title: PeerJ description: Articles published in PeerJ link: https://peerj.com/articles/index.rss3?journal=peerj&page=20 creator: info@peerj.com PeerJ errorsTo: info@peerj.com PeerJ language: en title: Efficacy and safety of rivaroxaban in neonatal catheter-related thrombosis: a single-center retrospective study of 122 cases link: https://peerj.com/articles/20375 last-modified: 2025-11-20 description: BackgroundTo systematically evaluate the clinical efficacy of rivaroxaban in treating neonatal catheter-related thrombosis (CRT) and analyze risk factors affecting treatment outcomes.MethodsClinical data of 122 neonatal CRT patients treated with rivaroxaban from March 2022 to October 2024 at Fujian Provincial Maternal and Child Health Hospital were retrospectively analyzed. The primary outcome was the complete thrombus resolution rate. Multivariate logistic regression was used to analyze risk factors affecting treatment efficacy.ResultsAmong 122 patients, the complete thrombus resolution rate was 71.31% (87/122) after 6 weeks of anticoagulation, which significantly increased to 88.52% (108/122) after extending to 3 months (p < 0.01). Multivariate logistic regression analysis showed that chemotherapy (OR = 5.48, 95% CI [1.04–28.73], P < 0.05) and difficult catheter placement (OR = 12.53, 95% CI [3.13–50.22], P < 0.05) were independent risk factors reducing the likelihood of complete thrombus resolution at 3 months. No anticoagulation-related bleeding or other complications were observed during the study period, though the sample size and follow-up period may limit the detection of rare events.ConclusionRetrospective data suggest that rivaroxaban is safe and effective in treating neonatal catheter-related thrombosis, with a higher complete thrombus resolution rate observed at 3 months compared to 6 weeks of anticoagulation therapy. Chemotherapy and difficult catheter placement were identified as independent risk factors affecting treatment efficacy. These findings, derived from a single-center retrospective study, require validation through multi-center, prospective, randomized controlled trials. creator: Rong Zhang creator: Gang Chen creator: Wen Hong Cai creator: Bin Yang creator: Yun Feng Lin creator: Teng Hui Zhan uri: https://doi.org/10.7717/peerj.20375 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Zhang et al. title: The bee bread of honey bees is characterized by a core microbiota despite the application of miticide treatments and variation across space and time link: https://peerj.com/articles/20366 last-modified: 2025-11-20 description: BackgroundBee bread is composed of a mixture of pollen and nectar used as the main source of proteins and lipids for the development of bee larvae. Despite its important role in honey bee food preservation, relatively little is known about the composition of bee bread microbiota and the potential impact of beekeeping management of hives on these microbial systems.MethodsHere, we evaluated whether (1) the bee bread of honey bees is characterized by a core microbiota and (2) miticide applications (formic acid and amitraz) affect the diversity and composition of the bee bread microbiota. We collected a total of 36 samples from six sites across two distinct geographic locations and sequenced the bee bread bacterial communities before and after miticide applications.ResultsOur results revealed a conserved bee bread core microbiota comprised of 15 taxa belonging to the phyla Proteobacteria (11 taxa), Firmicutes (two taxa), Actinobacteriota (one taxon), and Bacteroidota (one taxon). In addition, we found weak evidence of miticide treatments impacting the diversity of the bee bread microbiota, with a general trend of a decrease in the diversity of non-core taxa following the application of organic miticides.ConclusionTaken together, our results demonstrate that the bee bread of honey bees is characterized by a core microbiota despite variations associated with geographic location, sampling period, and miticide applications. creator: Brooke L. Lawrence creator: Gordon F. Custer creator: Robyn M. Underwood creator: Robert R. Dunn creator: Francisco Dini-Andreote creator: Margarita M. López-Uribe uri: https://doi.org/10.7717/peerj.20366 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Lawrence et al. title: Assessment of healing dynamics in dental extraction sockets among non-diabetic, prediabetic, and type 2 diabetic patients: a comparative clinical investigation link: https://peerj.com/articles/20361 last-modified: 2025-11-20 description: BackgroundDiabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycaemia, affecting various metabolic processes and leading to multiple complications, particularly in wound healing. This study aims to evaluate the impact of diabetes on the healing of extraction sockets in non-diabetic, prediabetic, and type 2 diabetic patients in Saudi Arabia.MethodologyA prospective observational study was conducted with 72 participants who were divided equally (n = 24 for each group) into three groups, viz. non-diabetic, prediabetic, and diabetic groups based on glycated hemoglobin (HbA1c) and random blood glucose levels. Tooth extractions were performed by an experienced maxillofacial surgeon. Healing outcomes were assessed by measuring extraction socket size, post-operative pain, discharge, swelling, infection, erythema, dry socket occurrence, and analgesic consumption over one week. Initially descriptive statistics were calculated and one way Analysis of Variance (ANOVA) test was done to compare the reduction in socket size between groups. The level of statistical significance was set at P ≤ 0.05.ResultsOut of 275 screened participants, 104 provided informed consent, and 72 completed the study. Significant differences were found in socket size reduction, with non-diabetic patients showing a 62.5% reduction, prediabetic 56.4%, and diabetic 48.6% (p < 0.001). Diabetic patients experienced more post-operative pain (p = 0.039) and a higher incidence of complications such as swelling, infection, and discharge, although not statistically significant (p = 0.141).ConclusionDiabetes significantly affects post-operative healing in dental extractions, leading to less socket size reduction, higher pain levels, and increased complications. These findings underscore the necessity for specialized post-operative care for diabetic patients, including stringent infection control and pain management strategies. Further research with larger sample sizes and extended follow-up periods is recommended to better understand the long-term impacts of diabetes on oral health. creator: Mohammed Saad Alqarni uri: https://doi.org/10.7717/peerj.20361 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Alqarni title: Hybrid contour and geometric partitioning for accurate plantar foot region segmentation link: https://peerj.com/articles/20352 last-modified: 2025-11-20 description: BackgroundPrecise segmentation of plantar foot regions is crucial for analyzing foot structure and pressure distribution, aiding in the diagnosis of pathologies and enabling preventive interventions. However, conventional segmentation approaches often struggle to accurately delineate key anatomical regions and detect their boundaries, particularly in the presence of foot abnormalities.MethodsWe created a dataset of plantar pressure images and proposed a hybrid algorithm that integrates edge contour detection techniques with dynamic geometric partitioning to address persistent challenges in plantar region segmentation. Our method first determines the lengths of the left and right feet using precise contour detection, then partitions the plantar surface into primary anatomical regions (forefoot, midfoot, and heel) based on standardized geometric proportions. Additionally, the methodology allows for finer subdivisions (e.g., inner/outer forefoot) that adapt to the unique morphology of each foot. This algorithm accommodates five foot types, including normal, low arch, high arch, inward heel tilt, and outward heel tilt.ResultsA comparative evaluation of three edge detection methods revealed that the Canny algorithm, when combined with geometric partitioning, yielded superior performance. On a dataset of 200 plantar pressure footprints encompassing both normal and abnormal feet, this hybrid approach achieved Intersection over Union (IoU) and mean Average Precision (mAP) scores exceeding 0.90 across all segmented regions (forefoot, midfoot, and heel). Furthermore, the results indicate that the proposed hybrid algorithm performs comparably across both normal and abnormal foot types, with no significant differences observed.ConclusionsOur synergistic integration of contour detection and geometric partitioning yields an efficient technique for segmenting plantar regions from static plantar pressure images. Validation on a diverse dataset shows that the proposed approach accurately distinguishes foot-specific regions across five different foot types, including both normal and pathological cases. creator: Shumei Zhang creator: Xi Liang creator: Minmin Wu creator: Weiming Gu uri: https://doi.org/10.7717/peerj.20352 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Zhang et al. title: DHCR7: from sterol biosynthesis to oncogenic role in colorectal cancer link: https://peerj.com/articles/20323 last-modified: 2025-11-20 description: Objective7-Dehydrocholesterol reductase (DHCR7) is an enzyme that plays a crucial regulatory role in sterol biosynthesis and has been implicated in tumorigenesis and progression. This study aims to elucidate the biological function of DHCR7 in the pathogenesis of colorectal cancer (CRC).MethodsBy integrating multi-omics data (including public genomic databases and mass spectrometry data from clinical samples) and establishing in vivo and in vitro experimental systems (encompassing animal models and CRC cell lines with gene overexpression and knockdown), we systematically investigated the functional role of DHCR7 in CRC. A multimodal research strategy combining bioinformatics analysis with molecular biology experiments (Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR), western blotting, immunohistochemistry, etc.), proteomics analysis (liquid chromatography–mass spectrometry), and cellular functional assays (proliferation, apoptosis, migration, and invasion) was employed.ResultsElevated levels of sterols were observed in CRC tumor tissues, and high cholesterol levels were found to promote the malignant phenotype of tumor cells. Mass spectrometry revealed that DHCR7 was significantly upregulated in CRC tissues and correlated with poor clinical prognosis. DHCR7 could modulate the cholesterol levels in CRC cells; overexpression of this gene enhanced cell proliferation, inhibited apoptosis, and promoted invasion and migration. Conversely, inhibition of DHCR7 expression abrogated these pro-tumorigenic effects, which was consistent with the inactivation of the PI3K/AKT/mTOR signaling pathway and confirmed by pathway reactivation experiments. DHCR7 deficiency significantly reduced tumorigenicity in vivo.ConclusionDHCR7 regulates the progression of CRC both in vitro and in vivo through the PI3K/AKT/mTOR signaling axis and affects the cholesterol levels in CRC. creator: Chuan Zhou creator: Jia Wang creator: Han He creator: Chao Wang creator: YunFeng Zhang creator: Wenbo Zhang creator: Bin Wei creator: Mingxu Da creator: Minghui Pang uri: https://doi.org/10.7717/peerj.20323 license: https://creativecommons.org/licenses/by-nc/4.0 rights: © 2025 Zhou et al. title: Unveiling the clinical profiles of critically ill COVID-19 patients: insights from Ezhou during the early spread link: https://peerj.com/articles/20318 last-modified: 2025-11-20 description: The coronavirus disease 2019 (COVID-19) started in December 2019 in Wuhan. This article evaluated clinical characteristics, and imaging manifestations in Ezhou, an early locked-down city, 80 kilometers east of Wuhan. We analyzed data from 98 confirmed severe COVID-19 patients in Ezhou Central Hospital between February 1st and March 22nd, 2020. We compared patients’ laboratory results, imaging manifestations, and treatments between survival and death groups. Of these 98 confirmed COVID-19 patients, 24 individuals (24.6%) had chronic diseases. The main symptoms of critically ill patients were fever (86.7%), cough (83.7%), and dyspnea (59.1%). Common complications were acute respiratory distress syndrome (ARDS; 49%), acute kidney injury (37.7%), and multiple organ dysfunction syndrome (MODS; 32.6%). Computed tomography (CT) scans displayed ground-glass opacity at subpleural regions that were associated with interlobular septal thickening. Within 28 days, 39 (39.8%) patients died. Compared to survivors, the death group had a higher median age (69.8 vs. 61.3, p < 0.05), and were more prone to ARDS (100% vs. 15.2%) and MODS (76% vs. 3.4%). Our report showed that in the early days of the COVID-19 outbreak, there was a high mortality rate in critically ill patients. Elderly patients (>65 years) normally have an increased risk of complications and ARDS. Most non-survivors were highly dependent upon mechanical ventilation. CT scans with imaging manifestations showed abnormal conditions in the lower multiple bilateral lung lobes, which provides a useful characterization of this fatal disease by recognizing COVID-19 pneumonia and assessing its evolution for the target for intervention of the patient recovery. creator: Guohui Yang creator: Zewen Liu creator: Tabitha Abraham creator: Linwei Li creator: Tingyang Zhou creator: Qing Zhang creator: Li Zuo uri: https://doi.org/10.7717/peerj.20318 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Yang et al. title: Selection and preliminary evaluation of superior individual plant in Camellia oleifera link: https://peerj.com/articles/20283 last-modified: 2025-11-20 description: Camellia oleifera exhibits significant economic and ecological value as a woody oil crop. However, widespread low-yield stands persist due to suboptimal agricultural management and historical neglect of scientific cultivation practices. This study conducted a systematic characterization of 25 elite C. oleifera germplasms with high fruit set but phenotypic variability in fruit morphology and yield components. Multi-dimensional assessments were performed at late-stage fruit development, focusing on architecture traits (height, canopy area), fruit morphological parameters (size, weight, pericarp thickness), and key economic indices including yield potential and oil content. Multivariate analysis revealed H2 as the top-performing genotype, demonstrating superior performance across all evaluated traits. Genotypes H16, H5 and H6 ranked second tier but require optimized agronomic practices to maximize yield potential. Hierarchical cluster analysis based on 17 quantitative traits classified the elite trees into five distinct phenotypic groups. These findings provide a scientific framework for genotype selection in low-yield forest restoration programs. The identified superior trees offer potential for regional production enhancement, while the established trait correlation inform targeted breeding strategies. creator: Wenpei Song creator: Siqi Huang creator: Fang Li creator: Panfeng Tu creator: Yongquan Li creator: Bipei Zhang creator: Yi Wang creator: Jinghan Dou creator: Caiqin Li uri: https://doi.org/10.7717/peerj.20283 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Song et al. title: Effectiveness of multi-component exercise in individuals with type 2 diabetes: a systematic review and meta-analysis link: https://peerj.com/articles/20146 last-modified: 2025-11-20 description: ObjectiveThis meta-analysis aimed to explore the effects of multi-component exercise interventions on glycemic and lipid metabolism, physical fitness, and cognitive function in individuals with type 2 diabetes mellitus (T2DM).MethodsFrom inception to December 28, 2024, PubMed, Web of Science, Cochrane, and Elsevier databases were systematically searched for randomized controlled trials (RCTs) investigating multi-component exercise interventions for T2DM. A total of 37 articles, comprising 3,201 participants, were included. Primary and secondary outcome measures were categorized, summarized, and analyzed using RevMan 5.4 software.ResultsCompared to control groups, multi-component exercise interventions produced statistically significant improvements across all measured outcomes in individuals with T2DM: (1) Glycemic control: HbA1c (standard mean difference (SMD) = −0.52, 95% confidence interval (CI) [−0.76 to −0.28]); fasting blood glucose (SMD = −0.53, 95% CI [−0.93 to −0.12]). (2) Lipid metabolism: high density lipoprotein (HDL) (SMD = 0.32, 95% CI [0.21–0.44]); low density lipoprotein (LDL) (SMD = −0.21, 95% CI [−0.33 to −0.09]); triglycerides (SMD = −0.18, 95% CI [−0.30 to −0.06]). (3) Physical fitness: upper limb strength (SMD = 0.67, 95% CI [0.51–0.83]); lower limb strength (SMD = 0.56, 95% CI [0.10–1.02]); peak oxygen consumption (SMD = 0.62, 95% CI [0.31–0.93]); body mass index (BMI) (SMD = −0.38, 95% CI [−0.67 to −0.09]). (4) Cognitive function: overall cognitive performance (SMD = 0.34, 95% CI [0.18–0.50]). (5) Quality of life: vitality (SMD = 0.37, 95% CI [0.09–0.64]); physical functioning (SMD = 0.48, 95% CI [0.20–0.75]); mental health (SMD = 0.35, 95% CI [0.07–0.63]); general health (SMD = 0.34, 95% CI [0.06–0.61]). Quality assessment indicated that the included studies were of high overall quality. Egger’s regression analysis did not reveal significant publication bias.ConclusionsMulti-component exercise interventions significantly improved glycemic and lipid metabolism, physical fitness, and cognitive function in individuals with T2DM. These findings support the clinical value of incorporating multi-component exercise programs—particularly those performed at least three times per week and lasting 6 months or longer—into diabetes management strategies. creator: Zhiyuan Sun creator: Haiqing Zeng creator: Hualei Liu creator: Mengqi Hu creator: Xuewen Tian creator: Dewei Mao creator: Rui Zhang uri: https://doi.org/10.7717/peerj.20146 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Sun et al. title: Effects of foliar applied asparagine, glycine and citric acid on cadmium uptake and yield in wheat link: https://peerj.com/articles/20102 last-modified: 2025-11-20 description: Cadmium (Cd) contamination is an important heavy metal that threatens agricultural production and food safety. This study investigates the potential of foliar applications of asparagine (Asn), glycine (Gly) and citric acid (CA) to reduce Cd uptake and improve the nutrient balance of wheat (Triticum durum L.). A pot experiment was conducted under controlled conditions with three different Cd concentrations (0, 3 and 12 mg Cd kg−1 soil). The mixture containing 0.5 mMg Gly, Asn, and CA was applied to the leaves a total of five times at 5-day intervals during the tillering, stem elongation, heading and flowering periods of wheat, starting 39 days after planting. The analysis showed that the application of Asn reduced the Cd concentration in the grains by 14.82%, 31.08% and 16.66%, respectively, while the application of Gly resulted in a reduction of 37.78%, 16.41% and 12.79% and the application of CA resulted in a reduction of 34.78%, 36.25% and −1.60% compared to the control (C0) group. In addition, grain yield increased in response to the amino acid applications, with Asn improving yield by 6.10%, 9.95% and 5.90%; glycine by 3.86%, 7.59% and 9.34%; CA by −2.64%, 6.16% and 3.44%, respectively. These amino acid treatments alleviated the growth limitations caused by Cd stress by increasing the grain yield of wheat. However, the effect of CA on Cd detoxification was lower compared to the amino acids. The results show that Asn and Gly not only reduce Cd accumulation in wheat but also improve nutrient balance and increase yield. Consequently, foliar application of these amino acids is a promising strategy to improve plant safety in Cd-contaminated agricultural soils. creator: Özlem Ete Aydemir uri: https://doi.org/10.7717/peerj.20102 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Ete Aydemir title: El Niño-driven phase shift to algal dominance on Isla del Caño’s coral reefs: implications for urgent restoration link: https://peerj.com/articles/20088 last-modified: 2025-11-20 description: BackgroundThe 2023–24 El Niño event caused extreme marine heat stress and widespread coral bleaching. Coral reefs at the Reserva Biológica Isla del Caño and the northern coast of the Osa Peninsula, Costa Rica, underpin critical ecosystem services, including biodiversity conservation and marine tourism, and have previously withstood similar events with minimal coral loss. Evaluating the ecological impacts of the 2023–24 El Niño is essential to assess coral reef resilience and guide future management.MethodsCoral Reef Watch sea surface temperature (SST) data (1985–2025; CoralTemp V3.1) were used to calculate long-term SST trends and degree heating weeks (DHW). Reef surveys were conducted at nine sites between 2019 and 2025, with primary benthic composition and coral health data collected in 2024–25. Benthic cover was assessed using point-intercept, line-intercept, and quadrat methods, while coral diversity, abundance, and health were measured via belt transects. Beta regression was used to assess the effect of temperature on coral cover, and multivariate analyses, including principal component analysis (PCA) and similarity percentage analysis (SIMPER), evaluated benthic community changes and bleaching patterns. An Ecological Recovery Feasibility Index (ERFI) was developed using PCA loadings and benthic indicators to rank sites by recovery potential.ResultsSST increased significantly over the past 40 years (∼0.23 °C/decade), with the 2023–24 El Niño recording peak SST (31.2 °C). Bleaching threshold exceedance days increased, while cool days declined. Twelve coral taxa were recorded; Pocillopora spp. and Porites lobata were present at all sites. Coral diversity varied, with Cueva and Ancla highest, and San Josecito lowest. Estimated baseline bleaching prevalence was ∼23%, highest in Pocillopora spp. (33.9%). SIMPER and PCA revealed a shift from coral to algal dominance: turf algae increased by 70.62%, dead coral declined 80.71%, and coral cover fell 40.44%. Major coral declines were statistically significant at Ancla, Esquina, and Tina. Bayesian regression confirmed coral decline at Chorro, Cueva, Tina, and Ancla, alongside turf algae increases. Coral cover was higher at warmer sites, though non-temperature site-specific factors were also influential. Chorro and Esquina had the highest recovery potential; Ancla, San Josecito, and Barco Profundo the lowest.ConclusionThere is an urgent need to develop and implement a coral reef restoration strategy for Isla del Caño that addresses site-specific conditions, integrates tourism management, and promotes long-term resilience. Under continued climate change, localized, targeted restoration will be essential to maintain the ecological function of these historically resilient but increasingly vulnerable reefs in Costa Rica’s Eastern Tropical Pacific. creator: Caroline V. Palmer creator: Shanttal Valeria Rodríguez Esquivel creator: Christopher M. Parker uri: https://doi.org/10.7717/peerj.20088 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Palmer et al.