title: PeerJ description: Articles published in PeerJ link: https://peerj.com/articles/index.rss3?journal=peerj&page=95 creator: info@peerj.com PeerJ errorsTo: info@peerj.com PeerJ language: en title: An integrated health management model to improve the health of professional e-sports athletes: a literature review link: https://peerj.com/articles/19323 last-modified: 2025-04-21 description: BackgroundWith the rapid development of the esports industry, an increasing number of esports athletes face various health issues due to occupational characteristics such as a prolonged sedentary lifestyle, high-intensity training, and multi-cycle competitions. Effectively managing and improving the health status of esports athletes has become an urgent need. As a systematic and multidisciplinary collaborative management strategy, the Integrated Health Management Model has been widely applied to various occupational groups, but its application among esports athletes has not yet been systematically reviewed.MethodologyThis study adopted a narrative literature review method to collect and analyze the existing literature on the health issues and health management of esports athletes. This study aimed to identify the major health problems of esports athletes and explore the role of the Integrated Health Management Model in improving and preventing these health problems.ResultsThis study resulted in two main findings: (1) The main health issues faced by esports athletes include musculoskeletal disorders, visual fatigue, metabolic disorders, and psychological stress; (2) the Integrated Health Management Model, through the integration of physical activity and fitness training, psychological counseling, ergonomic optimization, vision protection, and health education, can effectively alleviate common health problems among esports athletes and promote overall health improvement.ConclusionThe Integrated Health Management Model can effectively improve the overall health level of esports athletes through the integration and synergy of multiple strategies. creator: Yunxuan Mi creator: Siyuan Zhao creator: Fangyuan Ju uri: https://doi.org/10.7717/peerj.19323 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Mi et al. title: Barriers to seeking consultation at public service and medical facilities among pregnant and postpartum women in Japan: a cross-sectional study link: https://peerj.com/articles/19320 last-modified: 2025-04-21 description: BackgroundPregnant and postpartum women often experience parenting problems which may affect their mental health and children’s health and development. However, their ability to seek consultation at public service or medical facilities remains unclear. This study aimed to identify the characteristics associated with women who refrain from visiting these facilities for consultation and their reasons for it.MethodsThis cross-sectional internet-based survey was conducted in Japan between July and August 2021, involving 7,326 women (1,639 pregnant and 5,687 postpartum women). The study outcome was defined as refraining from seeking consultation on family or parenting issues at public service or medical facilities despite a perceived need. We identified women’s characteristics associated with refraining from consultation using multivariable logistic regression and conducted a descriptive analysis of 13 listed reasons for refraining from the consultation.ResultsThe percentage of women who reported refraining from seeking consultation at public service or medical facilities was 8.6% and 5.1%, respectively. Common factors associated with refraining from seeking consultation at these facilities included having a child(ren) and being in the postpartum period, low health literacy, lack of partner support, and current disability. “Difficulty taking child(ren) to the consultation” and “uncertainty about the seriousness of the problem” were major reasons for refraining from consultation.DiscussionHealthcare workers at public service and medical facilities should offer prenatal education on the importance of seeking help. An online consultation service and an improved facility environment may mitigate women’s perceived barriers to seeking consultation. creator: Sumiyo Okawa creator: Kaori Seino creator: Hiroyasu Iso creator: Takahiro Tabuchi uri: https://doi.org/10.7717/peerj.19320 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2025 Okawa et al. title: Knowledge and attitudes toward pediatric pain management among nursing interns from a selected university in Riyadh, Saudi Arabia: a descriptive cross-sectional quantitative study link: https://peerj.com/articles/19288 last-modified: 2025-04-21 description: IntroductionPediatric pain is often not addressed properly in the literature, which suggests a research gap in pediatric health-care providers’ knowledge and attitudes toward the treatment of pain experienced by children in various health-care settings. To improve future practice in this area, nursing interns should be well versed in pediatric pain assessment and management to improve pediatric pain management practices in collaboration with other health-care professionals.PurposeThis study aimed to assess the levels of knowledge and attitudes toward pediatric pain management among nursing interns at a specific academic institution.MethodsThis descriptive cross-sectional quantitative study employed an online questionnaire to collect data from 119 female nursing interns in Riyadh, Saudi Arabia. In addition to collecting the participants’ demographic profiles, the questionnaire gathered data using the Pediatric Nurses’ Knowledge and Attitudes Survey Regarding Pain instrument. Descriptive and inferential statistics were calculated using SPSS for Windows (v. 21.0).ResultsThe nursing interns’ overall knowledge and attitudes toward pediatric pain management were found to be poor, with a mean score of 36.59% (standard deviation, 13.2).ConclusionAdditional education and clinical training for nursing interns is essential to enhance their knowledge and attitudes toward pediatric pain management. creator: Sumathi Robert Shanmugam creator: Amany Anwar Saeed Alabdullah creator: Maha Hanis Alenezi creator: Shahad Khalid Aldughyshim creator: Maryam Fahad Alnemer creator: Wedad Khalid Almutairi creator: Ghaida Saad Alhadyan creator: Rasha Zaid Albugomi creator: Fatimah Abdullah Alkhulayfi uri: https://doi.org/10.7717/peerj.19288 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Shanmugam et al. title: Effects of phosphorus-solubilizing fungi on bulb quality and the Fritillaria taipaiensis rhizosphere soil environment link: https://peerj.com/articles/19283 last-modified: 2025-04-21 description: BackgroundFritillaria taipaiensis P.Y. Li is commonly used in Chinese medicine for its cough-suppressing and expectorant properties. Due to over-excavation and ecological damage, the wild resources of F. taipaiensis have suffered serious damage. Understanding and improving the inter-root soil environment plays an important role in improving the success rate of artificial cultivation of F. taipaiensis and the quality of medicinal herbs.MethodsThis study employed a pot experiment to inoculate three strains of phosphorus-solubilizing fungi from the Aspergillus genus for a total of seven treatment groups, with sterile physiological saline serving as the control group (CK). The research aims to examine the impact of inoculating phosphorus-solubilizing fungi on the biomass of F. taipaiensis, alkaloid concentration in its bulbs, and characteristics of the rhizosphere soil environment. The specific inoculation treatments included: Aspergillus tubingensis (Z1); Aspergillus niger (Z2); Aspergillus fumigatus (Z3); a combination of A. tubingensis and A. niger (Z12); a combination of A. niger and A. fumigatus (Z13); a combination of A. tubingensis and A. fumigatus (Z23); and a combination of all three fungi, A. tubingensis, A. niger, and A. fumigatus (Z123).ResultsInoculation with phosphorus-soluble fungi significantly increased the biomass of F. taipaiensis, and the largest increase was in the Z123 group, which was 62.85% higher than that of the CK group. Total alkaloid content increased the most (0.11%) in the Z3 group, which was an 83.87% increase compared with the CK group. The total content of monomer alkaloids in the Z3, Z13, and Z123 groups increased by 10.53%, 12.48%, and 9.61%, respectively, compared with those in the CK group, indicating that the quality of F. taipaiensis could be significantly improved after applying phosphorus-solubilizing fungi. The soil environment improved after inoculation with different phosphorus-solubilizing fungi. The Z23 and Z123 groups had the greatest effect on the rhizosphere soil bacteria and Actinomyces. Overall, the soil nutrient content of the Z13 group increased the most, and the contents of available phosphorus, available potassium, available nitrogen, total phosphorus, and organic matter increased by 47.71%, 27.36%, 26.78%, 25.13%, and 31.72%, respectively, compared with those in the CK group.ConclusionThese results show that the treatment groups that included different combinations of strains were superior to the single-strain treatment groups, and the Z123 group was the best treatment group when considering bulb biomass and alkaloid and soil nutrient contents. Applying phosphorus-solubilizing fungus fertilizer is highly feasible during F. taipaiensis production in the field. creator: Xueyang Ren creator: Lin Yuan creator: Huan Yao creator: Yuhan Wang creator: Huan Wang creator: Dongqin Guo creator: Nong Zhou uri: https://doi.org/10.7717/peerj.19283 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Ren et al. title: A study of diel and seasonal patterns of loss of commercial lychee fruits to vertebrate frugivores: implications for mitigating a human-wildlife conflict link: https://peerj.com/articles/19269 last-modified: 2025-04-21 description: Human-wildlife conflicts pose a growing threat to biodiversity, particularly when the targeted species plays an ecological keystone role. Mauritius has repeatedly mass-culled an endemic and threatened flying fox species (the Mauritian flying fox; Pteropus niger) failing the intended objectives of crop protection and elevating the species’ extinction risks. In this context, the ecology of this species should be better understood to develop non-lethal management strategies. Here we investigated foraging patterns of vertebrate frugivores over 24 hour cycles in lychee orchards and backyard gardens. We assessed all agents of damage (mainly flying fox, alien bird, alien mammal) and the temporal variation of flying fox and bird foraging (take and amount eaten relative to fruit ripeness) on lychee trees. The most important frugivores foraging on lychees were flying foxes (78.3%) and birds (16.1%), namely ring-necked parakeets (Alexandrinus krameri), red-whiskered bulbuls (Pycnonotus jocosus), village weavers (Ploceus cucullatus) and common mynas (Acridotheres tristis) while damage by alien mammals was negligible (<1%). Flying foxes consumed more fruits in the early night (59%) compared to the late night and this was statistically significant in one orchard and backyards. However, the difference in damage was on average one to three fruits per tree per night. Bird damage at both orchards was highest during the first half of the day (64%). Flying foxes ate fewer fruits towards the end of the fruiting season while birds followed the opposite trend. As fruit ripeness increased from unripe to fully ripe, flying foxes ate 39–42% more lychee pulp per fruit at the two orchards. Parakeets ate 7% more fruit pulp with increasing ripeness at one orchard only. Deliberate disturbances involving smoke, noise or light to deter flying foxes were common in orchards. The weak difference in the extent of flying fox damage to fruits between early and late night suggested at best minor advantages of concentrating deliberate disturbances in early night, and that netting would be a better strategy as it would also protect against diurnal frugivores. Additionally, trees should be protected from the sixth week after fruit set as most damage occurred when fruits were unripe. Such an improved timing of crop protection should play an important role in reducing fruit losses and thereby alleviate the human-wildlife conflict around the flying fox’s diet. creator: Geetika Bhanda creator: Ryszard Z. Oleksy creator: Raphaël D. Reinegger creator: Cláudia Baider creator: F.B. Vincent Florens uri: https://doi.org/10.7717/peerj.19269 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Bhanda et al. title: Occult zonulopathy detected during cataract surgery in patients with acute primary angle closure: a retrospective study link: https://peerj.com/articles/19330 last-modified: 2025-04-18 description: BackgroundWhether occult zonulopathy contributes to the development of acute primary angle closure (APAC) remains elusive. This study aimed to determine the association between occult zonulopathy detected during cataract surgery and APAC and to investigate the biometric characteristics of APAC patients with or without occult zonulopathy.MethodsRetrospective case-control study. A total of 27 Chinese unilateral APAC subjects and 132 control subjects with comprehensive ophthalmic examinations were recruited. Occult zonulopathy was identified with the intraoperative signs during cataract surgery. The proportion of occult zonulopathy was compared between the APAC and control groups. A multivariate logistic analysis was conducted to determine the association between occult zonulopathy and APAC. The ocular biometric parameters were compared between APAC and the contralateral eyes in APAC patients with or without occult zonulopathy.ResultsAPAC patients (63.0%) had a significantly larger proportion of occult zonulopathy than control subjects (1.5%, P < 0.001). In the multivariate logistic analysis, occult zonulopathy was significantly associated with APAC after adjusting the axial length (AL) and sex (OR = 126.49, 95% CI [20.89–766.02]; P < 0.001). Compared to contralateral eyes, shallower central anterior chamber depth, more anterior lens position and relative lens position were found in APAC eyes both with and without occult zonulopathy (all P < 0.05), but no difference in AL and lens thickness.ConclusionA larger proportion of occult zonulopathy was significantly associated with APAC. Occult zonulopathy could be a risk factor for APAC by inducing forward shifting of the lens. creator: Jiawei Chen creator: Xiang-Ling Yuan creator: Xinyue Zhang creator: Yanjun Huang creator: Xiaona Huang creator: Xuanchu Duan uri: https://doi.org/10.7717/peerj.19330 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Chen et al. title: Acute effects of optimal power load flywheel half-squat training on lower limb explosive power under different load volumes link: https://peerj.com/articles/19321 last-modified: 2025-04-18 description: BackgroundTo explore the effects of flywheel half-squat interventions with different volumes of optimal power load (OPL) on post-activation performance enhancement (PAPE) in countermovement jump (CMJ) height and 30 m sprint performance among collegiate athletes.MethodsA randomized crossover design was employed, recruiting 20 collegiate athletes to participate in the experiment. After determining each participant’s OPL, four different training load schemes were arranged for eight formal experiments, including four CMJ tests and four 30 m sprint tests. The differences between baseline and post-intervention at 0, 4, 8, and 12 min were compared. A two-factor repeated measures ANOVA was used for data analysis, with a significance level set at P < 0.05, and Cohen’s d value was used to represent the effect size (ES).Results(1) The improvement in CMJ height for different flywheel half-squat load volumes peaked at 8 min of recovery. In terms of ES, the improvement was Group B > Group C > Group A. (2) The improvement in 30 m sprint speed for Group A peaked at 4 min post-intervention, while the improvement for Groups B and C peaked at 8 min post-intervention. In terms of ES, the improvement was Group B > Group C > Group A.ConclusionUsing two sets × six repetitions of OPL flywheel half-squat arrangement can induce a more reliable PAPE effect compared to higher load volumes. However, when using half-squats as a pre-stimulation exercise, the PAPE effect on CMJ height is superior to that on 30 m sprint speed. creator: Haonan Qi creator: Mushuai Hao creator: Boyang Qu creator: Liang Zhao creator: Wei Han uri: https://doi.org/10.7717/peerj.19321 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Qi et al. title: Therapeutic strategy and prognostic analysis of inflammatory myofibroblastic tumor in the head and neck: a retrospective study link: https://peerj.com/articles/19315 last-modified: 2025-04-18 description: ObjectiveThis study aimed to investigate the clinical features, treatment methods, and prognosis of head and neck inflammatory myofibroblastic tumor (HNIMT).MethodsA retrospective analysis was conducted using the clinical data of 12 HNIMT patients who were admitted to Shanxi Cancer Hospital between January 2016 and December 2023. This analysis focused on their clinical manifestations, pathological characteristics, treatment strategies, and prognosis.ResultsAmong the 12 cases analyzed, four involved inflammatory myofibroblastic tumors (IMT) located in the nasal sinuses or nasopharynx, with symptoms including nasal congestion, rhinorrhea, and maxillofacial swelling. Two cases each in the salivary glands and oral cavity presented as localized, painless masses. One right cervical IMT case also presented as a painless lump. Two laryngeal IMT cases had hoarseness, and one subglottic endotracheal IMT case showed inspiratory dyspnea. All patients received surgery, with postoperative pathology confirming IMT. During follow-up, four cases recurred. Finally, nine patients were disease-free, two survived with disease, and one died.ConclusionsHNIMT is a rare, low-grade malignant or borderline tumor that is generally associated with a favorable prognosis. Accurate diagnosis relies on pathological examination, and surgical resection remains the primary treatment for HNIMT. The need for adjuvant therapy following surgery should be determined by clinicians based on tumor location, surgical approach, and the presence of high-risk factors. creator: Feng Liu creator: Yanchao Qin creator: Zhiwei Zhang creator: Mengru Li creator: Bowei Feng creator: Wei Ding creator: Shubin Dong uri: https://doi.org/10.7717/peerj.19315 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Liu et al. title: Ex-situ avian sex skews: determinants and implications for conservation link: https://peerj.com/articles/19312 last-modified: 2025-04-18 description: With over half of all avian species in decline globally, zoo-based recovery programs are increasingly relied upon to save species from extinction. The success of such programs not only rests with political will, but also in our understanding of species’ breeding biology and how individuals and populations respond to changes in their environment. Sex skews, that is, an imbalance in the optimal number of males to females, is an underlying mechanism of population decline in some threatened species. Ex-situ (i.e., zoo-based) management practices will need to become more efficient to support the growing number of conservation reliant species and manage sex skews to amend, repair and restore population stability both in- and ex-situ. In this article, we analysed data from over 182,000 birds in global ex-situ collections. We interpreted sex ratio variation by observing the proportion of males within and between orders, International Union for Conservation of Nature (IUCN) threat status and housing inside and outside of a species’ natural range. Overall, our results showed that male-biased sex skews are more prevalent ex-situ than they are in the wild and although they vary greatly at the institutional level, were closer to parity at a global level. The variation amongst threat status and housing outside of range were less significant. These findings have implications for the conservation management of threatened birds and the potential of ex-situ populations to function with maximum effect in an integrated management system. creator: Clancy A. Hall creator: Gabriel C. Conroy creator: Dominique A. Potvin uri: https://doi.org/10.7717/peerj.19312 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Hall et al. title: Tailored lymph node dissection in right hemicolectomy: a retrospective study focusing on the anterior tissue of the superior mesenteric vein surgical trunk link: https://peerj.com/articles/19290 last-modified: 2025-04-18 description: BackgroundThe optimal extent of lymph node dissection in right hemicolectomy for colon cancer remains a topic of debate. This study aimed to refine lymph node dissection strategies by investigating the histopathological characteristics of the anterior tissue of the superior mesenteric vein (SMV) surgical trunk.MethodsOne hundred sixty-two patients underwent surgery, with their medial resection border determined to be either to the right or left of the SMV. Pathological and perioperative variables were assessed, and the anterior tissue of the SMV was analyzed to quantify lymph nodes and nerve fibers.ResultsOf the patients included, 84 were in the SMV-right group and 78 in the SMV-left group. After propensity score matching (PSM), the SMV-left group with dissection extending to the left side of the SMV and removal of the anterior tissue of SMV surgical trunk, retrieved more lymph nodes (36.9 vs. 26.8, P < 0.001) than the SMV-right group. However, there was no difference in node-positive staging. The SMV-left group also experienced more postoperative complications (16.7% vs. 1.7%, P = 0.011) and prolonged postoperative defecation times (4.2 vs. 3.5, P = 0.035), accompanied by a higher resection of nerve fibers (12.1 ± 4.2/case). Multivariate analysis identified tumor location above the ileocolic vein (ICV) root and elevated preoperative CA 19-9 levels as independent risk factors for metastasis to main lymph nodes.ConclusionRight hemicolectomy with extended lymph node dissection improves lymph node retrieval but increases complication risks and prolongs bowel recovery time. For patients with tumors located below the ICV root, a more limited dissection with the right side of the SMV as the medial boundary may be a preferable option, given the low rate of main lymph node metastasis. creator: Xianda Chi creator: Xuejie Li creator: Qiong Liang creator: Pinjie Huang creator: Jianpei Liu uri: https://doi.org/10.7717/peerj.19290 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Xianda et al.