title: PeerJ description: Articles published in PeerJ link: https://peerj.com/articles/index.rss3?journal=peerj&page=98 creator: info@peerj.com PeerJ errorsTo: info@peerj.com PeerJ language: en title: Changes in the spectrum of kidney diseases: a 14-year single-center retrospective renal biopsy study from southeast China link: https://peerj.com/articles/19302 last-modified: 2025-04-14 description: ObjectiveKidney disease has become a significant public health issue. Socioeconomic improvements and environmental changes in China have influenced the kidney disease spectrum. This study aims to examine the changing spectrum of biopsy-confirmed kidney diseases in a single center from southeastern China and explore their clinical-pathological correlations.MethodsPatients who underwent renal biopsy at the First Affiliated Hospital of Fujian Medical University from January 2010 to December 2023 were included in this retrospective study. Clinicopathological data were collected and analyzed.Results2,832 patients were enrolled. Primary glomerular diseases accounted for the majority of kidney diseases (69.0%), followed by secondary glomerular diseases, tubulointerstitial diseases, and others. Among primary glomerular diseases, membranous nephropathy (MN) was the most prevalent (34.9%), followed closely by IgA nephropathy (IgAN) (34.5%) and minimal change disease (18.5%), with an increasing trend for MN. For secondary glomerular diseases, lupus nephritis (34.3%), diabetic nephropathy (DN) (24.8%), and hepatitis B virus-associated nephropathy (HBVN) (9.0%) were the most common. HBVN showed a significant decrease, while DN increased annually. Nephrotic syndrome (NS) was the most frequent indication for renal biopsy (40.3%), followed by progressive chronic kidney disease (22.4%). MN (47.2%) was the leading pathology in NS, and IgAN (51.6%) was predominant in patients with proteinuria and hematuria.ConclusionsThe spectrum of kidney disease has changed within the last 14 years. The relative frequency of MN and DN increased significantly, while that of HBVN decreased significantly. These findings highlight the need for ongoing public health efforts tailored to the changing spectrum of kidney diseases. creator: Zishan Lin creator: Shidong Xie creator: Wenfeng Wang creator: Tao Hong creator: Bingjing Jiang creator: Caiming Chen creator: Xuan Tao creator: Dewen Jiang creator: Jianxin Wan creator: Hong Chen creator: Yanfang Xu uri: https://doi.org/10.7717/peerj.19302 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Lin et al. title: Psidium guajava L. hydroethanolic extract as endodontic irrigant: phytochemical analysis, antioxidant activity, antimicrobial action and biocompatibility link: https://peerj.com/articles/19301 last-modified: 2025-04-14 description: BackgroundThe search for novel antimicrobial agents in Endodontics is constant to overcoming persistent infections. Psidium guajava L. is a medicinal plant little explored in Endodontics. The aim of this study was to produce hydroethanolic extract of P. guajava L. and to evaluate its phytochemical composition, antimicrobial and antibiofilm action against standard and clinical strains of Enterococcus faecalis and Candida albicans, and cytotoxicity and genotoxicity on human keratinocyte cultures (HaCaT cells). The findings provide new insights into the potential of P. guajava as an alternative endodontic antimicrobial agent, contributing to the development of more effective and biocompatible therapeutic strategies.MethodsP. guajava hydroethanolic extract was produced using young leaves of guajava and extracted using absolute ethanol and ultrapure water in a ratio (30 g:100 mL). The solid soluble, total flavonoid and total phenols content were determined. The chemical composition was determined via high-performance liquid chromatography (HPLC) analysis, then the free radical suppressive activity was assessed by determining the IC50 value, indicating the concentration required to eliminate 50% of free radicals. Later, the minimum inhibitory concentration (MIC) and minimum microbicidal concentration (MMC) of the extract was evaluated against the strains using clinical and laboratory standards institute (CLSI) guidelines (M27-S4 and M7-A9). Then, the antibiofilm activity was evaluated via MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay. Finally, the cytotoxicity of the extract was evaluated via Alamar Blue assay, and the genotoxicity via micronucleus assay on human keratinocyte cultures (HaCaT cells). Data were analyzed using ANOVA and Tukey’s test or Kruskal-Wallis and Dunn’s test.ResultsThe soluble solids content in the extract was 3.35%. Using the quercetin standard curve, the total flavonoid concentration was 0.130 ± 0.110 mg/mL. In addition, using standard curve for phenolic acids, the total phenolic concentration was 1.770 ± 1.540 mg/mL. HPLC analysis revealed peaks of rutin, quercetin and kaempferol as major flavonoids in the P. guajava L. extract. The extract demonstrated notable antioxidant activity, with an IC50 value of 10.39 µg/mL. The MMC values ranged 1.04–8.37 mg/mL. The extract at 8.37 mg/mL was effective in reducing the biofilms of standard and clinical strains of E. faecalis and C. albicans after 10 min. Cytotoxicity analysis revealed that all tested concentrations exhibited relatively low toxicity toward HaCaT cells. Genotoxicity assessment via the micronucleus assay indicated minimal DNA damage at all tested concentrations. Overall, P. guajava L. hydroethanolic extract at 8.37 mg/mL is the most effective concentration in reducing the biofilm of the standard and clinical strains of E. faecalis and C. albicans, while maintaining biocompatibility with HaCaT cultures. creator: Lara Steffany de Carvalho creator: Vanessa Marques Meccatti-Domiciano creator: Livia Ramos Dorta da Silva creator: Maria Cristina Marcucci creator: Cláudio Antonio Talge Carvalho creator: Amjad Abu Hasna creator: Luciane Dias de Oliveira uri: https://doi.org/10.7717/peerj.19301 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 de Carvalho et al. title: Behavioral adaptations of Caenorhabditis elegans against pathogenic threats link: https://peerj.com/articles/19294 last-modified: 2025-04-14 description: This review examines the behavioral adaptation mechanisms of Caenorhabditis elegans in response to pathogenic bacterial threats, emphasizing their ecological significance. It systematically explores how mechanisms such as avoidance behavior, transgenerational learning, and forgetting enable C. elegans to optimize its survival and reproductive strategies within dynamic microbial environments. C. elegans detects harmful signals through chemosensation and initiates avoidance behaviors. Simultaneously, it manages environmental adaptation and energy allocation through transgenerational memory and forgetting, allowing C. elegans to cope with selective pressures from environmental fluctuations. In contrast, pathogenic bacteria such as Pseudomonas aeruginosa and Salmonella influence C. elegans behavior through strategies such as toxin release and biofilm formation, highlighting the complex co-evolutionary dynamics between hosts and pathogens. Additionally, these pathogens employ “Trojan Horse-like” and “Worm Star” mechanisms to kill C. elegans, further complicating host-pathogen interactions. These processes are driven by behavioral adaptations, biochemical signaling, and evolutionary pressures, which emphasize the ecological niche of C. elegans within microbial ecosystems. C. elegans serves as a valuable model for studying host-pathogen interactions. This study provides crucial theoretical insights into adaptive evolution and ecosystem dynamics, offering valuable guidance for the development of biocontrol strategies and the effective management of microbial ecosystems. creator: Xin Zhao creator: Xinyu Li creator: Jiayi Gao creator: Shi Shen creator: Wei Zou uri: https://doi.org/10.7717/peerj.19294 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Zhao et al. title: The regulatory effect of blood group on ferritin levels in aging: a retrospective study link: https://peerj.com/articles/19281 last-modified: 2025-04-14 description: BackgroundFerritin plays a pivotal role in the ageing process. Previous studies have identified statistically significant differences in ferritin levels among various ABO blood groups. However, the interaction between the ABO blood group and ferritin levels during senescence remains underexplored.MethodsThis research was conducted as a retrospective study involving a cohort of 3,843 individuals aged 40 and over who underwent blood type and ferritin testing at Beijing Zhongguancun Hospital. Assumption testing is employed to assess the normal distribution of continuous variables in the context of regression analysis. Spearman correlation analysis was employed to examine the relationship between the non-normally distributed biochemical indicators and ferritin levels. Age was considered the independent variable, while gender and biochemical indicators related to ferritin served as control variables. Blood type was analyzed as a moderating factor to evaluate its impact on the relationship between age and ferritin levels.ResultsOur findings revealed a negative correlation between ferritin and age (ρ =  − 0.099, p < 0.001). Significant differences in ferritin levels were observed between genders (p = 0.005) and blood groups (p < 0.001). The influence of age on ferritin levels varied across different blood groups, particularly in individuals with blood types A (p = 0.003, β =  − 0.072) and B (p < 0.001, β =  − 0.110), where the negative association between age and ferritin was more pronounced.ConclusionABO blood type may influence ferritin levels as individuals age. Notably, in individuals with blood types A and B, the inverse relationship between age and ferritin levels was particularly significant among middle-aged and elderly individuals. These findings suggested the potential benefit of targeted iron supplementation for this population. creator: Ni Xiaolin creator: Fenghong Yao creator: Mingkang Pan uri: https://doi.org/10.7717/peerj.19281 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Xiaolin et al. title: Downregulation of EB1 impedes Cx43 localization and cardiac conduction after hypothermic ischemia-reperfusion in rats link: https://peerj.com/articles/19276 last-modified: 2025-04-14 description: BackgroundHypothermic ischemia-reperfusion arrhythmia is a common complication after cardiopulmonary bypass heart surgery, which can lead to hemodynamic disorders and even sudden cardiac death and is still not effectively prevented. This study aims to investigate the role and mechanisms of EB1 in hypothermic ischemia-reperfusion arrhythmia.Methods4–6 week old male Sprague-Dawley (SD) rats were randomly assigned to four groups with a control group receiving no treatment. In the treatment groups, the rats received an injection of a negative control adenovirus (AAV9-CON) or an adenoviral vector containing Mapre1 gene (AAV9-EB1) or an equal volume of saline via the tail vein. After 4 weeks, untreated rat hearts underwent continuous isolated heart perfusion for 5 min, while the treatment groups were subjected to Langendorff isolated heart ischemia-reperfusion. The multi-electrode array (MEA) technique was used to measure the conduction heterogeneity of rat heart, evaluating the protective effects of EB1 overexpression against reperfusion arrhythmias. Additionally, histological staining and western blotting were used to explore the potential pathways by which EB1 exerts its anti-arrhythmic effects, potentially through promoting the localization of connexin 43 (Cx43) to the intercalated discs (IDs). Furthermore, western blot analysis was conducted to assess microtubule stability and evaluate the possible mechanism by which EB1 facilitates the localization of Cx43 to the IDs.ResultsFollowing ischemia-reperfusion, EB1 expression was downregulated, accompanied by a reduction in Cx43. Overexpression of myocardial EB1 reduced the incidence of reperfusion arrhythmias and shortened their duration, which was associated with improved myocardial conduction. Male SD rats injected with AAV overexpressing EB1 had significantly higher levels of both total myocardial Cx43 and gap junction Cx43 after ischemia-reperfusion compared to the non-overexpression groups. Histological staining revealed lateralization of Cx43 in ischemia-reperfusion myocardium, which was corrected by EB1 overexpression. Additionally, EB1 overexpression increased the distribution of Cx43 at the IDs, overall reducing Cx43 remodeling. Moreover, EB1 overexpression can also alleviate microtubule damage caused by ischemia-reperfusion, which may be an important mechanism for the transport of Cx43 to the IDs.ConclusionsEB1 downregulation following hypothermic ischemia-reperfusion was accompanied by a reduction in gap junction Cx43. EB1 overexpression improved cardiac conduction and reduced reperfusion arrhythmias by promoting Cx43 localization to IDs, facilitating gap junctions (GJs) formation. These findings contribute to the development of new therapeutic targets for reperfusion arrhythmias. creator: Chunlei Wen creator: Rongfeng Yang creator: Jing Yi creator: Ying Cao creator: Yuting Song creator: Li An creator: Zijun Wang creator: Hong Gao uri: https://doi.org/10.7717/peerj.19276 license: https://creativecommons.org/licenses/by/4.0/ rights: © 2025 Wen et al. title: Treatment preferences of patients with chronic low back pain in physical therapy clinics in Saudi Arabia: a cross-sectional study link: https://peerj.com/articles/19274 last-modified: 2025-04-14 description: BackgroundLow back pain (LBP) is a prevalent musculoskeletal disorder that significantly contributes to disability and health care burden. Clinical practice guidelines (CPGs) recommend non-pharmacological interventions, such as those delivered by physical therapists, to improve clinical outcomes. Incorporating patient preferences into treatment decisions is essential for promoting patient-centered care and enhancing adherence to CPGs. This study aimed to explore the physical therapy treatment preferences of patients with chronic LBP (CLBP) in Saudi Arabia and to evaluate their alignment with CPG recommendations.MethodsThis cross-sectional survey-based study was conducted across three healthcare centers in Saudi Arabia. Patient preferences were assessed using a validated questionnaire that listed available physical therapy treatments for CLBP. The participants were provided with a standardized explanation of evidence-based treatment options based on the updated CPGs for LBP before selecting their preferred treatments. Data analysis included descriptive statistics and chi-square tests to assess the alignment of preferences with CPG recommendations.ResultsA total of 138 participants were included, with 60.1% of the selected treatments aligning with CPG recommendations (p < 0.001). Sociodemographic factors, such as sex, prior physical therapy experience, and body mass index (BMI), influenced treatment preferences. Exercise was the most preferred treatment, aligning with CPGs, while passive modalities, such as interferential therapy, were also frequently chosen despite not being recommended.ConclusionThis study highlights the importance of understanding patient preferences to improve adherence to CPGs and promote evidence-based care for CLBP. Educational interventions tailored to the cultural context can bridge the gap between patient preferences and evidence-based recommendations, empower patients, and enhance clinical outcomes. creator: Maryam Alasfour creator: Majd Bajnaid creator: Salhah Hobani creator: Muhammad Alrwaily uri: https://doi.org/10.7717/peerj.19274 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2025 Alasfour et al. title: Effects of exercise intervention on executive function in children with overweight and obesity: a systematic review and meta-analysis link: https://peerj.com/articles/19273 last-modified: 2025-04-14 description: BackgroundWeight control in children depends on executive function. Previous studies have shown that exercise interventions can effectively improve children’s executive function. However, the effects of these interventions on children with overweight and obesity remain unclear and require further investigation. This systematic review and meta-analysis was conducted to evaluate the effects of exercise interventions on executive function-related indicators in children with overweight and obesity.MethodsRandomized controlled trials (RCTs) investigating the effects of exercise interventions on executive functions in children with overweight and obesity were included by searching PubMed, Web of Science, EMbase, Cochrane Library, ProQuest, Scopus, CNKI, China Wanfang, and VIP databases. The quality of the included studies was assessed using the Cochrane risk of bias assessment tool. RevMan 5.4 software was used for effect size pooling, forest plot creation, and subgroup analyses. Stata 16.0 software was employed for publication bias testing and sensitivity analysis. The evidence levels of the results were evaluated using the GRADEpro tool.ResultsThis meta-analysis included a total of 13 studies. The results indicate that exercise interventions may help improve executive functions in children with overweight and obesity. Specifically, inhibitory control (standardized mean (SMD) = −0.59, 95% confidence interval (CI) [−0.89 to −0.29], Z = 3.85, P < 0.001) and cognitive flexibility (SMD = −0.54, 95% CI [−1.06 to −0.01], Z = 2.01, P < 0.05) showed moderate effect sizes. Working memory exhibited a smaller effect size (SMD = 0.40, 95% CI [−0.69 to −0.10], Z = 2.61, P < 0.01), while attention did not show significant improvement (SMD = 0.13, 95% CI [−0.39 to 0.65], Z = 0.50, P > 0.05).ConclusionThe results of this meta-analysis indicate that exercise interventions have significant benefits for inhibitory control, working memory, and cognitive flexibility in children with overweight and obesity, but the impact on attention is not significant. Moreover, the effects of inhibitory control interventions are influenced by exercise duration, exercise intensity, exercise type, and age. creator: Pengfei Wang creator: Ying Meng creator: Jinnian Tong creator: Tiance Jiang uri: https://doi.org/10.7717/peerj.19273 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Wang et al. title: The acidic latex protein from Hevea brasiliensis serves as an anionic antimicrobial peptide link: https://peerj.com/articles/19242 last-modified: 2025-04-14 description: BackgroundHev b5 is a unique acidic protein identified as an allergen in natural latex and latex gloves, known for stimulating histamine release from human basophils sensitized with serum from latex-allergic individuals. It is rich in glutamic acid and proline residues arranged in repeated motifs. The protein’s unusual amino acid composition includes 48% negatively charged residues and 13% positively charged residues.MethodsThe recombinant form of Hev b5 (rHev b5) was produced in Escherichia coli. Its chitinase activity, which may provide antifungal properties by breaking down chitin in phytopathogen cell walls, was assessed. Additionally, the antibacterial activity of rHev b5 against Gram-positive and Gram-negative bacteria, including Bacillus cereus, Staphylococcus aureus, E. coli and Salmonella typhi, was evaluated. The potential enhancement of this activity in the presence of calcium or zinc ions was investigated to understand the underlying mechanism involving binding to microbial membranes via metal ion-mediated cationic salt bridges.ResultsrHev b5 exhibited significant chitinase activity and demonstrated substantial antibacterial effects against both Gram-positive and Gram-negative bacteria. The antibacterial activity was notably enhanced in the presence of zinc or calcium ions, suggesting that rHev b5 binds to microbial membranes through metal ion-mediated cationic salt bridges, leading to cell lysis and microbial death.ConclusionAntimicrobial properties and chitinase activity of Hev b5 underline its potential as an anionic antimicrobial peptide, offering both antifungal and antibacterial defenses. These findings position Hev b5 as a promising candidate for further research in antimicrobial peptide applications. creator: Methaporn Meethong creator: Kitiya Ekchaweng creator: Sumalee Obchoei creator: Chanawee Jakkawanpitak creator: Phanthipha Runsaeng uri: https://doi.org/10.7717/peerj.19242 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Meethong et al. title: Prognostic value and immunotherapy analysis of immune cell-related genes in laryngeal cancer link: https://peerj.com/articles/19239 last-modified: 2025-04-14 description: BackgroundLaryngeal cancer (LC) is a prevalent head and neck carcinoma. Extensive research has established a link between immune cells in the tumor microenvironment (TME) and cancer progression, as well as responses to immunotherapy. This study aims to develop a prognostic model based on immune cell-related genes and examine the TME in LC.MethodsRNA-seq data for LC were sourced from The Cancer Genome Atlas (TCGA), and GSE27020 and GSE51985 datasets were retrieved from the Gene Expression Omnibus (GEO) database. Key genes were identified through the intersection of differentially expressed genes (DEGs) between normal and LC samples and module genes derived from weighted gene co-expression network analysis (WGCNA), followed by functional enrichment analysis. The prognostic risk model was constructed using univariate Cox and Least Absolute Shrinkage and Selection Operator (LASSO) analyses. Gene Set Variation Analysis (GSVA) was subsequently performed for hallmark and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses in high- and low-risk groups. Immune infiltration analysis between risk groups was conducted via Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) and single sample gene set enrichment analysis (ssGSEA). Finally, the relationship between the risk model and immunotherapy response was explored.ResultsA total of 124 key genes were identified through the overlap analysis, predominantly enriched in GO terms such as defense response to viruses and regulation of response to biotic stimuli, as well as KEGG pathways related to phagosome and Epstein-Barr virus infection. Machine learning indicated that the optimal prognostic model was constructed from two biomarkers, RENBP and OLR1. GSVA revealed that in the high-risk group, epithelial-mesenchymal transition and ECM-receptor interaction were the most significantly enriched pathways, while autoimmune thyroid disease, ribosome, and oxidative phosphorylation predominated in the low-risk group. Additionally, the stromal score was significantly higher in the high-risk group, while CD8+ T cells, cytolytic activity, inflammation promotion, and T cell co-stimulation were elevated in the low-risk group. Tumor Immune Dysfunction and Exclusion (TIDE) analysis showed higher TIDE and exclusion scores in the high-risk group, whereas the CD8 score was higher in the low-risk group. Finally, CD274 (PD-L1) expression was significantly elevated in the low-risk group.ConclusionsThis study identified two key prognostic biomarkers, RENBP and OLR1, and characterized TME differences across risk groups, offering novel insights into the diagnosis and treatment of LC. creator: Sen Zhang creator: Jianrui Pan creator: Huina Guo creator: Xiaoya Guan creator: Chenxu Yan creator: Lingling Ji creator: Xiansha Wu creator: Hui Huangfu uri: https://doi.org/10.7717/peerj.19239 license: https://creativecommons.org/licenses/by-nc/4.0 rights: ©2025 Zhang et al. title: Catecholamine exposure and the gut microbiota in obstructive sleep apnea link: https://peerj.com/articles/19203 last-modified: 2025-04-14 description: Patients with obstructive sleep apnea (OSA) have increased mortality from chronic inflammatory and cardiovascular diseases. Excess catecholamine exposure contributes to the disease associations of OSA, but the underlying mechanism is unknown. This study tested the hypothesis that increased catecholamine exposure is associated with Enterobacteriaceae abundance in OSA. We compared urinary norepinephrine and the fecal microbiota in 24 patients with OSA and 23 controls. Urinary norepinephrine was elevated in OSA patients, consistent with increased sympathetic activation in those patients. OSA patients did not show changes in the community structure of the microbiome or in Enterobacteriaceae abundance compared to controls. Longitudinal changes in Enterobacteriaceae abundance in OSA patients were significantly associated with within-subject changes in norepinephrine, but this association was absent in controls. These results provide a preliminary association between norepinephrine exposure and Enterobacteriaceae in patients with disordered sleep. creator: Joe Alcock creator: Dongdong Lin creator: Prashanth Setty creator: Lee K. Brown creator: Armand E.K. Dichosa creator: Benjamin J. Burnett creator: Cliff S. Han creator: Henry C. Lin uri: https://doi.org/10.7717/peerj.19203 license: https://creativecommons.org/licenses/by/4.0/ rights: ©2025 Alcock et al.