Displaying publications 381 - 398 of 398 in total

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  1. Mansor J, Safian N, Abdul Razak F, Ismail H, Ghazali MH, Ismail N
    PeerJ, 2024;12:e18571.
    PMID: 39619183 DOI: 10.7717/peerj.18571
    BACKGROUND: Social interactions within and between communities influenced the spread of COVID-19. By using social network analysis (SNA), we aimed to understand the effect of social interaction on the spread of disease in a rural district.

    METHOD: A retrospective record review study using positive COVID-19 cases and contact-tracing data from an area in Malaysia was performed and analysed using the SNA method through R software and visualised by Gephi software. The justification for utilizing SNA is its capability to pinpoint the individuals with the highest impact and accountability for the transmission of COVID-19 within the area, as determined through SNA.

    RESULT: Analysis revealed 76 (4.5%) people tested positive for COVID-19 from 1,683 people, with 51 (67.1%) of the positive ones being male. Outdegrees for 38 positive people were between 1 and 12, while 41 people had 1-13 indegree. Older males have a higher outdegree, while younger females have a higher outdegree than other age groups among same-sex groups. Betweenness was between 0.09 and 34.5 for 15 people. We identified 15 people as super-spreaders from the 42 communities detected.

    CONCLUSION: Women play a major role in bridging COVID-19 transmission, while older men may transmit COVID-19 through direct connections. Thus, health education on face mask usage and hand hygiene is important for both groups. Working women should be given priority for the work-from-home policy compared to others. A large gathering should not be allowed to operate, or if needed, with strict adherence to specific standard operating procedures, as it contributes to the spread of COVID-19 in the district. The SNA allows the identification of key personnel within the network. Therefore, SNA can help healthcare authorities recognise evolving clusters and identify potential super-spreaders; hence, precise and timely action can be taken to prevent further spread of the disease.

  2. Zhang J, Sun Z, Deng Q, Yu Y, Dian X, Luo J, et al.
    PeerJ, 2024;12:e18573.
    PMID: 39687001 DOI: 10.7717/peerj.18573
    BACKGROUND: Despite extensive knowledge of tuberculosis (TB) and its control, there remains a significant gap in understanding the comprehensive impact of the COVID-19 pandemic on TB incidence patterns. This study aims to explore the impact of COVID-19 on the pattern of pulmonary tuberculosis in China and examine the application of time series models in the analysis of these patterns, providing valuable insights for TB prevention and control.

    METHODS: We used pre-COVID-19 pulmonary tuberculosis (PTB) data (2007-2018) to fit SARIMA, Prophet, and LSTM models, assessing their ability to predict PTB incidence trends. These models were then applied to compare the predicted PTB incidence patterns with actual reported cases during the COVID-19 pandemic (2020-2023), using deviations between predicted and actual values to reflect the impact of COVID-19 countermeasures on PTB incidence.

    RESULTS: Prior to the COVID-19 outbreak, PTB incidence in China exhibited a steady decline with strong seasonal fluctuations, characterized by two annual peaks-one in March and another in December. These seasonal trends persisted until 2019. During the COVID-19 pandemic, there was a significant reduction in PTB cases, with actual reported cases falling below the predicted values. The disruption in PTB incidence appears to be temporary, as 2023 data indicate a gradual return to pre-pandemic trends, though the incidence rate remains slightly lower than pre-COVID levels. Additionally, we compared the fitting and forecasting performance of the SARIMA, Prophet, and LSTM models using RMSE (root mean squared error), MAE (mean absolute error), and MAPE (mean absolute percentage error) indexes prior to the COVID-19 outbreak. We found that the Prophet model had the lowest values for all three indexes, demonstrating the best fitting and prediction performance.

    CONCLUSIONS: The COVID-19 pandemic has had a temporary but significant impact on PTB incidence in China, leading to a reduction in reported cases during the pandemic. However, as pandemic control measures relax and the healthcare system stabilizes, PTB incidence patterns are expected to return to pre-COVID-19 levels. The Prophet model demonstrated the best predictive performance and proves to be a valuable tool for analyzing PTB trends and guiding public health planning in the post-pandemic era.

  3. Hussein AO, Khalil K, Mohd Zaini NA, Al Atya AK, Aqma WS
    PeerJ, 2025;13:e18541.
    PMID: 39790459 DOI: 10.7717/peerj.18541
    Lactic acid bacteria (LAB), known for their health benefits, exhibit antimicrobial and antibiofilm properties. This study investigated the cell-free supernatant (CFS) of Lactobacillus spp., particularly L. plantarum KR3, against the common foodborne pathogens S. aureus, E. coli and Salmonella spp. Lactobacillus strains were isolated from cheese, pickles and yoghurt. They were then identified by morphological, physiological and biochemical characteristics and confirmed by 16S rRNA gene sequencing. Culture supernatants from seven lactobacilli isolates showed varying inhibitory activities. Notably, L. plantarum KR3 and L. pentosus had the highest bacteriocin gene counts. L. plantarum KR3 CFS demonstrated significant antibacterial activity, with inhibition zones of 20 ± 0.34 mm for S. aureus, 23 ± 1.64 mm for E. coli, and 17.1 ± 1.70 mm for Salmonella spp. The CFS also exhibited substantial antibiofilm activity, with 59.12 ± 0.03% against S. aureus, 83.50 ± 0.01% against E. coli, and 60. ± 0.04% against Salmonella spp., which were enhanced at the minimum inhibitory concentration (MIC). These results highlighted the potential of L. plantarum KR3 in antimicrobial applications, however, further research is needed to evaluate its viability and functional properties for probiotic use. Additionally, the CFS demonstrated exceptional thermal stability, reinforcing its promise as an antimicrobial agent.
  4. Zainal Ariffin SH, Megat Abdul Wahab R, Abdul Razak M, Yazid MD, Shahidan MA, Miskon A, et al.
    PeerJ, 2024;12:e17790.
    PMID: 39071131 DOI: 10.7717/peerj.17790
    BACKGROUND: Understanding human stem cell differentiation into osteoblasts and osteoclasts is crucial for bone regeneration and disease modeling. Numerous morphological techniques have been employed to assess this differentiation, but a comprehensive review of their application and effectiveness is lacking.

    METHODS: Guided by the PRISMA framework, we conducted a rigorous search through the PubMed, Web of Science and Scopus databases, analyzing 254 articles. Each article was scrutinized against pre-defined inclusion criteria, yielding a refined selection of 14 studies worthy of in-depth analysis.

    RESULTS: The trends in using morphological approaches were identified for analyzing osteoblast and osteoclast differentiation. The three most used techniques for osteoblasts were Alizarin Red S (mineralization; six articles), von Kossa (mineralization; three articles) and alkaline phosphatase (ALP; two articles) followed by one article on Giemsa staining (cell morphology) and finally immunochemistry (three articles involved Vinculin, F-actin and Col1 biomarkers). For osteoclasts, tartrate-resistant acid phosphatase (TRAP staining) has the highest number of articles (six articles), followed by two articles on DAPI staining (cell morphology), and immunochemistry (two articles with VNR, Cathepsin K and TROP2. The study involved four stem cell types: peripheral blood monocyte, mesenchymal, dental pulp, and periodontal ligament.

    CONCLUSION: This review offers a valuable resource for researchers, with Alizarin Red S and TRAP staining being the most utilized morphological procedures for osteoblasts and osteoclasts, respectively. This understanding provides a foundation for future research in this rapidly changing field.

  5. Syazwan WM, Then AY, Chong VC, Rizman-Idid M
    PeerJ, 2025;13:e18483.
    PMID: 39830958 DOI: 10.7717/peerj.18483
    Population blooms of scyphozoan jellyfish in tropical shallow water regions can fuel localized fisheries but also negatively impact human welfare. However, there is a lack of baseline ecological data regarding the scyphozoans in the region, which could be used to manage a fast-growing fishery and mitigate potential impacts. Thus, this study aims to investigate the temporal factors driving the distribution of scyphozoan community along the environmental gradients under different monsoon seasons, rainfall periods, moon phases, and diel-tidal conditions in the Klang Strait located in the central region along the west coast of Peninsular Malaysia, where bloom events are increasing. Scyphozoan samples were collected using commercial bag nets during a 19-month survey. Temporal variations in species abundance and composition were evident and related to the local environmental parameters (salinity, dissolved oxygen, temperature, turbidity, and pH) that varied with the regional monsoon events, although these effects appeared to be species-specific. Phyllorhiza punctata, Acromitus flagellatus, Lychnorhiza malayensis, and Rhopilema esculentum were more abundant during the wetter northeast monsoon (NEM) while the abundance of Chrysaora chinensis and Lobonemoides robustus increased during the drier southwest monsoon (SWM). During the wet period of NEM, scyphozoan abundance was generally higher during the daytime than night-time. The regional monsoon regime and local hydrological events account for jellyfish abundance in the nearshore area with concurrent threats to coastal tourism and power plants, as well as benefits to fisheries especially during the NEM.
  6. Alotaibi S, Alotaibi MM, Alghamdi FS, Alshehri MA, Bamusa KM, Almalki ZF, et al.
    PeerJ, 2025;13:e18795.
    PMID: 39834791 DOI: 10.7717/peerj.18795
    BACKGROUND: Functional magnetic resonance imaging (fMRI) has revolutionized our understanding of brain activity by non-invasively detecting changes in blood oxygen levels. This review explores how fMRI is used to study mind-reading processes in adults.

    METHODOLOGY: A systematic search was conducted across Web of Science, PubMed, and Google Scholar. Studies were selected based on strict inclusion and exclusion criteria: peer-reviewed; published between 2000 and 2024 (in English); focused on adults; investigated mind-reading (mental state decoding, brain-computer interfaces) or related processes; and employed various mind-reading techniques (pattern classification, multivariate analysis, decoding algorithms).

    RESULTS: This review highlights the critical role of fMRI in uncovering the neural mechanisms of mind-reading. Key brain regions involved include the superior temporal sulcus (STS), medial prefrontal cortex (mPFC), and temporoparietal junction (TPJ), all crucial for mentalizing (understanding others' mental states).

    CONCLUSIONS: This review emphasizes the importance of fMRI in advancing our knowledge of how the brain interprets and processes mental states. It offers valuable insights into the current state of mind-reading research in adults and paves the way for future exploration in this field.

  7. Rafi'i MR, Ja'afar MH, Mohammed Nawi A, Md Hanif SA, Md Asari SN
    PeerJ, 2025;13:e18962.
    PMID: 39959824 DOI: 10.7717/peerj.18962
    BACKGROUND: Toxic heavy metals such as chromium (Cr), arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) are known to be priority pollutants due to their high degrees of toxicity and widespread presence in the environment. This review aimed to explore the association between heavy metals and noncancerous thyroid diseases by synthesizing findings from observational and experimental studies. This review addressed a critical intersection of environmental health, endocrinology, and public health. The findings would be of interest to a wide range of disciplines given the ubiquitous presence of toxic heavy metals in the environment and their potential to disrupt endocrine systems. The evidence-based information from diverse fields generated from this review will provide insights into the health implications of heavy metal exposure on thyroid function and guide the necessary interdisciplinary research and collaborative interventions.

    METHOD: Three databases were searched, namely PubMed, Web of Science, and Scopus. The Arksey and O'Malley (2005) framework was used as a guide in conducting this scoping review. The reporting was carried out based on the Preferred Reporting Items for Systematic Reviews and the Meta-Analyses Extension for Scoping Reviews (PRISMA). The literature search retrieved 552 articles and 29 articles were included in the final review.

    RESULTS: As high as 83% of the 29 included studies followed an observational study design while the rest were experimental animal studies. Among the observational studies, two-thirds (66%) were cross-sectional studies while the rest were case-control studies (31%) and cohort studies (n = 1, 3%). Few number of studies in this review reported a significant association between Cr, As, Cd, Hg, and Pb with noncancerous thyroid diseases (2, 3, 16, 8, and 12) while another few (5, 8, 9, 5, and 11) did not show any significant association.

    CONCLUSION: A heterogeneous and diverse sample population in the included studies could have potentially led to mixed findings about the association between toxic heavy metals and thyroid diseases in this review. Therefore, future research should prioritize longitudinal studies and controlled clinical trials to better elucidate the causative mechanisms and long-term impact of heavy metal exposure on thyroid health.

  8. Ahmad AL, Sanchez-Bornot JM, Sotero RC, Coyle D, Idris Z, Faye I
    PeerJ, 2024;12:e18490.
    PMID: 39686993 DOI: 10.7717/peerj.18490
    BACKGROUND: Alzheimer's Disease (AD) poses a major challenge as a neurodegenerative disorder, and early detection is critical for effective intervention. Magnetic resonance imaging (MRI) is a critical tool in AD research due to its availability and cost-effectiveness in clinical settings.

    OBJECTIVE: This study aims to conduct a comprehensive analysis of machine learning (ML) methods for MRI-based biomarker selection and classification to investigate early cognitive decline in AD. The focus to discriminate between classifying healthy control (HC) participants who remained stable and those who developed mild cognitive impairment (MCI) within five years (unstable HC or uHC).

    METHODS: 3-Tesla (3T) MRI data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and Open Access Series of Imaging Studies 3 (OASIS-3) were used, focusing on HC and uHC groups. Freesurfer's recon-all and other tools were used to extract anatomical biomarkers from subcortical and cortical brain regions. ML techniques were applied for feature selection and classification, using the MATLAB Classification Learner (MCL) app for initial analysis, followed by advanced methods such as nested cross-validation and Bayesian optimization, which were evaluated within a Monte Carlo replication analysis as implemented in our customized pipeline. Additionally, polynomial regression-based data harmonization techniques were used to enhance ML and statistical analysis. In our study, ML classifiers were evaluated using performance metrics such as Accuracy (Acc), area under the receiver operating characteristic curve (AROC), F1-score, and a normalized Matthew's correlation coefficient (MCC').

    RESULTS: Feature selection consistently identified biomarkers across ADNI and OASIS-3, with the entorhinal, hippocampus, lateral ventricle, and lateral orbitofrontal regions being the most affected. Classification results varied between balanced and imbalanced datasets and between ADNI and OASIS-3. For ADNI balanced datasets, the naíve Bayes model using z-score harmonization and ReliefF feature selection performed best (Acc = 69.17%, AROC = 77.73%, F1 = 69.21%, MCC' = 69.28%). For OASIS-3 balanced datasets, SVM with zscore-corrected data outperformed others (Acc = 66.58%, AROC = 72.01%, MCC' = 66.78%), while logistic regression had the best F1-score (66.68%). In imbalanced data, RUSBoost showed the strongest overall performance on ADNI (F1 = 50.60%, AROC = 81.54%) and OASIS-3 (MCC' = 63.31%). Support vector machine (SVM) excelled on ADNI in terms of Acc (82.93%) and MCC' (70.21%), while naïve Bayes performed best on OASIS-3 by F1 (42.54%) and AROC (70.33%).

    CONCLUSION: Data harmonization significantly improved the consistency and performance of feature selection and ML classification, with z-score harmonization yielding the best results. This study also highlights the importance of nested cross-validation (CV) to control overfitting and the potential of a semi-automatic pipeline for early AD detection using MRI, with future applications integrating other neuroimaging data to enhance prediction.

  9. Yusoff NA, Abd Hamid Z, Budin SB, Taib IS
    PeerJ, 2025;13:e18854.
    PMID: 39897489 DOI: 10.7717/peerj.18854
    Stem cells are special cells with the distinctive capability to self-renew, forming a new pool of undifferentiated stem cells. They are also able to differentiate into lineage-specific cell types that are specialized and matured. Thus, stem cells are considered as the building blocks of tissues and organs in which they reside. Among the many types of stem cells, hematopoietic stem cells (HSCs) are the most studied adult stem cells and are considered as a promising source of cells for applications in the clinical and basic sciences. Historically, research on HSCs was initiated in the 1940s, where in a groundbreaking experiment, intravenously injected bone marrow (BM) cells prevented the death of irradiated mice by restoring blood cell production. Since then, HSCs have been studied and utilized in medical therapies and research for over several decades. Over time, more sophisticated tools have been developed to evaluate the behaviour of specifically purified subsets of hematopoietic cells that have the capacity to produce blood cells. One of the established tools is the colony-forming units (CFUs) assay. This assay facilitates the identification, enumeration, and analysis of colonies formed by differentiated hematopoietic stem and progenitor cells (HSPCs) from myeloid, erythroid and lymphoid lineages. Hence, the CFUs assay is a fundamental in vitro platform that allows functional studies on the lineage potential of an individual HSPCs. The outcomes of such studies are crucial in providing critical insights into hematopoiesis. In this review, we explore the fundamental discoveries concerning the CFUs assay by covering the following aspects: (i) the historical overview of the CFUs assay for the study of clonal hematopoiesis involving multilineage potential of HSPCs, (ii) its use in various experimental models comprising humans, mice/rodents, zebrafish and induced pluripotent stem cells (iPSCs) and (iii) research gaps and future direction concerning the role of CFUs assay in clinical and basic sciences. Overall, the CFUs assay confers a transformative platform for a better understanding of HSPCs biology in governing hematopoiesis.
  10. Ahmed SZ, Khan AS, Alshehri M, Alsebaa F, Almutawah F, Mohammed Aljeshi M, et al.
    PeerJ, 2025;13:e18831.
    PMID: 39897486 DOI: 10.7717/peerj.18831
    BACKGROUND: Teeth with small to moderate cavities can be repaired with enamel resin infiltrants, a form of dental restorative material. In dental materials, it is standard practice to include several filler particles for experimental use in dental resin infiltrates. The resin's BG particles penetrate the lesion and release ions that combine with saliva to provide a mineral-rich environment that can strengthen enamel and heal. This study aimed to compare resin infiltrants based on three types of bioactive glass materials and investigate the penetration depth, microleakage, and the effect of thermal and chemical aging.

    METHODOLOGY: A triethylene glycol dimethacrylate (TEGDMA) and urethane dimethacrylate (UDMA)-based experimental resin infiltrate was prepared. Initial mixing was done manually for 1 h at room temperature, followed by another mix for 30 min on a magnetic stirrer. This prepared resin, called "PURE RESIN" was then further incorporated with three different types of bioactive glasses, i.e., Bioglass (45S5), boron-substituted (B-BG), and fluoride-substituted (F-BG). Initial manual mixing for 1 h, followed by ultrasonic mixing for 3 min and then proceeded for the final mixing on a magnetic stirrer for 24 h in a dark room at ambient temperature. Human-extracted teeth were demineralized, and the experimental resins were infiltrated on the demineralized surface. The surface area, pore size, and volume of the demineralized surface were measured. The microleakage and penetration depth were analyzed with the stereomicroscope and micro-CT, respectively. The samples were challenged with the pH cycle for 14 days, followed by a scanning electron microscope (SEM). Thermocycling (5,000 cycles) and chemical aging (4 weeks) were conducted, followed by microhardness, surface roughness, and SEM analyses. Statistical analyses were conducted after each test.

    RESULTS: The F-BG group achieved the highest initial and day 14 penetration coefficients. There was a superior dye penetration with the microleakage analysis in the F-BG group. The 45S5 group had the highest average penetration depth via micro-CT analysis. After thermocycling and chemical aging, the micro-hardness was reduced (non-significantly) among all samples except the F-BG group in post-chemical aging analysis, whereas the surface roughness was significantly increased. SEM images showed the presence of micro-pits on the surfaces after the thermal and chemical aging.

    CONCLUSION: The F-BG group achieved the highest initial and day 14 penetration coefficients. There was a superior dye penetration with the microleakage analysis in the F-BG group. The 45S5 group had the highest average penetration depth via micro-CT analysis. After thermocycling and chemical aging, the micro-hardness was reduced (non-significantly) among all samples except the F-BG group in post-chemical aging analysis, whereas the surface roughness was significantly increased. SEM images showed the presence of micro-pits on the surfaces after the thermal and chemical aging.

  11. Engku Abd Rahman ENS, Irekeola AA, Yamin D, Elmi AH, Chan YY
    PeerJ, 2024;12:e18604.
    PMID: 39703916 DOI: 10.7717/peerj.18604
    Borderline oxacillin-resistant Staphylococcus aureus (BORSA) has been a persistent yet under-researched concern in the realm of antibiotic resistance, characterized by unique resistance mechanisms and potential for severe infections. This systematic review and meta-analysis consolidates data from 29 studies encompassing 18,781 samples, revealing a global BORSA prevalence of 6.6% (95% CI [4.0-10.7]). The highest prevalence was found in animals (46.3%), followed by food (8.9%), and humans (5.1%). Notably, significant regional disparities were observed, with Brazil exhibiting the highest prevalence at 70.0%, while The Netherlands reported just 0.5%. These findings underscore the multifaceted nature of BORSA epidemiology, influenced by local antibiotic usage practices and healthcare infrastructures. The analysis also reveals substantial heterogeneity (I2 = 96.802%), highlighting the need for improved reporting practices and tailored surveillance protocols that account for the specific contexts of each study. As antibiotic resistance continues to escalate, understanding BORSA's global footprint is crucial for informing targeted interventions and optimizing antibiotic stewardship programs. This study fills critical gaps in current knowledge of BORSA and highlights the need for coordinated efforts among researchers, healthcare providers, and policymakers to develop effective strategies for addressing the rising threat of antibiotic-resistant pathogens like BORSA, including further exploration of its genetic and phenotypic characteristics.
  12. Khang TF, Soo OY, Tan WB, Lim LH
    PeerJ, 2016;4:e1668.
    PMID: 26966649 DOI: 10.7717/peerj.1668
    Background. Anchors are one of the important attachment appendages for monogenean parasites. Common descent and evolutionary processes have left their mark on anchor morphometry, in the form of patterns of shape and size variation useful for systematic and evolutionary studies. When combined with morphological and molecular data, analysis of anchor morphometry can potentially answer a wide range of biological questions. Materials and Methods. We used data from anchor morphometry, body size and morphology of 13 Ligophorus (Monogenea: Ancyrocephalidae) species infecting two marine mugilid (Teleostei: Mugilidae) fish hosts: Moolgarda buchanani (Bleeker) and Liza subviridis (Valenciennes) from Malaysia. Anchor shape and size data (n = 530) were generated using methods of geometric morphometrics. We used 28S rRNA, 18S rRNA, and ITS1 sequence data to infer a maximum likelihood phylogeny. We discriminated species using principal component and cluster analysis of shape data. Adams's K mult was used to detect phylogenetic signal in anchor shape. Phylogeny-correlated size and shape changes were investigated using continuous character mapping and directional statistics, respectively. We assessed morphological constraints in anchor morphometry using phylogenetic regression of anchor shape against body size and anchor size. Anchor morphological integration was studied using partial least squares method. The association between copulatory organ morphology and anchor shape and size in phylomorphospace was used to test the Rohde-Hobbs hypothesis. We created monogeneaGM, a new R package that integrates analyses of monogenean anchor geometric morphometric data with morphological and phylogenetic data. Results. We discriminated 12 of the 13 Ligophorus species using anchor shape data. Significant phylogenetic signal was detected in anchor shape. Thus, we discovered new morphological characters based on anchor shaft shape, the length between the inner root point and the outer root point, and the length between the inner root point and the dent point. The species on M. buchanani evolved larger, more robust anchors; those on L. subviridis evolved smaller, more delicate anchors. Anchor shape and size were significantly correlated, suggesting constraints in anchor evolution. Tight integration between the root and the point compartments within anchors confirms the anchor as a single, fully integrated module. The correlation between male copulatory organ morphology and size with anchor shape was consistent with predictions from the Rohde-Hobbs hypothesis. Conclusions. Monogenean anchors are tightly integrated structures, and their shape variation correlates strongly with phylogeny, thus underscoring their value for systematic and evolutionary biology studies. Our MonogeneaGM R package provides tools for researchers to mine biological insights from geometric morphometric data of speciose monogenean genera.
  13. Augustine S, Foster R, Barton G, Lake MJ, Sharir R, Robinson MA
    PeerJ, 2025;13:e18613.
    PMID: 39763706 DOI: 10.7717/peerj.18613
    BACKGROUND: Gait analysis is traditionally conducted using marker-based methods yet markerless motion capture is emerging as an alternative. Initial studies have begun to evaluate the reliability of markerless motion capture yet the evaluation of different clothing conditions across sessions and complete evaluation of the lower limb and pelvis reliability have yet to be considered. The aim of this study was to evaluate the inter-trial, inter-session and inter-session-clothing variation and root mean square differences between tight- or loose-fitting clothing during walking.

    METHOD: Twenty-two healthy adult participants walked along an indoor walkway whilst eight video cameras recorded their gait in either tight- or loose-fitting clothing. A commercial markerless motion capture system (Theia3D) provided gait kinematics for evaluation.

    RESULTS: Reliability results showed average inter-trial variation of <2°, inter-session variation of <3° and inter-session-clothing variation <3.5°. Root mean square differences (RMSD) between clothing conditions were <2°.

    DISCUSSION: Pelvis variations were smaller than those at the hip, knee and ankle. Our results showed smaller variation than in previous studies which may be due to updates to software. The demonstration of the reliability of markerless motion capture for gait analysis in healthy adults should prompt further evaluation in clinical conditions and reconsideration of multi-assessor marker-based gait analysis protocols, where variation is highest.

  14. Salleh MZ, Nik Zuraina NMN, Deris ZZ, Mohamed Z
    PeerJ, 2025;13:e18986.
    PMID: 40017659 DOI: 10.7717/peerj.18986
    Pseudomonas aeruginosa continues to be a significant contributor to high morbidity and mortality rates worldwide, particularly due to its role in severe infections such as hospital-acquired conditions, including ventilator-associated pneumonia and various sepsis syndromes. The global increase in antimicrobial-resistant (AMR) P. aeruginosa strains has made these infections more difficult to treat, by limiting the effective drug options available. This systematic review and meta-analysis aim to provide an updated summary of the prevalence of AMR P. aeruginosa over the past 5 years. A systematic search was performed across three major electronic databases-PubMed, ScienceDirect, and Web of Science-yielding 40 eligible studies published between 2018 and 2023. Using a random-effects model, our meta-analysis estimated that the overall prevalence of P. aeruginosa in Asia and Africa over the past 5 years was 22.9% (95% CI [14.4-31.4]). The prevalence rates for multidrug-resistant (MDR) and extensively drug-resistant (XDR) P. aeruginosa strains were found to be 46.0% (95% CI [37.1-55.0]) and 19.6% (95% CI [4.3-34.9]), respectively. Furthermore, the prevalence rates of extended-spectrum β-lactamase- and metallo-β-lactamase-producing P. aeruginosa were 33.4% (95% CI [23.6-43.2]) and 16.0% (95% CI [9.8-22.3]), respectively. Notably, resistance rates to β-lactams used for treating pseudomonal infections were alarmingly high, with rates between 84.4% and 100.0% for cephalosporins, and over 40% of P. aeruginosa isolates showed resistance to penicillins. Our analysis identified the lowest resistance rates for last-resort antimicrobials, with 0.3% (95% CI [0.0-1.3]) resistance to polymyxin B and 5.8% (95% CI [1.5-10.2]) to colistin/polymyxin E. The low resistance rates to polymyxins suggest that these antibiotics remain effective against MDR P. aeruginosa. However, the findings also highlight the critical public health threat posed by antimicrobial-resistant P. aeruginosa, particularly concerning β-lactam antibiotics. This underscores the need for effective and carefully planned intervention strategies, including the development of new antibiotics to address the growing challenge of resistance. Developing robust antibiotic treatment protocols is essential for better management and control of pseudomonal infections globally. Therefore, continued research and international collaboration is vital to tackle this escalating public health challenge. This study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), under registration number CRD42023412839.
  15. Sakinah-Syed G, Liew JS, Abdul Majid N, Inche Zainal Abidin SA
    PeerJ, 2025;13:e18931.
    PMID: 40017656 DOI: 10.7717/peerj.18931
    BACKGROUND: Aberrations in primary cilia expression and intraflagellar transport (IFT) protein function have been implicated in tumourigenesis. This study explores the relationship between the alteration of primary cilia and tumourigenesis by investigating primary cilia expression and the role of IFT20 in regulating matrix metalloproteinase 9 (MMP-9) expression in oral squamous cell carcinoma (OSCC) cell lines.

    METHODS: The frequency and length of primary cilia were determined in OKF6-TERT2 cells, HSC-2 cells, and HSC-3 cells using immunofluorescence. Additionally, primary cilia presence in non-proliferating OSCC cells was examined. OSCC cells were treated with either small interfering RNA (siRNA) negative control or siRNA targeting IFT20 for functional analysis. mRNA expression levels of IFT20 and MMP-9 were quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR).

    RESULTS: Results showed that HSC-2 cells exhibit abundant primary cilia when cultured in low serum media (2% serum) for 48 h, followed by serum starvation for over 72 h. No significant changes in cilia expression were observed in HSC-3 cells compared to OKF6-TERT2 cells. Ciliated cells were found in non-proliferating HSC-2 and HSC-3 cells. OSCC cells showed longer cilia than OKF6-TERT2 cells, indicating ciliary abnormalities. Changes in ciliation and cilium length of OSCC cells were accompanied by increased expression of IFT20, an intraflagellar transport protein crucial for the primary cilia assembly. However, IFT20 knockdown did not affect MMP-9 at the mRNA level in these cells.

    CONCLUSIONS: This study reveals the differences in primary cilia expression among OSCC cells. Furthermore, the increased abundance and elongation of primary cilia in OSCC cells are accompanied by elevated expression of IFT20. Nonetheless, IFT20 did not affect MMP-9 mRNA expression in OSCC cells.

  16. Ma L, Chee CS, Amri S, Gao X, Wang Q, Wang N, et al.
    PeerJ, 2025;13:e18952.
    PMID: 39995991 DOI: 10.7717/peerj.18952
    BACKGROUND: The professional development of teachers in the digital age will positively impact the effectiveness of physical education teaching. Exploring key factors such as self-efficacy, burnout, and digital technology is crucial to ensure the professional development of teachers.

    METHODS: The search was conducted in accordance with the PRISMA guidelines and utilized the following databases: Scopus, Web of Science, ProQuest, and Google Scholar. Inclusion and exclusion criteria: population, research methods, keywords, and time limit were described for this study. This article predominantly includes cross-sectional studies, so we have used the AXIS risk assessment methodology.

    RESULTS: The study included ten articles, seven of which (70%) were quantitative. Three key findings emerged from this review: first, the studies on self-efficacy were more noteworthy than the studies on burnout. Second, female teachers were more expressive in their digital teaching, while male teachers had higher levels of self-efficacy in their digital teaching. Finally, the study explored various factors affecting self-efficacy and burnout in relation to digital teaching. The study demonstrated that professional development has a higher impact on physical education teachers' self-efficacy, and in turn, self-efficacy reduces burnout. Additionally, burnout had a significant impact on professional development.

    CONCLUSION: This study describes the limitations of risk assessment and uses the AXIS tool to assess the methodological quality of this review report instead of using the risk of bias tool. The use of digital teaching methods can increase self-efficacy and alleviate burnout among physical education teachers. This review analyses the effects of digital technology, self-efficacy, and burnout on the career progression of physical education instructors and examines the implications for future developments.

  17. Dong Y, Tang L, Badrin S, Badrin S, Wu J
    PeerJ, 2025;13:e19052.
    PMID: 40061230 DOI: 10.7717/peerj.19052
    BACKGROUND: Post-stroke fatigue (PSF) is a common complication experienced by stroke survivors. These individuals often confront psychological challenges such as depression and anxiety, along with significant obstacles like reduced quality of life (QoL) and limitations in activities of daily living (ADLs). Such challenges can profoundly affect their overall recovery and well-being. Despite its prevalence, the associated factors contributing to PSF remain poorly understood. This study aims to primarily investigate these associated factors, while also examining the interrelationships among PSF, depression level, QoL, and ADLs, highlighting the need for a better understanding of these complex interactions.

    METHODS: This cross-sectional study involved 271 stroke survivors and was conducted at the Department of Neurology, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, China, from September 2023 to January 2024. Participants independently completed the Fatigue Severity Scale (FSS), Patient Health Questionnaire-9 (PHQ-9), and the Short Version of the Stroke-Specific Quality of Life Scale (SV-SS-QoL) as part of a convenience sampling method, while medical professionals assessed the Barthel Index (BI) using the same sampling framework. Multivariable linear regression analyses were employed to determine the factors associated with the persistence of PSF.

    RESULTS: The mean FSS score was 35.04 ± 11.60, while the average score for the SV-SS-QoL was 34.28 ± 9.51, and the BI score averaged 77.79 ± 25.90. Approximately 45.8% of participants (n = 124) experienced PSF. The mean score on the PHQ-9 was 7.63 ± 6.13. A significant negative correlation was identified between fatigue and both QoL and ADLs (P 

  18. Ab Kadir MA, Abdul Manaf R, Mokhtar SA, Ismail LI
    PeerJ, 2025;13:e18851.
    PMID: 40061226 DOI: 10.7717/peerj.18851
    BACKGROUND: Leptospirosis is an endemic disease in countries with tropical climates such as South America, Southern Asia, and Southeast Asia. There has been an increase in leptospirosis incidence in Malaysia from 1.45 to 25.94 cases per 100,000 population between 2005 and 2014. With increasing incidence in Selangor, Malaysia, and frequent climate change dynamics, a study on the disease hotspot areas and their association with the hydroclimatic factors could enhance disease surveillance and public health interventions.

    METHODS: This ecological cross-sectional study utilised a geographic information system (GIS) and remote sensing techniques to analyse the spatiotemporal distribution of leptospirosis in Selangor from 2011 to 2019. Laboratory-confirmed leptospirosis cases (n = 1,045) were obtained from the Selangor State Health Department. Using ArcGIS Pro, spatial autocorrelation analysis (Moran's I) and Getis-Ord Gi* (hotspot analysis) was conducted to identify hotspots based on the monthly aggregated cases for each subdistrict. Satellite-derived rainfall and land surface temperature (LST) data were acquired from NASA's Giovanni EarthData website and processed into monthly averages. These data were integrated into ArcGIS Pro as thematic layers. Machine learning algorithms, including support vector machine (SVM), Random Forest (RF), and light gradient boosting machine (LGBM) were employed to develop predictive models for leptospirosis hotspot areas. Model performance was then evaluated using cross-validation and metrics such as accuracy, precision, sensitivity, and F1-score.

    RESULTS: Moran's I analysis revealed a primarily random distribution of cases across Selangor, with only 20 out of 103 observed having a clustered distribution. Meanwhile, hotspot areas were mainly scattered in subdistricts throughout Selangor with clustering in the central region. Machine learning analysis revealed that the LGBM algorithm had the best performance scores compared to having a cross-validation score of 0.61, a precision score of 0.16, and an F1-score of 0.23. The feature importance score indicated river water level and rainfall contributes most to the model.

    CONCLUSIONS: This GIS-based study identified a primarily sporadic occurrence of leptospirosis in Selangor with minimal spatial clustering. The LGBM algorithm effectively predicted leptospirosis hotspots based on the analysed hydroclimatic factors. The integration of GIS and machine learning offers a promising framework for disease surveillance, facilitating targeted public health interventions in areas at high risk for leptospirosis.

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