title: PeerJ description: Articles published in PeerJ link: https://peerj.com/articles/index.rss3?journal=peerj&page=525 creator: info@peerj.com PeerJ errorsTo: info@peerj.com PeerJ language: en title: Clinical characteristics and prognostic nomogram analysis of patients with dual primary cancers with first gastric cancer: a retrospective study in China link: https://peerj.com/articles/15278 last-modified: 2023-05-01 description: BackgroundWith the improvement in diagnosis and treatment of gastric cancer (GC), the survival time of patients has been gradually prolonged. However, these survivors are at increased risk for other diseases, including second primary cancers (SPCs). Currently, there remain few central studies concerning double primary cancers with first gastric cancer (DPCFGC). Thus, this study aimed to investigate these patients’ clinical characteristics and perform prognostic nomogram analysis.MethodsThe clinical data of 78 DPCFGC patients were retrospectively collected and analyzed through the hospital electronic medical record system. Univariate and multivariate Cox regression analyses were performed to screen independent risk factors, based on which the prognostic nomogram was further constructed and validated using the R software package. Finally, Kaplan–Meier curves were plotted to explore the association of overall survival (OS) with prognostic factors and the model.ResultsThe prevalence of DPCFGC was 0.86%, of which the proportions of synchronous and metachronous patients were 47.44% and 52.56% , respectively; 65.38% (51/78) and 34.62% (27/78) of patients were male and female, respectively. The median age at GC and SPC diagnosis was 63 and 65 years, respectively, and 52.57% of GC patients developed SPCs within 1 year. The top three SPCs were in the esophagus (19.24%), colon (16.67%), and rectum (15.39%). The most common features of GC and SPCs were adenocarcinoma, poorly and moderately differentiated histology, and pathological stages I and II. The radical resection rate of GC was significantly lower in synchronous patients than in metachronous patients (45.94% vs. 100.00%, P < 0.001), but no significant difference was noted in the radical resection rate of SPCs (35.13% vs. 46.34%, P = 0.315). The OS of DPCFGC patients was 31.03 ±  4.14 months. The pathological stage of GC and SPCs, whether to operate for GC, and diagnostic interval were independent risk factors. The predictive efficacy of the prognostic nomogram for 1-, 2- and 3-year OS in DPCFGC patients was 0.922, 0.935 and 0.796 , respectively, with good consistency and clinical applicability. The OS was significantly lower in the high-risk group than in the low-risk group.ConclusionsDuring follow-up, clinicians should attach great importance to the screening of GC survivors, especially at early stage in older men within 1 year after diagnosis, and be alert to the possibility of occurrent digestive system malignancies. The nomogram constructed in this study can provide a theoretical basis for the early clinical development of individualized treatment plans. creator: Bing Wang creator: Lu Liu uri: https://doi.org/10.7717/peerj.15278 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Wang and Liu title: Loot box consumption by adolescents pre- and post- pandemic lockdown link: https://peerj.com/articles/15287 last-modified: 2023-05-01 description: Loot boxes are virtual items that can be redeemed to receive randomly selected other virtual items, and have been criticized for being similar to gambling. The presence of loot boxes in video games has dramatically increased since 2010, with little evidence available for the current prevalence rate of loot box purchasing in the general population, particularly during and following the COVID-19 pandemic lockdowns. This study uses data from representative samples of American youth to estimate prevalence rates for video game play and loot box consumption before the pandemic (2019) and after the pandemic lockdowns (2022) to examine whether the pandemic has affected loot box usage in the general population and among gamers. The results suggest that youth loot box consumption has increased, rising from 24.9% in 2019 to 31.6% in 2022 among 8th grade (age 13–14) youth. The increase over this time period was larger for girls, though boys are still more likely to purchase loot boxes overall. creator: Whitney DeCamp creator: Kevin Daly uri: https://doi.org/10.7717/peerj.15287 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 DeCamp and Daly title: Indoor air quality in a training centre used for sports practice link: https://peerj.com/articles/15298 last-modified: 2023-05-01 description: BackgroundOne of the measures for controlling the coronavirus disease 2019 (COVID-19) pandemic was the mass closure of gyms. This measure leads us to determine the differences between indoor and outdoor air quality. That is why the objective of this study was to analyse the indoor air quality of a sports centre catering to small groups and rehabilitation.MethodsThe study was conducted in a single training centre, where 26 measurements were taken in two spaces (indoors and outdoors). The air quality index, temperature, relative humidity, total volatile compounds, carbon monoxide, ozone, formaldehyde, carbon dioxide, and particulate matter were measured indoors and outdoors using the same protocol and equipment. These measurements were taken twice, once in the morning and once in the afternoon, with all measurements made at the same time, 10 am and 6 pm, respectively. Additionally, four determinations of each variable were collected during each shift, and the number of people who had trained in the room and the number of trainers were counted.ResultsIn the different variables analysed, the results show that CO2 and RH levels are higher indoors than outdoors in both measurement shifts. Temperatures are higher outside than inside and, in the evening, than in the morning. TVOC, AQI and PM show less variation, although they are higher outdoors in the morning. CO is highest indoors. HCHO levels are almost negligible and do not vary significantly, except for a slight increase in the afternoon outside. Ozone levels are not significant. All the variables showed practically perfect reliability in all the measurements, except for ozone measured outside in the morning. On the other hand, the variables exhibit variations between indoors and outdoors during the morning and afternoon, except for the three types of PM. Also, the data show that all the main variables measured inside the sports training centre are similar between morning and afternoon. However, outside, temperature, relative humidity and HCHO levels show significant differences between morning and afternoon while no differences are observed for the other variables.ConclusionThe indoor air quality of the training centre assessed was good and met current regulations; some of its components even exhibited better levels than fresh air. This article is the first to measure indoor air quality in a sports training centre catering to rehabilitation and small groups. creator: Victoria Mazoteras-Pardo creator: Marta Elena Losa-Iglesias creator: Israel Casado-Hernández creator: César Calvo-Lobo creator: Ángel Morales-Ponce creator: Alfredo Medrano-Soriano creator: Sergio Coco-Villanueva creator: Ricardo Becerro-de-Bengoa-Vallejo uri: https://doi.org/10.7717/peerj.15298 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2023 Mazoteras-Pardo et al. title: Identification and analysis of differentially expressed trihelix genes in maize (Zea mays) under abiotic stresses link: https://peerj.com/articles/15312 last-modified: 2023-05-01 description: BackgroundTrihelix transcription factors play important roles in triggering plant growth and imparting tolerance against biotic and abiotic stresses. However, a systematical analysis of the trihelix transcription factor family under heat and drought stresses in maize has not been reported.MethodsPlantTFDB and TBtools were employed to identify the trihelix domain-containing genes in the maize genome. The heat-regulated transcriptome data for maize were obtained from NCBI to screen differentially expressed ZmTHs genes through statistical analysis. The basic protein sequences, chromosomal localization, and subcellular localization were analyzed using Maize GDB, Expasy, SOMPA, TBtools, and Plant-mPLoc. The conserved motifs, evolutionary relationships, and cis-elements, were analyzed by MEME, MEGA7.0 and PlantCARE software, respectively. The tissue expression patterns of ZmTHs and their expression profiles under heat and drought stress were detected using quantitative real-time PCR (qRT-PCR).ResultsA total of 44 trihelix family members were discovered, and members were distributed over 10 chromosomes in the maize genome. A total of 11 genes were identified that were regulated by heat stress; these were unevenly distributed on chromosomes 1, 2, 4, 5, and 10. ZmTHs encoded a total of 16 proteins, all of which were located in the nucleus; however, ZmTH04.1 was also distributed in the chloroplast. The protein length varied from 206 to 725 amino acids; the molecular weight ranged from 22.63 to 76.40 kD; and the theoretical isoelectric point (pI) ranged from 5.24 to 11.2. The protein’s secondary structures were mainly found to be random coils and α-helices, with fewer instances of elongation chains and β-rotations. Phylogenetic relationship analysis showed that these can be divided into five sub-groups. The conserved domain of ZmTHs was GT1 or MyB_DNA-Bind_4. The protein and gene structure of ZmTHs differed greatly among the subfamilies, while the structures within the subfamilies were similar. The promoter of ZmTHs contained abundant tissue-specific expression cis-acting elements and abiotic stress response elements. qRT-PCR analysis showed that ZmTHs expression levels were significantly different in different tissues. Furthermore, the expression of ZmTH08 was dramatically up-regulated by heat stress, while the expression of ZmTH03, ZmTH04, ZmTH05, ZmTH06, ZmTH07, ZmTH09, ZmTH10, and ZmTH11 were down-regulated by heat stress. Upon PEG-simulated drought stress, ZmTH06 was significantly up-regulated, while ZmTH01 and ZmTH07 were down-regulated.ConclusionsWe performed a genome-wide, systematic identification and analysis of differentially expressed trihelix genes under heat and drought stresses in maize. creator: Dongbo Zhao creator: Fengju Gao creator: Peiyan Guan creator: Jiansheng Gao creator: Zhihui Guo creator: Jianjun Guo creator: Huini Cui creator: Yongjun Li creator: Guijun Zhang creator: Zhao Li creator: Lianghai Guo uri: https://doi.org/10.7717/peerj.15312 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2023 Zhao et al. title: Novel immune cell infiltration-related biomarkers in atherosclerosis diagnosis link: https://peerj.com/articles/15341 last-modified: 2023-05-01 description: BackgroundImmune cell infiltration (ICI) has a close relationship with the progression of atherosclerosis (AS). Therefore, the current study was aimed to explore the role of genes related to ICI and to investigate potential mechanisms in AS.MethodsSingle-sample gene set enrichment analysis (ssGSEA) was applied to explore immune infiltration in AS and controls. Genes related to immune infitration were mined by weighted gene co-expression network analysis (WGCNA). The function of those genes were analyzed by enrichment analyses of the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO). The interactions among those genes were visualized in the protein-protein interaction (PPI) network, followed by identification of hub genes through Cytoscape software. A receiver operating characteristic (ROC) plot was generated to assess the performance of hub genes in AS diagnosis. The expressions of hub genes were measured by reverse transcription quantitative real-time PCR (RT-qPCR) in human leukemia monocyticcell line (THP-1) derived foam cells and macrophages, which mimic AS and control, respectively.ResultsWe observed that the proportions of 27 immune cells were significantly elevated in AS. Subsequent integrative analyses of differential expression and WGCNA identified 99 immune cell-related differentially expressed genes (DEGs) between AS and control. Those DEGs were associated with tryptophan metabolism and extracellular matrix (ECM)-related functions. Moreover, by constructing the PPI network, we found 11 hub immune cell-related genes in AS. The expression pattern and receiver ROC analyses in two independent datasets showed that calsequestrin 2 (CASQ2), nexilin F-Actin binding protein (NEXN), matrix metallopeptidase 12 (MMP12), C-X-C motif chemokine ligand 10 (CXCL10), phospholamban (PLN), heme oxygenase 1 (HMOX1), ryanodine receptor 2 (RYR2), chitinase 3 like 1 (CHI3L1), matrix metallopeptidase 9 (MMP9), actin alpha cardiac muscle 1 (ACTC1) had good performance in distinguishing AS from control samples. Furthermore, those biomarkers were shown to be correlated with angiogenesis and immune checkpoints. In addition, we found 239 miRNAs and 47 transcription factor s (TFs), which may target those biomarkers and regulate their expressions. Finally, we found that RT-qPCR results were consistent with sequencing results. creator: Ruoyu Dong creator: Jikuan Li creator: Guangwei Jiang creator: Ning Han creator: Yaochao Zhang creator: Xiaoming Shi uri: https://doi.org/10.7717/peerj.15341 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2023 Dong et al. title: Validation and cross-cultural adaptation of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) into Spanish link: https://peerj.com/articles/15138 last-modified: 2023-04-28 description: BackgroundThe Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) is a valid and reliable tool to assess the sexuality of people with multiple sclerosis. The objectives of this study were: 1) to cross-culturally adapt and examine the psychometric properties of the MSISQ-15 in the Spanish context and 2) to examine the association between sexual dysfunction and other related factors.MethodsWe conducted a instrumental study. People diagnosed with multiple sclerosis and members of multiple sclerosis associations in Spain were included. The linguistic adaptation of the questionnaire was performed through a translation-back translation procedure. For the psychometric validation, the confirmatory factor analysis was used while the internal consistency was examined by the ordinal alpha test. The construct validity was examined by correlating the results with the Male Sexual Function (FSH), Female Sexual Function-2 (FSM-2), Dyadic Adjustment Scale-13 (EAD-13) and Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL) questionnaires.ResultsA total of 208 participants were included. Both the fit of the Spanish version of the MSISQ-15 to the original scale and the internal consistency were adequate (α = 0.89). The construct validity showed correlations with the FSH, FSM-2, and MusiQoL but not with the EAD-13.ConclusionsThe Spanish version of the MSISQ-15 is a valid and reliable tool to assess the sexuality of people with multiple sclerosis in the Spanish context. creator: Antonio Esteve Ríos creator: María José Cabañero-Martínez creator: Silvia Escribano creator: Frederick Foley creator: Sofía García-Sanjuán uri: https://doi.org/10.7717/peerj.15138 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Esteve Ríos et al. title: Non-deep physiological dormancy and germination characteristics of Primula florindae (Primulaceae), a rare alpine plant in the Hengduan Mountains of southwest China link: https://peerj.com/articles/15234 last-modified: 2023-04-28 description: Timing of seed germination is directly related to the survival probability of seedlings. For alpine plants, autumn-dispersal seeds should not germinate immediately because the cold temperature is not conducive to the survival of seedlings. Seed dormancy is a characteristic of the seed that prevents it from germinating after dispersal. Primula florindae is an alpine perennial forb endemic to eastern Tibet, SW China. We hypothesized that primary dormancy and environmental factors prevent seeds of P. florindae to germinate in autumn and allow them to germinate at the first opportunity in spring. We determined how GA3, light, temperature, dry after-ripening (DAR) and cold-wet stratification (CS) treatments affect seed germination by conducting a series of laboratory experiments. Firstly, the effects of gibberellic acid (GA3; 0, 20, and 200 mg L−1) on germination of freshly shed seeds at alternating temperatures (15/5 and 25/15 °C) were immediately investigated to characterize seed with a physiological dormancy component. Then, the fresh seeds treated with 0, 3, and 6 months of after-ripening (DAR) and cold-wet stratification (CS) were incubated at seven constant (1, 5, 10, 15, 20, 25, and 30 °C) and two alternating temperatures (5/1, 15/5, and 25/15 °C) at light and dark conditions. Fresh seeds were dormant, which only germinated well (>60%) at 20, 25, and 25/15 °C in light but not at ≤15 °C and to higher percentages in light than in dark. GA3 increased germination percentage of fresh seeds, and DAR or CS treatments increased final germination percentage, germination rate (speed), and widened the temperature range for germination from high to low. Moreover, CS treatments reduced the light requirement for germination. Thus, after dormancy release, seeds germinated over a wide range of constant and alternating temperatures, regardless of light conditions. Our results demonstrated that P. florindae seeds have type 2 non-deep physiological dormancy. Timing of germination should be restricted to early spring, ensuring a sufficient length of the growing season for seedling recruitment. These dormancy/germination characteristics prevent seeds from germinating in autumn when temperatures are low but allow them to germinate after snowmelt in spring. creator: Yingbo Qin creator: Boyang Geng creator: Li-E Yang creator: Deli Peng uri: https://doi.org/10.7717/peerj.15234 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Qin et al. title: Nutritional status and its associated factors among commercial female sex workers in Hawassa city, south Ethiopia link: https://peerj.com/articles/15237 last-modified: 2023-04-28 description: BackgroundCommercial female sex workers (CFSWs) regularly or occasionally trade sex for money. Sex work is widespread, mainly in urban areas of Ethiopia. The study on the nutritional status of CFSWs is unavailable in Ethiopia, and data are also scanty at the global level. This study aims to assess nutritional status and associated factors among CFSWs in Hawassa city, Ethiopia.MethodsThis cross-sectional study used facility-based mixed data collection methods (qualitative and quantitative). The study was conducted in three key population clinics in Hawassa city. A total of 297 CFSWs were randomly selected for the ‘quantitative survey,’ and twelve (n = 12) purposively selected participants were involved in the ‘qualitative study.’ Body mass index/BMI (Kg/m2) was used in assessing the nutritional status of CFSWs. Statistical software packages were used for analyzing both quantitative and qualitative data. Significant variables (P<0.05) in bivariate analysis (Chi-square test) were incorporated in the multivariable analyses. Multinomial logistic regression (MNLR) was employed where dependable variable like ‘normal BMI’ (18.5–24.9 kg/m2) was set as a reference category and simultaneously compared with ‘underweight’ (<18.5 BMI) and ’overweight/obesity’ (≥ 25 BMI) categories. Thus, two models, namely the underweight model (model-1: Underweight versus normal BMI) and the overweight/obesity model (model-2: overweight/obesity versus normal), were generated.ResultsThe prevalence of underweight and overweight/obesity among CFSWs in Hawassa city were respectively 14.1% and 16.8%. Living alone (Adjusted odds ratio/AOR = 0.18), chewed Khat regularly (AOR = 0.23), used drugs regularly (AOR = 10.57), used drugs in exchange of sex (AOR = 4.97), and HIV positive status (AOR = 21.64) were significantly (P < 0.05) associated with underweight (model-1). In the overweight/obesity model-2, having jobs other than sex work (AOR = 0.11), higher daily mean income (AOR = 3.02), being hotel/home-based CFSWs (AOR = 12.35), and presence of any chronic illness (AOR = 5.15) were significant (P < 0.05) predictors of overweight/obesity. From the ‘qualitative part’ of this study, it was also revealed that ‘lack of food and money’ was the main influencing factor among CFSWs to enter into the sex business.ConclusionsCommercial female sex workers in this study faced a double burden of malnutrition. Multiple factors influenced their nutritional status. Substance abuse and HIV-positivity are the most significant predictors of being underweight and having higher income, being hotel/home-based CFSWs, and suffering from any chronic illness are associated with overweight/obesity. Government and other partners should be essential in providing comprehensive programs focusing on sexual, reproductive health, and nutrition education. Steps should be taken to improve their socioeconomic status and strengthen those good initiatives at key population clinics and other health facilities. creator: Zegeye Gelan creator: Zelalem Tafese creator: Eskinder Yilma creator: Mahbuba Kawser uri: https://doi.org/10.7717/peerj.15237 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Gelan et al. title: An improved method for preparing stained ground teeth sections link: https://peerj.com/articles/15240 last-modified: 2023-04-28 description: ObjectiveIn oral histopathology teaching and research, there is a need for high-quality undemineralized tooth sections that are easy to handle, have controlled thickness, allow the observation of intact microstructures, and can be preserved for long periods of time.MethodsTeeth were collected under non-demineralizing conditions. Tooth sections (15–25 µm) were prepared using a diamond knife, then randomly divided into three groups: (1) stained with rosin, (2) stained with hematoxylin and eosin, or (3) not stained. The prepared tooth sections were evaluated by microscopy for clarity and microstructure visibility.ResultsThe use of a diamond knife in the sectioning and grinding process yielded high-quality ground sections of teeth. Rosin-stained ground sections allowed better identification of microstructures within the teeth, compared with unstained or hematoxylin and eosin-stained ground sections.ConclusionThe best results were obtained in the ground sections of teeth that were stained with rosin. Ground sections of teeth prepared using this staining method could be useful in oral histopathology teaching and research. creator: Qizhong Qin creator: Yueheng Li creator: Yujian Zhou uri: https://doi.org/10.7717/peerj.15240 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Qin et al. title: Value of preoperative 18F-FDG PET/CT and HRCT in predicting the differentiation degree of lung adenocarcinoma dominated by solid density link: https://peerj.com/articles/15242 last-modified: 2023-04-28 description: PurposeTo evaluate the value of positron emission tomography/computed tomography (PET/CT) combined with high-resolution CT (HRCT) in determining the degree of differentiation of lung adenocarcinoma.MethodsFrom January 2018 to January 2022, 88 patients with solid density nodules that are lung adenocarcinoma were surgically treated. All patients were examined using HRCT and PET/CT before surgery. During HRCT, two independent observers assessed the presence of lobulation, spiculation, pleural indentation, vascular convergence, and air bronchial signs (bronchial distortion and bronchial disruption). The diameter and CT value of the nodules were measured simultaneously. During PET/CT, the maximum standard uptake value (SUVmax), mean standard uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the nodules were measured. The risk factors of pathological classification were predicted by logistic regression analysis.ResultsAll 88 patients (mean age 60 ± 8 years; 44 males and 44 females) were evaluated. The average nodule size was 2.6 ± 1.1 cm. The univariate analysis showed that carcinoembryonic antigen (CEA), pleural indentation, vascular convergence, bronchial distortion, and higher SUVmax were more common in poor differentiated lung adenocarcinoma, and in the multivariate analysis, pleural indentation, vascular convergence, and SUVmax were predictive factors. The combined diagnosis using these three factors showed that the area under the curve (AUC) was 0.735.ConclusionSUVmax >6.99 combined with HRCT (pleural indentation sign and vascular convergence sign) is helpful to predict the differentiation degree of lung adenocarcinoma dominated by solid density. creator: Xiaolin Chen creator: Ping Li creator: Minghui Zhang creator: Xuewei Wang creator: Dalong Wang uri: https://doi.org/10.7717/peerj.15242 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2023 Chen et al.