title: PeerJ description: Articles published in PeerJ link: https://peerj.com/articles/index.rss3?journal=peerj&page=501 creator: info@peerj.com PeerJ errorsTo: info@peerj.com PeerJ language: en title: Predictors of cognitive impairment in patients undergoing ileostomy for colorectal cancer: a retrospective analysis link: https://peerj.com/articles/15405 last-modified: 2023-06-05 description: BackgroundEarly detection of cognitive impairment in patients undergoing ileostomy for colorectal cancer may help improve patient outcomes and quality of life. Identifying risk factors and clinically accessible factors is crucial for prevention and treatment.ObjectiveThis retrospective study aimed to identify risk factors for post-operative cognitive impairment in patients undergoing ileostomy for colorectal cancer and to explore potential factors for its prevention and treatment.MethodsA total of 108 cases were selected and included in the study. Patient data including general characteristics, disease stage, complications, and chemotherapy status were collected, and sleep quality and cognitive function were assessed using questionnaires and follow-up. Patients were randomly divided into training and validation groups. A random forest model was used to rank clinical features based on their contribution to predicting the prognosis of cancer-related cognitive impairment (CRCI). Nomograms were constructed using the support vector machine–recursive feature elimination (SVM-RFE) method, and the minimal root-mean-square error (RMSE) values were compared to select the best model. Regression analysis was performed to determine independent predictors.ResultsSignificant differences were observed in age, body mass index (BMI), alcohol consumption, frequency of physical activity, comorbidity, and cancer-related anemia (CRA) between the CRCI and non-CRCI groups. Random forest analysis revealed that age, BMI, exercise intensity, PSQI scores, and history of hypertension were the most significant predictors of outcome. Univariate logistic regression analysis of 18 variables revealed that age, alcohol consumption, exercise intensity, BMI, and comorbidity were significantly associated with the outcome of CRCI (p < 0.05). Univariate and multivariate models with P-values less than 0.1 and 0.2, respectively, showed better predictive performance for CRCI. The results of univariate analysis were plotted on a nomogram to evaluate the risk of developing CRCI after colorectal cancer surgery. The nomogram was found to have good predictive performance. Finally, regression analysis revealed that age, exercise intensity, BMI, comorbidity, and CRA were independent predictors of CRCI.ConclusionsThis retrospective cohort study revealed that age, exercise intensity, BMI, comorbidity, CRA, and mobility are independent predictors of cognitive impairment in patients undergoing ileostomy for colorectal cancer. Identifying these factors and potential factors may have clinical implications in predicting and managing post-operative cognitive impairment in this patient population. creator: Jing Xu creator: Yuelan Yang creator: Die Hu uri: https://doi.org/10.7717/peerj.15405 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Xu et al. title: Determinants of acute undernutrition among pregnant women attending primary healthcare unit in Chinaksen District, Eastern Ethiopia: a case-control study link: https://peerj.com/articles/15416 last-modified: 2023-06-05 description: BackgroundWomen’s undernutrition during pregnancy increases the risks and burdens of maternal and neonatal morbidity, death, and disability through its vicious cycles of irreversible intergenerational negative effects. Despite the high burden of maternal undernutrition during pregnancy in semi-pastoral communities of eastern Ethiopia, there is a paucity of information on its major risk factors. This study revealed determinants of acute undernutrition among pregnant women attending primary healthcare units in Chinaksen district in rural eastern Ethiopia.MethodA facility-based case-control study was conducted among 113 cases and 113 controls in Chinaksen district from February 01 to March 30, 2017. Data were entered using EpiData version 3.1 and analyzed using SPSS version 24. Multivariable logistic regression analyses conducted to identify significant determinants of acute undernutrition. Adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of association and statistical significance declared at p value < 0.05.ResultsSixty (53.1%) of cases and 56 (49.6%) of controls were in the age group of 25-34 years and their mean ± SD age of cases and controls were 26.6 ± 5.7 and 28 ± 5.5 years, respectively. In this study, larger family size (AOR = 6.98, 95 CI [2.82–17.27]), lack of prenatal dietary advice (AOR = 3.68, 95% CI [1.67–8.00]), did not participate in a cooking demonstration (AOR = 5.41, 95% CI [2.39–12.24]), used substances (AOR = 3.65, 95% CI [1.30–10.23]), absence of basic latrine (AOR = 2.91, 95% CI [1.28–6.58]), low minimum dietary diversity of women (AOR = 2.48, 95% CI [1.20–5.12]), and household food insecurity (AOR = 3.06, 95% CI [1.44–6.51]) were significantly increased the odds of acute undernutrition among pregnant women.ConclusionsThe study revealed that living in crowded families, lack prenatal dietary advice, did not participate in cooking demonstrations, substances use; lack of toilet, low minimum dietary diversity, and household food insecurity were significant risk factors for acute undernutrition among pregnant women. Strengthening multi-sectoral approaches through improving dietary diversity/quality and food access/quantity would be essential to prevent, and reduce the risks, burdens, and impacts of maternal undernutrition during pregnancy. creator: Hassen Abdi Adem creator: Ahmedin Aliyi Usso creator: Habtemu Jarso Hebo creator: Abdulhalik Workicho creator: Fila Ahmed uri: https://doi.org/10.7717/peerj.15416 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Adem et al. title: The diagnostic value of serum insulin-like growth factor binding protein 7 in gastric cancer link: https://peerj.com/articles/15419 last-modified: 2023-06-05 description: BackgroundsEarly detection might help in reducing the burden and promoting the survival rate of gastric cancers. Herein, we tried to explore the diagnostic value of insulin-like growth factor binding protein 7 (IGFBP7) in gastric cancers.MethodsIn this study, we first analyzed the expression levels and prognostic value of IGFBP7 mRNA in gastric cancers from The Cancer Genome Atlas (TCGA) database. Then, we recruited 169 gastric cancer patients and 100 normal controls as training cohort, and 55 gastric cancer patients and 55 normal controls as independent validation cohort. Enzyme-linked immunosorbent assay was applied to test the serum levels of IGFBP7. The receiver operating characteristic curve (ROC) and the area under the curve (AUC) were applied to evaluation the diagnostic value.ResultsTCGA showed that IGFBP7 mRNA was dysregulated and associated with prognosis in gastric cancer patients. Then, we examined the expression of serum IGFBP7 and found that serum IGFBP7 expressed lower in gastric cancer patients than normal controls both in training and independent validation cohorts (p < 0.0001). In training cohort, with the cutoff value of 1.515 ng/ml, the AUC for distinguishing gastric cancer patients was 0.774 (95% CI [0.713–0.836]) with sensitivity of 36.7% (95% CI [29.5–44.5]) and specificity of 90.0% (95% CI [82.0–94.8]). As for early-stage EJA, the AUC was 0.773 (95% CI [0.701–0.845]) with the sensitivity of 33.3% (95% CI [14.4–58.8]). In independent validation cohort, with the same cutoff value, the AUC reached to 0.758 (95% CI [0.664–0.852]). Similarly, for early-stage gastric cancer diagnosis in the independent validation cohort, the AUC value was 0.778 (95% CI [0.673–0.882]).ConclusionsThis study indicated that serum IGFBP7 might act as a potential early diagnostic marker for gastric cancers. creator: Can-Tong Liu creator: Fang-Cai Wu creator: Yi-Xuan Zhuang creator: Xin-Yi Huang creator: Xin-Hao Li creator: Qi-Qi Qu creator: Yu-Hui Peng creator: Yi-Wei Xu creator: Shu-Lin Chen creator: Xu-Chun Huang uri: https://doi.org/10.7717/peerj.15419 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2023 Liu et al. title: Exploring forearm muscle coordination and training applications of various grip positions during maximal isometric finger dead-hangs in rock climbers link: https://peerj.com/articles/15464 last-modified: 2023-06-05 description: BackgroundMaximal isometric finger dead-hangs are used in rock climbing to strengthen finger flexors. Although various grip positions are often used when performing finger dead-hangs, little is known regarding how these grip positions can affect forearm muscle activity. Understanding how forearm muscles are recruited during dead-hangs could help foreseeing the potential for training of different grip positions. The aim of the present study was to explore the training applications of the various grip positions by comparing the activity of forearm muscles during maximal dead-hangs in rock climbers.Materials & MethodsTwenty-five climbers performed maximal dead-hangs in three climbing-specific grip positions: CRIMP, SLOPE, and SLOPER. We recorded the maximal loads used and the sEMG of the flexor digitorum profundus (FDP), the flexor digitorum superficialis (FDS), the flexor carpi radialis (FCR), and the extensor digitorum communis (EDC). Individual and global (sum of all muscles) root mean square (RMS) and neuromuscular efficiency (NME) values were computed. Repeated measures analysis were performed to assess grip differences (p < 0.05).ResultsSLOPER showed the largest maximal load values among the three grip positions (p < 0.001, d ≥ 2.772). Greater global (p ≤ 0.044, d ≥ 0.268), FDS (p ≤ 0.005, d ≥ 0.277), and FCR (p < 0.001, d ≥ 1.049) activity was observed for the SLOPER compared to CRIMP and SLOPE, while EDC (p ≤ 0.005, d ≥ 0.505) showed lower activity in the SLOPER compared to the other two grip positions. SLOPER presented the highest global (p < 0.001, d ≥ 0.629), FDP (p < 0.001, d ≥ 0.777), FDS (only CRIMP vs SLOPER: p < 0.001, d = 0.140), and EDC NME (p < 0.001, d ≥ 1.194). The CRIMP showed greater FDS activity (p = 0.001, d = 0.386) and lower NME (p = 0.003, d = 0.125) compared to SLOPE.ConclusionsThese results revealed that, under maximum intensity conditions, SLOPER could stimulate the FDS and FCR better than the other grip positions at the expense of using greater loads. Similarly, maximum CRIMP dead-hang could better stimulate the FDS than the SLOPE, even when using similar loads. creator: Blai Ferrer-Uris creator: Denisse Arias creator: Priscila Torrado creator: Michel Marina creator: Albert Busquets uri: https://doi.org/10.7717/peerj.15464 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Ferrer-Uris et al. title: Ferroptosis-associated gene CISD2 suppresses colon cancer development by regulating tumor immune microenvironment link: https://peerj.com/articles/15476 last-modified: 2023-06-05 description: BackgroundDespite the association of ferroptosis with various tumors, the specific mechanism by which it influences colon adenocarcinoma (COAD) microenvironmental equilibrium remains elusive. This study aims to elucidate how ferroptosis affects COAD microenvironmental homeostasis and its potential impact on COAD research.ObjectiveBy employing genetic screening and single-cell analysis of tumor data, we investigated the role of ferroptosis genes in COAD microenvironmental homeostasis. The genes were correlated with immune cell infiltration in tissue samples and patient outcomes.MethodsFerroptosis-associated genes were initially identified through the FerrDb database. Utilizing the tidyverse and Seurat packages, genes with substantial expression differences were extracted, and clustering analysis was performed on the single-cell data. A Venn diagram depicted shared differential genes for ferroptosis and tumors. To screen key ferroptosis genes, further enrichment analysis and immune cell infiltration analysis were conducted. Lastly, human COAD cell lines were employed to overexpress CDGSH iron sulfur domain 2 (CISD2) through cellular assays to validate its function in COAD.ResultsFollowing screening of The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases, 414 COAD patient samples and 341 normal samples were included. Through the FerrDb database, 259 ferroptosis genes were identified. Clustering the single-cell data revealed 911 tumor marker genes, of which 18 were ferroptosis genes. Analysis of variance (ANOVA) and univariate regression analysis determined that only CISD2 was statistically significantly associated with clinical outcomes. Additionally, CISD2 was found to positively correlate with activated memory T cells and negatively correlate with regulatory T cells (Tregs) and plasma cells in COAD, as well as being significantly associated with several immune-related and cancer-related pathways. CISD2 expression was elevated in most tumors, likely due to cell cycle regulation and immune system activation. Moreover, CISD2 upregulation inhibited COAD cell proliferation and enhanced 5-fluorouracil (5-FU) sensitivity. Our findings indicate, for the first time, that CISD2 governs the cell cycle and stimulates the immune system to impede COAD progression.ConclusionBy modulating the cell cycle and mediating immune infiltration, CISD2 may inhibit COAD development by influencing tumor immune microenvironment equilibrium, providing valuable insights into the relevance and potential impact of the research results on the COAD research field. creator: Yuanyuan Xu creator: Qingzhu Tang creator: Ning Ding creator: Tao Zhang creator: Hongbiao Luo uri: https://doi.org/10.7717/peerj.15476 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2023 Xu et al. title: Land use scenarios, seasonality, and stream identity determine the water physicochemistry of tropical cloud forest streams link: https://peerj.com/articles/15487 last-modified: 2023-06-05 description: BackgroundLand use is a major factor determining stream water physicochemistry. However, most streams move from one land use type to another as they drain their watersheds. Here, we studied three land use scenarios in a tropical cloud forest zone in Mexico. We addressed three main goals, to: (1) assess how land use scenarios generate different patterns in stream physicochemical characteristics; (2) explore how seasonality (i.e., dry, dry-to-wet transition, and wet seasons) might result in changes to those patterns over the year; and (3) explore whether physicochemical patterns in different scenarios resulted in effects on biotic components (e.g., algal biomass).MethodsWe studied Tropical Mountain Cloud Forest streams in La Antigua watershed, Mexico. Streams drained different three scenarios, streams with (1) an upstream section draining forest followed by a pasture section (F-P), (2) an upstream section in pasture followed by a forest section (P-F), and (3) an upstream forest section followed by coffee plantation (F-C). Physicochemistry was determined at the upstream and downstream sections, and at the boundary between land uses. Measurements were seasonal, including temperature, dissolved oxygen, conductivity, and pH. Water was analyzed for suspended solids, alkalinity, silica, chloride, sulfate, magnesium, sodium, and potassium. Nutrients included ammonium, nitrate, and phosphorus. We measured benthic and suspended organic matter and chlorophyll.ResultsStreams presented strong seasonality, with the highest discharge and suspended solids during the wet season. Scenarios and streams within each scenario had distinct physicochemical signatures. All three streams within each scenario clustered together in ordination space and remained close to each other during all seasons. There were significant scenario-season interactions on conductivity (F = 9.5, P < 0.001), discharge (F = 56.7, P < 0.001), pH (F = 4.5, P = 0.011), Cl− (F = 12.2, P < 0.001), SO42− (F = 8.8, P < 0.001) and NH4+ (F = 5.4, P = 0.005). Patterns within individual scenarios were associated with stream identity instead of land use. Both P-F and F-C scenarios had significantly different physicochemical patterns from those in F-P in all seasons (Procrustes analysis, m12 = 0.05–0.25; R = 0.86–0.97; P < 0.05). Chlorophyll was significantly different among scenarios and seasons (F = 5.36, P = 0.015, F = 3.81, P = 0.42, respectively). Concentrations were related to physicochemical variables more strongly during the transition season.ConclusionOverall, land use scenarios resulted in distinctive water physicochemical signatures highlighting the complex effects that anthropogenic activities have on tropical cloud forest streams. Studies assessing the effect of land use on tropical streams will benefit from assessing scenarios, rather than focusing on individual land use types. We also found evidence of the importance that forest fragments play in maintaining or restoring stream water physicochemistry. creator: Gabriela Vázquez creator: Alonso Ramírez creator: Mario E. Favila creator: M. Susana Alvarado-Barrientos uri: https://doi.org/10.7717/peerj.15487 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2023 Vázquez et al. title: Development and validation of a nomogram to predict protein-energy wasting in patients with peritoneal dialysis: a multicenter cohort study link: https://peerj.com/articles/15507 last-modified: 2023-06-05 description: BackgroundProtein-energy wasting (PEW) is a common complication in patients with peritoneal dialysis (PD). Few investigations involved risk factors identification and predictive model construction related to PEW. We aimed to develop a nomogram to predict PEW risk in patients with peritoneal dialysis.MethodsWe collected data from end-stage renal disease (ESRD) patients who regularly underwent peritoneal dialysis between January 2011 and November 2022 at two hospitals retrospectively. The outcome of the nomogram was PEW. Multivariate logistic regression screened predictors and established a nomogram. We measured the predictive performance based on discrimination ability, calibration, and clinical utility. Evaluation indicators were receiver operating characteristic (ROC), calibrate curve, and decision curve analysis (DCA). The performance calculation of the internal validation cohort validated the nomogram.ResultsIn this study, 369 enrolled patients were divided into development (n = 210) and validation (n = 159) cohorts according to the proportion of 6:4. The incidence of PEW was 49.86%. Predictors were age, dialysis duration, glucose, C-reactive protein (CRP), creatinine clearance rate (Ccr), serum creatinine (Scr), serum calcium, and triglyceride (TG). These variables showed a good discriminate performance in development and validation cohorts (ROC = 0.769, 95% CI [0.705–0.832], ROC = 0.669, 95% CI [0.585–0.753]). This nomogram was adequately calibrated. The predicted probability was consistent with the observed outcome.ConclusionThis nomogram can predict the risk of PEW in patients with PD and provide valuable evidence for PEW prevention and decision-making. creator: Ziwei Mei creator: Bin Zhu creator: Xiaoli Sun creator: Yajie Zhou creator: Yuanyuan Qiu creator: Xiaolan Ye creator: Hongjuan Zhang creator: Chunlan Lu creator: Jun Chen creator: Hong Zhu uri: https://doi.org/10.7717/peerj.15507 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2023 Mei et al. title: The conservation value of freshwater habitats for frog communities of lowland fynbos link: https://peerj.com/articles/15516 last-modified: 2023-06-05 description: Amphibians are more threatened than any other vertebrate class, yet evidence for many threats is missing. The Cape lowland fynbos (endemic scrub biome) is threatened by habitat loss, and natural temporary freshwater habitats are removed in favour of permanent impoundments. In this study, we determine amphibian assemblages across different freshwater habitat types with special attention to the presence of invasive fish. We find that anuran communities differ primarily by habitat type, with permanent water habitats having more widespread taxa, while temporary water bodies have more range restricted taxa. Invasive fish are found to have a significant impact on frogs with toads most tolerant of their presence. Temporary freshwater habitats are a conservation priority in the area, and their amphibian assemblages represent endemic taxa that are intolerant of invasive fish. Conservation of a biodiverse amphibian assemblage in lowland fynbos areas will rely on the creation of temporary freshwater habitats, rather than a northern hemisphere pond based solution. creator: Naas Terblanche creator: John Measey uri: https://doi.org/10.7717/peerj.15516 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2023 Terblanche and Measey title: Association between free thyroxine levels and clinical phenotype in first-episode psychosis: a prospective observational study link: https://peerj.com/articles/15347 last-modified: 2023-06-02 description: AimTo determine whether thyroid hormone levels are associated with a specific clinical phenotype in patients with first-episode psychosis (FEP).MethodsNinety-eight inpatients experiencing FEP and with less than 6 weeks of antipsychotic treatment were included in the study and were followed up for one year. Baseline psychiatric evaluation included assessment of prodromal symptoms, positive and negative symptoms, depressive symptoms, stressful life events and cycloid psychosis criteria. Thyroid function (thyroid-stimulating hormone (TSH) and free thyroxin (FT4)) was determined at admission. Partial correlation analysis was conducted to analyse the correlation between levels of TSH/FT4 and symptoms. Logistic regression was performed to explore the association between psychopathological symptoms, 12-month diagnoses and thyroid hormones while adjusting for covariates.ResultsPatients with prodromal symptomatology showed lower baseline FT4 levels (OR = 0.06; p = 0.018). The duration of untreated psychosis (DUP) was inversely associated with FT4 concentrations (r =  − 0.243; p = 0.039). FEP patients with sudden onset of psychotic symptoms (criteria B, cycloid psychosis) showed higher FT4 levels at admission (OR = 10.49; p = 0.040). Patients diagnosed with affective psychotic disorders (BD or MDD) at the 12-month follow-up showed higher FT4 levels at admission than patients diagnosed with nonaffective psychosis (schizophrenia, schizoaffective) (OR = 8.57; p = 0.042).ConclusionsOur study suggests that higher free-thyroxine levels are associated with a specific clinical phenotype of FEP patients (fewer prodromal symptoms, shorter DUP duration and sudden onset of psychosis) and with affective psychosis diagnoses at the 12-month follow-up. creator: Eloi Gine-Serven creator: Maria Martinez-Ramirez creator: Ester Boix-Quintana creator: Eva Davi-Loscos creator: Nicolau Guanyabens creator: Virginia Casado creator: Desiree Muriana creator: Cristina Torres-Rivas creator: M.J. Cuesta creator: Javier Labad uri: https://doi.org/10.7717/peerj.15347 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Gine-Serven et al. title: Influence of SPIO labelling on the function of BMSCs in chemokine receptors expression and chemotaxis link: https://peerj.com/articles/15388 last-modified: 2023-06-02 description: Bone marrow-derived mesenchymal stem cells (BMSCs) are increasingly being used in bone marrow transplantation (BMT) to enable homing of the allogeneic hematopoietic stem cells and suppress acute graft versus host disease (aGVHD). The aim of this study was to optimize the labelling of BMSCs with superparamagnetic iron oxide particles (SPIOs), and evaluate the impact of the SPIOs on the biological characteristics, gene expression profile and chemotaxis function of the BMSCs. The viability and proliferation rates of the SPIO-labeled BMSCs were analyzed by trypan blue staining and CCK-8 assay respectively, and the chemotaxis function was evaluated by the transwell assay. The expression levels of chemokine receptors were measured by RT-PCR and flow cytometry. The SPIOs had no effect on the viability of the BMSCs regardless of the labelling concentration and culture duration. The labelling rate of the cells was higher when cultured for 48 h with the SPIOs. Furthermore, cells labeled with 25 µg/ml SPIOs for 48 h had the highest proliferation rates, along with increased expression of chemokine receptor genes and proteins. However, there was no significant difference between the chemotaxis function of the labeled and unlabeled BMSCs. To summarize, labelling BMSCs with 25 µg/ml SPIOs for 48h did not affect their biological characteristics and chemotaxis function, which can be of significance for in vivo applications. creator: Yuanchun Liu creator: Wanyi Huang creator: Huiyang Wang creator: Wei Lu creator: Jiayu Guo creator: Li Yu creator: Lina Wang uri: https://doi.org/10.7717/peerj.15388 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Liu et al.