ attitudes towards sharing information in decision-making with patients, but notably, the medical students’ caring attitudes declined. This indicates a need for further emphasis on patient-centered communication, especially on the caring aspects, in the medical curriculum. creator: Khalid Gaffer Mohamed creator: Amer Almarabheh creator: Asim Mukhideer Almughamsi creator: Hany Atwa creator: Mohamed Hany Shehata uri: https://doi.org/10.7717/peerj.18676 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2024 Mohamed et al. title: Genetic diversity of the Khorat snail-eating turtle (Malayemys khoratensis) in Thailand link: https://peerj.com/articles/18699 last-modified: 2024-12-09 description: IntroductionMalayemys khoratensis is a freshwater turtle species endemic to northeastern Thailand and Lao PDR. While M. khoratensis is relatively common and widespread in Thailand, its population size and demographic trends remain largely unknown, as direct population estimates are lacking. This species faces significant threats from consumption, exploitation, and trade. Therefore, this study aims to investigate the genetic diversity, population structure, and demographic trends of M. khoratensis in northeastern Thailand, using two mitochondrial DNA genes, Cyt b and ND4.MethodWe grouped the turtles based on three major river basins in northeastern Thailand: Mun, Chi, and Northeast Mekong to assess population structure and test the isolation-by-basin hypothesis. The Cyt b and ND4 genes of 49 M. khoratensis individuals across 15 provinces in Thailand were sequenced, and 15 sequences from a previous study of Ihlow et al. (2016) were included into the analyses. We constructed a haplotype network from the concatenated sequences and analyzed the population structure with the analysis of molecular variance (AMOVA). Additionally, we used a Bayesian Skyline plot (BSP) analysis to estimate the effective female population size and explore the demographic history of this species.ResultsOur analysis identified 13 unique haplotypes defined by 26 polymorphic sites from 64 samples. The total haplotype diversity for M. khoratensis was 0.819, while nucleotide diversity was 0.0031. The haplotype network and AMOVA revealed no distinct population structure among the river basins, suggesting gene flow across these regions. The BSP estimated a stable effective female population size of approximately 130,000 individuals since around 100,000 years ago (late Pleistocene).ConclusionOur findings indicated no significant population structure by river basin, which may be due to natural movement between basins or potential human-mediated translocations linked to the turtle trade. The demographic trend of M. khoratensis appears to have been stable over time. However, given the ongoing exploitation of this species, we recommend regular monitoring of population trends to support its long-term survival. creator: Thotsapol Chaianunporn creator: Monthakarn Mokarat creator: Apichaya Ruangsakunporn creator: Tanapipat Walalite creator: Wibhu Kutanan creator: Khemika Lomthaisong creator: Kanokporn Chaianunporn creator: Sarun Keithmaleesatti uri: https://doi.org/10.7717/peerj.18699 license: https://creativecommons.org/licenses/by-nc/4.0 rights: © 2024 Chaianunporn et al. title: A single-center retrospective study of ectopic lymphoid tissues in idiopathic membranous nephropathy: clinical pathological characteristics and prognostic value link: https://peerj.com/articles/18703 last-modified: 2024-12-09 description: BackgroundIn recent years, ectopic lymphoid tissue (ELT) has been increasingly confirmed as a new biomarker for kidney injury or inflammation. However, there is insufficient research on the relationship between ELT grading and the progression of idiopathic membranous nephropathy (IMN).MethodsA total of 147 patients with biopsy-proven IMN in our institution from March 2020 to June 2022 were classified into five grades based on the different distribution of lymphocyte subsets in renal tissue (G0: no B cells or T cells, G1: scattered B and T cells, G2: clustered B and T cells, G3: an aggregation region of B and T cells without a central network, G4: highly organized and formed zones of B and T cells with a central network of follicular dendritic cells and scattered macrophages), and were further divided into low-grade group (G0+G1), intermediate-grade group (G2) and high-grade group (G3+G4). The clinicopathological data, induction treatment response and prognosis among the three groups were analyzed and compared retrospectively.ResultsAs the grading of ectopic lymphoid tissues increased, patients were older, with a higher prevalence of hypertension, a higher 24-h urinary protein level, lower baseline hemoglobin and estimated glomerular filtration rate (eGFR) levels, and more severe renal pathological damage. Logistic regression analysis showed that after 6 months of induction treatment, patients in the high-grade group were more likely to be in non-remission than those in the low-grade group (odds ratios [ORs] of the three adjusted models were 4.310, 4.239, and 5.088, respectively, P-values were 0.005, 0.006, and 0.001, respectively). Kaplan-Meier survival analysis indicated that patients in the intermediate- and high-grade groups had significantly lower renal cumulative survival rate than those in the low-grade group (P = 0.025). Univariate Cox analysis showed that the risk of adverse renal outcome was 3.662 times higher in the intermediate- and high-grade groups than in the low-grade group (95% confidence interval [CI] [1.078–12.435]; P = 0.037). Multivariate Cox analysis revealed that failure of remission at the first 6 months (hazard ratio [HR] = 5.769; 95% CI [1.854–17.950]; P = 0.002) remained an independent risk factor for poor renal outcome in patients with IMN.ConclusionsGrading of renal ectopic lymphoid tissues correlates with disease activity and severity in IMN patients and can be used as an indicator to assess the risk of IMN progression. creator: Jing Zhang creator: Siyu Chen creator: Haiying Zheng creator: Siyi Rao creator: Yuanyuan Lin creator: Jianxin Wan creator: Yi Chen uri: https://doi.org/10.7717/peerj.18703 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2024 Zhang et al. title: Association of vaccine intention against COVID-19 using the 5C Scale and its constructs: a Pima County, Arizona cross-sectional survey link: https://peerj.com/articles/18316 last-modified: 2024-12-06 description: BackgroundVaccine hesitancy has been ranked as one of the top 10 threats to global health by the World Health Organization. The 5C model (Confidence, Calculation of risk, Complacency, Collective Responsibility, and Constraints) and an accompanying tool to measure vaccine hesitancy, summarize several significant explanatory variables, and move beyond the most common explanatory variable, Confidence.MethodsFrom January to May 2021, we administered a cross-sectional survey among adults in Pima County, Arizona in collaboration with the local health department to assess psychological antecedents to (i.e., psychological factors that lead to) COVID-19 vaccination using the 5C Scale. Participants were recruited virtually for the survey using multiple recruitment methods. Unadjusted and adjusted hierarchical ordinal logistic regressions were conducted to determine if the 5C variables had an association with intention to vaccinate (or intent to vaccinate) against COVID-19.ResultsOf the 1,823 participants who responded to the survey, 924 (76%) were included in the final analyses. Respondents were White (71%), non-Hispanic (59%), Female (68%), Liberal (37%) and Married (46%). The average age of the participants was 43.9 (±1.3) years. Based on the 5C Scale, Confidence (adjOR:3.64, CI [3.08–4.29]), Collective Responsibility (adjOR:1.94, CI [1.57–2.39]) and Complacency (adjOR:0.64, CI [0.51–0.80]) were significantly associated with intention to vaccinate against COVID-19.ConclusionThree of the five 5C variables were associated with the intention to vaccinate, two positively and one negatively. A limitation of the study was that the sample was not weighted to be representative of Pima County. Future research should focus on determining which interventions can bolster Confidence and Collective Responsibility attitudes in communities, while dampening Complacency, to better promote vaccine uptake. creator: Maiya G. Block Ngaybe creator: Namoonga Mantina creator: Benjamin Pope creator: Veena Raghuraman creator: Jacob Marczak creator: Sonja Velickovic creator: Dominique Jordan creator: Mary Kinkade creator: Carlos Mario Perez-Velez creator: Beatrice J. Krauss creator: Shailesh M. Advani creator: Melanie Bell creator: Purnima Madhivanan uri: https://doi.org/10.7717/peerj.18316 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2024 Block Ngaybe et al.