Lipoprotein(a) [Lp(a)], one of the major residual cardiovascular risks, is a highly polymorphic low-density lipoprotein (LDL)-like particle. Epidemiological and Mendelian randomization studies have su Show more
Lipoprotein(a) [Lp(a)], one of the major residual cardiovascular risks, is a highly polymorphic low-density lipoprotein (LDL)-like particle. Epidemiological and Mendelian randomization studies have suggested that elevated Lp(a) is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) due to its pro-inflammatory, pro-atherogenic and pro-thrombotic properties. However, metabolic and pathological mechanisms of Lp(a) remain under-investigated. Recent genomic and population studies show that very low Lp(a) levels are associated with increased risk of type 2 diabetes mellitus (T2DM). Thus, whether potent Lp(a)-lowering therapies might increase the risk of T2DM incident has been raised as a potential issue from recent guidelines. This review details Lp(a)-induced inflammation and thrombosis evidences, the underlying mechanisms of Lp(a) in ASCVD, and the complicated associations and potential mechanistic effects of Lp(a) on the development of T2DM. Current evidences tend to favor that the anti-atherogenic benefits of lowering Lp(a) shall override the paradoxical negative impact on the new-onset T2DM. The risk-benefit assessments for potent Lp(a)-lowering therapies are warranted. Show less
This study aimed to identify the latent profiles of cognitive function among community-dwelling and institutionalized older adults, and to examine their associated influencing factors, in order to inf Show more
This study aimed to identify the latent profiles of cognitive function among community-dwelling and institutionalized older adults, and to examine their associated influencing factors, in order to inform the development of targeted interventions. A convenience sampling method was used to select 6,708 elderly people aged 60 years and older from six communities and nine long-term care institutions across China, who were assessed using a general information questionnaire, Mini-Mental State Examination (MMSE), the Frailty Scale, the Anxiety Scale, the Depression Scale, and the Pittsburgh Sleep Quality Index. Latent profile analysis (LPA) was performed based on the MMSE scores, and multiple logistic regression was used to analyse the influencing factors of cognitive function categories. A total of three cognitive function profiles were identified: High cognitive Function group (41.2%), Moderate Cognitive Function Group (48.2%) and Low cognitive Function group (10.7%). Higher Frailty [odds ratio (ORs) = 1.070-1.246], higher depressive symptom scores (OR = 1.059-1.191) and poorer sleep quality (higher PSQI; OR = 1.088) were associated with higher odds of belonging to the Moderate/Low cognitive profiles, whereas adequate social support (Yes vs. No; OR = 0.530-0.696), selected middle-income categories versus ≥¥6,000 in per-capita monthly household income (OR = 0.462-0.735) and male sex (OR = 0.556-0.876) were associated with lower odds. Cognitive function among older adults can be classified into three distinct latent profiles, each associated with different influencing factors. These findings underscore the need for stratified and personalized interventions at the community level to support stratified screening and tailored community programs; given the cross-sectional design, these associations do not establish causality or intervention effects. Show less
Death anxiety is a critical mental-health concern among young adults; however, its heterogeneity and underlying psychological mechanisms remain understudied. This study aimed to identify latent profil Show more
Death anxiety is a critical mental-health concern among young adults; however, its heterogeneity and underlying psychological mechanisms remain understudied. This study aimed to identify latent profiles of death anxiety in Chinese youth and examine the predictive roles of self-esteem, perceived social support, and security. We conducted a cross-sectional survey of 623 young adults ( Three latent death anxiety profiles emerged, High Death Anxiety (56.2%), Moderate Cognition and Low Death Anxiety (8.8%), and Low Cognition and Moderate Death Anxiety (35%). Higher self-esteem ( Death anxiety among young adults is heterogeneous, influenced by distinct psychological profiles and demographic factors. Interventions should prioritize enhancing self-esteem, social support networks, and security to mitigate death anxiety, especially in high-risk subgroups. Future research should employ longitudinal designs and cross-cultural samples to validate causal pathways and refine targeted strategies. Show less
Cognitive decline is prevalent among older adults and may be associated with their daily activity behaviours. However, no studies have examined how cognitive decline affects older adults' activity beh Show more
Cognitive decline is prevalent among older adults and may be associated with their daily activity behaviours. However, no studies have examined how cognitive decline affects older adults' activity behaviours within a 24-h framework. This study investigates the relationship between cognitive function and 24-h activity behaviours in older adults, further exploring whether these associations differ by sex. This study analyses data from the eighth wave of the Survey of Health, Ageing and Retirement in Europe, conducting a cross-sectional analysis of 814 older adults. Cognitive function was assessed using the SHARE-Cog tool, encompassing 10-word immediate recall, 10-word delayed recall, verbal fluency, and self-reported memory. 24-h activity behaviours (moderate-to-vigorous physical activity [MVPA], light physical activity [LPA], sedentary behaviour [SB], and sleep) were objectively measured with thigh-worn accelerometers. Compositional multivariate linear regression models were constructed using compositional data as the response variable, with cognitive function measures as predictors. Higher MVPA was linked to better cognitive outcomes (verbal fluency, 10-word immediate recall, and 10-word delayed recall) while SB and longer sleep related to poorer performance, with these associations being stronger in women (model p ≤ 0.001). Among women, cognitive outcomes were significantly associated with all activity behaviours (p range = 0.010-0.045). Women who self-reported poor memory and scored 0 on the verbal fluency spent approximately 45% of their day in SB, whereas those reporting excellent memory and scoring 60 spent 40.06% (37.18%, 42.86%) and 36.41% (31.53%, 41.10%) of their day sedentary, respectively. In contrast, men's 24-h activity composition did not vary significantly with cognitive function (p range = 0.051-0.845). Older adults with better cognitive function tend to engage in more PA and reduce sedentary and sleep time. This relationship differed by sex, with females' activity behaviours being more sensitive to cognitive function changes. These findings suggest that interventions promoting healthy lifestyles in older adults should account for cognitive function, particularly in females. Show less
This study aimed to identify and characterize the sedentary behavior (SED) and breaks accumulation patterns of children and adolescents and investigate the associations of these derived patterns with Show more
This study aimed to identify and characterize the sedentary behavior (SED) and breaks accumulation patterns of children and adolescents and investigate the associations of these derived patterns with adiposity indicators. A total of 348 children and 562 adolescents from China participated in this study. Accelerometers were used to measure the bouts of SED and breaks. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), and fat mass index (FMI). Latent profile analysis was used to identify the SED and breaks accumulation patterns on the basis of 11 compositions of SED bouts and breaks. Mixed-effects multivariable linear regression models were used to analyze the associations of accumulation patterns with adiposity indicators. Four accumulation patterns were identified in children: "prolonged sitters" (N = 77, 22.1%), "shortened sitters" (N = 90, 25.9%), "LPA breakers" (N = 69, 19.8%), and "MVPA breakers"(N = 112, 32.2%). "MVPA breakers" had significantly lower BMI z-score, FM%, and FMI than "prolonged sitters." No significant differences in adiposity indicators were observed among the other three patterns. In adolescents, "prolonged sitters" (N = 250, 44.5%), "moderate sitters" (N = 211, 37.5%), and "breakers" (N = 101, 18.0%) were identified. "Breakers" had the lowest BMI z-score, FM%, and FMI among the three groups, followed by "moderate sitters" and "prolonged sitters." Different accumulation patterns of SED and breaks were identified for children and adolescents in China. Among them, "MVPA breakers" and "Breakers" are most beneficial to maintain a normal weight status. Health promotion efforts could consider increasing MVPA and decreasing SED time for children and restricting SED to at least 30 min for adolescents to improve their adiposity indicators. Show less
The mediation effect of 24-hour physical activities on the association between type 2 diabetes and mortality is unclear. Additionally, Little evidence was found on the isotemporal substitution effect Show more
The mediation effect of 24-hour physical activities on the association between type 2 diabetes and mortality is unclear. Additionally, Little evidence was found on the isotemporal substitution effect of 24-hour physical activities components on changing Life expectancy among patients with type 2 diabetes diagnosed. To address the abovementioned research gap, the study has a two-fold aims: first, to examine the mediation effect of 24-hour physical activities in type 2 diabetes and mortality; and second, to address how reallocating time on different daily activities would affect life expectancy. Analysis was conducted on the accelerometer data of 103,359 participants in the UK Biobank, with a median age of 57 years (range 39 to 70). Compositional mediation cox model was conducted to analyze the mediating effects of 24-hour physical activities. Additionally, the cohort Life table method was utilized to estimate the changes of Life-years over the next 10 years resulting from the substitution effect of different physical activities. During a mean follow-up of 13.95 (range 2.95-16.28) years, 2,649 deaths were recorded. Diabetes was significantly associated with increased time spent engaging in sedentary behavior (SB), and reduced time spent on moderate-to-vigorous physical activity (MVPA) and light-intensive physical activity (LPA), thereby demonstrating an association with higher mortality risk. The indirect effect of physical activity (HR = 1.27, 95% CI 1.23-1.30) accounted for 41.9% of the total effect of diabetes on mortality. Furthermore, the Life expectancy gains with a maximum of 1.32 years over the next 10 years was found when reallocating SB time to MVPA. The results revealed that 24-hour physical activities might mediate the association between diabetes and mortality. Therefore, promoting participation in MVPA and reducing sedentary activities among diabetes patients was expected to have a positive effect on Life expectancy over the next 10 years. Show less
To investigate the risk factors associated with coronary heart disease (CHD) in patients with metabolic-associated fatty liver disease (MAFLD) and develop a nomogram prediction model. This study inclu Show more
To investigate the risk factors associated with coronary heart disease (CHD) in patients with metabolic-associated fatty liver disease (MAFLD) and develop a nomogram prediction model. This study included 394 patients with MAFLD who underwent coronary angiography at The Affiliated Hospital of Qingdao University between December 2019 and December 2024. The study cohort was divided in a 7:3 ratio into training and validation sets comprising 277 and 117 cases, respectively. The training group was further divided into the MAFLD-only ( Of the 394 MAFLD cases, 313 had CHD-related complications. Of the 277 patients in the training set, 220 had CHD, and of the 117 patients in the validation set, 93 had CHD. LASSO regression analysis revealed that the following variables were associated with the risk of CHD: sex, lipoprotein(a) (Lp[a]), low-density lipoprotein cholesterol, white blood cell count (WBC), glycated triglyceride-glucose index (TyG), and atherosclerosis index (AIP). Multivariate logistic regression analysis revealed that sex, Lp(a), WBC, TyG, and AIP were independent risk factors for CHD in MAFLD cases. A nomogram was constructed and an ROC curve was plotted, based on which the optimal cutoff value was determined as 0.698. The area under the curve of the nomogram in the training and validation cohorts was 0.860 (95% CI = 0.807-0.913) and 0.843 (95% CI = 0.757-0.929), respectively. Calibration curves for CHD risk probability showed good agreement between the nomogram's predicted probabilities and the observed event rates. DCA demonstrated the net clinical benefit of the constructed nomogram. Sex, Lp(a), WBC, TyG, and AIP emerged as independent risk factors for CHD in patients with MAFLD and the nomogram prediction model constructed using these factors could effectively predict CHD occurrence. Show less
Childhood cancer can disrupt family functioning, increase caregiver psychological distress, and impair caregiver quality of life. While family resilience is crucial for adaptation, most research has f Show more
Childhood cancer can disrupt family functioning, increase caregiver psychological distress, and impair caregiver quality of life. While family resilience is crucial for adaptation, most research has focused on individual-level factors, neglecting heterogeneity and multilevel influences on family resilience. Guided by the Social Ecological Model (SEM), this cross-sectional observational study used latent profile analysis (LPA) to identify distinct profiles of family resilience among caregivers of children with cancer and to explore factors associated with these profiles. Between July 2022 and March 2024, 292 caregivers were recruited. Family resilience was measured using the Family Resilience Assessment Scale. LPA was employed to identify resilience profiles, and binary logistic regression was used to explore influencing factors. Two latent profiles were identified: the Low Resources-Low Positivity profile (86%) and the High Internal Resilience profile (14%). The Low Resource-Low Positivity profile demonstrated generally lower scores, especially in utilizing social and economic resources and maintaining a positive outlook. The High Internal Resilience profile showed higher scores across all family resilience dimensions, particularly in communication/problem solving, positive outlook, and meaning-making, while the use of external social and economic resources remained relatively lower. Univariate analysis showed significant differences between profiles in residence, number of siblings, caregiver education, individual resilience, social support, caregivers' physical and psychological well-being and child communication (caregiver-reported). Binary logistic regression identified having more than one child (OR = 3.184, 95% CI: 1.437 ~ 7.057, P = 0.004) and higher individual resilience (OR = 1.095, 95% CI: 1.028 ~ 1.165, P = 0.005) as significant predictors of High Internal Resilience profile. This study identified two distinct family resilience profiles among caregivers of children with cancer. Limited use of social and economic resources was common, while caregiver resilience and having multiple children predicted higher family resilience. Interventions should enhance caregiver coping capacity, support one-child families through peer and family programs, and improve access to social support, flexible employment, and affordable care to strengthen family resilience. Not applicable. Show less
Cancer-related fatigue (CRF) is a multifaceted and subjective phenomenon that significantly impacts patients on physical, emotional, and mental levels. This study aims to identify specific subtypes of Show more
Cancer-related fatigue (CRF) is a multifaceted and subjective phenomenon that significantly impacts patients on physical, emotional, and mental levels. This study aims to identify specific subtypes of Cancer-related fatigue (CRF) in patients with Hepatocellular Carcinoma (HCC) and to explore the factors influencing each subtype. This cross-sectional study enrolled 220 participants from a tertiary cancer hospital. Latent Profile Analysis (LPA) and multinomial logistic regression were conducted to identify distinct fatigue profiles and to explore the influencing factors for different categories of CRF among the patients. The analysis revealed three potential categories of CRF severity: Physical balance -Low fatigue (20.1%); Physical imbalance -Moderate fatigue (69.6%); and Physical prominent -High fatigue (10.2%). It was found that the severe insomnia the greater the probability of patients belonging to the Physical prominent -High fatigue (OR = 1.299, 95%CI: 1.188-1.419). Has partner (OR = 5.171, 95%CI: 1.739-15.377), the severe financial stress (OR = 2.570, 95%CI: 1.209-5.463) and the moderate ISI (OR = 1.212, 95%CI: 1.136-1.292) were associated with the Physical imbalance - Moderate fatigue group. Protective factors for the Physical balance - Low fatigue group included higher scores in the physical activity Index (OR = 0.930, 95%CI: 0.870-0.995), Hope Index (OR = 0.647, 95%CI: 0.552-0.758), General self-efficacy (OR = 0.874, 95%CI: 0.793-0.965), Body Mass Index (OR = 0.799, 95%CI: 0.552-0.758), and Child-Pugh A classification (OR = 0.310, 95%CI: 0.119-0.808). CRF in patients with HCC demonstrates significant heterogeneity. It is conducive to the clinical identification of CRF risk characteristics and the design of personalized intervention measures. Show less
Lifestyle improvement may help reverse prediabetes. Indicators such as Life's Essential 8 (LE8) and biological aging measures (phenotypic age, cardiovascular biological age) partially reflect metaboli Show more
Lifestyle improvement may help reverse prediabetes. Indicators such as Life's Essential 8 (LE8) and biological aging measures (phenotypic age, cardiovascular biological age) partially reflect metabolic status in prediabetes, but their predictive value for cardiovascular mortality and stroke in this population remains unclear. We analyzed data from 74,678 White participants with prediabetes in the UK Biobank, defined by either HbA1c (5.7-6.4%) or fasting glucose (6.1-6.9 mmol/L). Follow-up continued until October 10, 2023. Cox regression was used to examine associations between LE8, phenotypic age (PhenoAge), cardiovascular biological age (CBA), and outcomes of cardiovascular (CVD) mortality and stroke. Restricted cubic spline (RCS) models identified biological age risk thresholds. Mediation analysis assessed whether proteins such as CST3, EFEMP1, FES, IGFBP2, IGFBP6, LPA, PCSK9, and TIMP1 mediated these effects. Over a median follow-up of 13.4 years, 2263 participants died from CVD causes. Each 1-year increase in CBA or PhenoAge was associated with a ~ 10% higher risk of CVD mortality (CBA aHR = 1.10; PhenoAge aHR = 1.09; both P < 0.001), while each 1-point increase in LE8 score was linked to a 3% lower risk (HR = 0.97, P < 0.001). The risk biological ages for these two indicators were also identified: PhenoAge ≥ 58.52 years and CBA ≥ 62.42 years. Similar trends were observed for stroke. Mediation analysis revealed that CST3, TIMP1, IGFBP2, and IGFBP6 contributed to the biological pathways between aging/lifestyle and CVD outcomes. The combined LE8 and PhenoAge model showed the strongest predictive performance for CVD mortality (AUC = 0.716) and stroke (AUC = 0.638) over 15 years. LE8 combined with phenotypic age provides prognostic value for CVD outcomes in prediabetes. These findings highlight the potential of lifestyle modification and delayed biological aging in reversing prediabetes and underscore comorbidity-related proteins as promising therapeutic targets. Show less
The primary aim of this study is to explore distinct patterns of post-traumatic growth (PTG) and fear of cancer progression (FOP) among breast cancer patients through latent profile analysis (LPA). Ad Show more
The primary aim of this study is to explore distinct patterns of post-traumatic growth (PTG) and fear of cancer progression (FOP) among breast cancer patients through latent profile analysis (LPA). Additionally, we assessed the differences in demographic and disease-related factors among breast cancer patients with varying patterns. Finally, we examined the influence of socio-demographic, disease-related, social support, anxiety, depression, and post-traumatic stress disorder (PTSD) factors on the varying patterns, aiming to assist healthcare providers in developing more effective psychological care strategies for breast cancer patients. A questionnaire survey was conducted on 752 breast cancer patients. Latent profile analysis was employed to explore the patterns of post-traumatic growth and fear of cancer progression in these patients, and multiple logistic regression analysis was used to identify the predictive factors for the different patterns. Based on the fit indices of latent class analysis, a three-class model was identified as the optimal solution, which included the Resisting group, Struggling group, and Growth group. In the Resisting group (24.33%), patients reported low levels of post-traumatic growth and high levels of fear of cancer progression; in the Struggling group (46.14%), patients exhibited moderate levels of post-traumatic growth and low levels of fear of cancer progression; in the Growth group (29.52%), patients demonstrated high levels of post-traumatic growth and moderate levels of fear of cancer progression. Additionally, the multiple logistic regression analysis reveals that marital status, place of residence, education level, disease stage, social support, anxiety, and post-traumatic stress disorder levels in breast cancer patients serve as significant factors influencing the distinct patterns of post-traumatic growth and fear of progression. This study suggests that there is heterogeneity in the PTG and FOP patterns in breast cancer patients. It provides a research basis for promoting the psychological recovery of breast cancer patients and highlights the importance of focusing on the positive effects of PTG while mitigating the negative impact of FOP. Healthcare providers can implement targeted nursing interventions based on the different patterns observed in breast cancer patients. Show less
"Penumbra freezing" aims to extend vascular recanalization treatment to acute ischemic stroke (AIS) patients beyond the standard time window by preserving the ischemic penumbra. Efficient biomarkers a Show more
"Penumbra freezing" aims to extend vascular recanalization treatment to acute ischemic stroke (AIS) patients beyond the standard time window by preserving the ischemic penumbra. Efficient biomarkers are crucial for identifying patients eligible for AIS treatment. This study enrolled 141 AIS patients who exceeded the conventional treatment window. Using CT perfusion imaging, patients were categorized into "penumbra freezing" and "non-penumbra freezing" groups based on the EXTEND criteria. Multiple regression analysis assessed the association of nine baseline factors and five blood lipid indicators with "penumbra freezing." Diagnostic accuracy was evaluated using ROC curves. Mendelian randomization (MR) analysis validated these findings using blood lipid indicators as exposures and penumbra biomarkers as outcomes. Among AIS patients beyond the treatment window, males exhibited better penumbra preservation (OR=0.243, 95% CI=0.072-0.813, p=0.022), while those with hyperlipidemia showed poorer preservation (OR=2.429, 95% CI=1.027-7.747, p=0.043). In the "penumbra freezing" group, ApoA1 levels were significantly lower (1.29 ± 0.03 g/L) compared to the "non-penumbra freezing" group (1.42 ± 0.06 g/L, p=0.034). Conversely, Lp(a) levels were significantly higher in the "penumbra freezing" group (304.63 ± 52.44 mg/L) than in the "non-penumbra freezing" group (110.26 ± 40.71 mg/L, p=0.034). Higher ApoA1 levels increased the likelihood of "non-penumbra freezing" beyond the time window (OR=3.206, 95% CI=1.034-9.938, p=0.044), while elevated Lp(a) levels reduced this likelihood (OR=0.075, 95% CI=0.007-0.848, p=0.036). MR analysis confirmed genetic associations of ApoA1 and Lp(a) with penumbra biomarkers. ApoA1 and Lp(a) may be linked to ischemic penumbra status, but further validation is needed due to limitations in sample size and study methodology. ApoA1 and Lp(a) are promising biomarkers for identifying AIS patients eligible for "penumbra freezing," suggesting the potential to extend the treatment window. Show less
Low physical activity (LPA) significantly heightens the susceptibility of both type 2 diabetes mellitus (T2DM) and chronic renal disease. Nearly half of population diagnosed with T2DM globally worsen Show more
Low physical activity (LPA) significantly heightens the susceptibility of both type 2 diabetes mellitus (T2DM) and chronic renal disease. Nearly half of population diagnosed with T2DM globally worsen into diabetic kidney disease (DKD). Focusing on physically inactive populations, we aimed to comprehensively evaluate the trends over time and regional changes in T2DM-associated DKD attributable to LPA burden. We utilized data of the 2021 Global Burden of Disease (GBD) Study to initially assess the worldwide effects of T2DM-associated DKD attributable to LPA by computing the numbers and age-standardized rates (ASRs) of death, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs), categorized by subtypes in 2021. Linear regression model was applied to analyze the illness burden from 1990 to 2021. Furthermore, cluster analysis was performed to assess the regional differences in disease burden across GBD regions. Lastly, to forecast the illness burden for the next 25 years, we utilized the autoregressive Integrated Moving Average (ARIMA) and Excess Risk (ER) models. In 2021, the fatalities attributed to T2DM-related DKD attributable to LPA amounted to 30835 (95%UI: 12346-51646) cases, with 698484 (95%UI: 275039-1158032) DALYs. The ASRs of death and DALYs were 0.38 (95%UI: 0.15-0.63) and 8.19 (95%UI: 3.21-13.6) per 100000 individuals, respectively. Between 1990 and 2021, there was a notable escalation in deaths, DALYs, YLDs, and YLLs, as well as their ASRs. The highest burden was observed among males, older adults (aged 70 years and above), and middle Socio-demographic Index (SDI). Significant differences were noted in the disease burden among various regions and countries as defined by the GBD study. Predictive analyses indicate a continued escalation of this burden by the year 2050. The global impact of DKD attributable to LPA remains considerable, with significant disparities noted across different genders, ages, and regions. To mitigate this burden, it is crucial to implement effective interventions aimed at addressing physical inactivity, specifically designed for targeted demographic groups. Show less
To investigate longitudinal changes in pelvic floor support in primiparous women with pelvic organ prolapse (POP) after vaginal delivery, focusing on single- and multiple-compartment involvement. Two Show more
To investigate longitudinal changes in pelvic floor support in primiparous women with pelvic organ prolapse (POP) after vaginal delivery, focusing on single- and multiple-compartment involvement. Two hundred primiparas after vaginal delivery were prospectively enrolled and underwent pelvic floor MRI at six weeks postpartum. POP was diagnosed and classified into subgroups (single or multiple compartments involved) based on MRI findings. Primiparas with POP underwent repeat MRI at four months postpartum. Pelvic floor measurements, including injury score and functional parameters of the levator ani muscle (puborectal hiatus line, H line; muscular pelvic floor relaxation line, M line; levator hiatus area, LHA; iliococcygeus angle, ICA; levator plate angle, LPA), were assessed on MRI. Measurements were compared among POP subgroups and a normal control group (without POP) at six weeks postpartum. Additionally, changes between six weeks and four months postpartum were analyzed within POP subgroups. Based on MRI criteria, approximately 41.5% of primiparas were diagnosed with POP, predominantly cystoceles commonly associated with uterine prolapse. Functional parameters of the levator ani, except for LPA at rest, were significantly increased in POP subgroups compared to controls. At four months postpartum, M line, H line, and LPA significantly decreased, and prolapsed organs were elevated in cases with multiple compartments involved, compared to six weeks postpartum. No significant changes were observed in cases with single-compartment involvement during follow-up. A substantial proportion of primiparas experienced postpartum POP. Impaired levator ani function contributed to POP. Pelvic floor support improved during early postpartum in cases with multiple-compartment involvement. Show less
Evidence has linked self-reported sedentary behaviors with dementia and cognitive impairment; however, the underlying mechanisms remain poorly understood. We investigated the associations of accelerom Show more
Evidence has linked self-reported sedentary behaviors with dementia and cognitive impairment; however, the underlying mechanisms remain poorly understood. We investigated the associations of accelerometer-measured sedentary behavior patterns with gray matter atrophy patterns in rural-dwelling older adults, while taking into account the manner in which sedentary time is accrued (in short or long bouts). This community-based study involved 911 dementia-free older adults (age ≥ 60 years, 59% women) who participated in both ActiGraph and brain MRI substudies within MIND-China (2018-2020). Sedentary behavior parameters (total sedentary time, mean sedentary bout duration, and sedentary breaks) were recorded with accelerometers. Regional gray matter volumes (GMV) were measured using voxel-based morphometry (VBM) methods. Data were analyzed using the general linear regression models, restricted cubic spline curves, and VBM analysis. There was an inverted U-shaped association between daily sedentary time and GMV in temporal, cingulate, and medial temporal cortex, while longer mean sedentary bout duration was linearly related to decreased GMV in total, frontal, temporal, insula, cingulate, and medial temporal cortex. Greater daily time spent in light or moderate-to-vigorous physical activity (LPA and MVPA) was correlated with larger insula GMV. The VBM analysis suggested that prolonged daily total sedentary time and mean sedentary bout duration were significantly associated with smaller GMV in extensive brain regions, especially in thalamus and insula. In conclusion, gray matter atrophy associated with sedentary behavior in older adults is characterized by reduced GMV in global, frontal, temporal, medial temporal, and cingulate cortex, especially in the insula and thalamus regions. Show less
Coronary heart disease (CHD) is a prominent cause of mortality and disability worldwide. Like most complex diseases, the risk of CHD in individuals is regulated by the interaction between genetic fact Show more
Coronary heart disease (CHD) is a prominent cause of mortality and disability worldwide. Like most complex diseases, the risk of CHD in individuals is regulated by the interaction between genetic factors and lifestyle. To investigate the influence of A total of 324 patients with CHD and 143 control participants were involved in this study. Single nucleotide polymorphisms rs429358 and rs7412 in the In the CHD group, the frequencies of In the Teochew population, the Show less
This study aimed to analyze latent profiles and characteristics of nurses' knowledge, attitudes, and practices (KAP) regarding pressure injury (PI) prevention, as well as influencing factors across di Show more
This study aimed to analyze latent profiles and characteristics of nurses' knowledge, attitudes, and practices (KAP) regarding pressure injury (PI) prevention, as well as influencing factors across distinct profiles. A convenience sampling method was employed to recruit nurses from hospitals at various tiers in Guangxi Zhuang Autonomous Region between July and August 2024. Data were collected using a General Information Questionnaire and a Nurse PI-KAP Questionnaire. Latent profile analysis (LPA) identified distinct PI-KAP profiles, while univariate analysis and multinomial logistic regression determined profile-specific influencing factors. Among 17,253 enrolled nurses, the total PI-KAP score was 63.44 ± 7.69. Three latent profiles emerged: low-level PI-KAP (12.82%), moderate-level PI-KAP (52.23%), and high-level PI-KAP (34.95%). Multinomial logistic regression revealed that hospital tier, years of experience, education level, professional title, gender, and attitudes toward PI training significantly influenced PI-KAP profiles (p < .05). Heterogeneity exists in nurses' PI-KAP profiles, with a substantial proportion demonstrating suboptimal competency. Nursing administrators should establish hierarchical training systems tailored to PI-KAP characteristics. Capacity-building strategies include prioritizing training for core nurses, optimizing resource allocation, and establishing tiered hospital assistance mechanisms to enhance team-based PI prevention capabilities. Not applicable. Show less
Given the lack of evidence, we cannot definitively determine the relationship between attachment networks and problematic mobile phone use, hindering effective intervention strategies. Therefore, a th Show more
Given the lack of evidence, we cannot definitively determine the relationship between attachment networks and problematic mobile phone use, hindering effective intervention strategies. Therefore, a three-wave longitudinal study was designed to explore the heterogeneity of parent-child attachment networks using latent profile analysis (LPA) and random intercept latent transition analysis (RI-LTA). Participants included 2116 adolescents (ages 14-21; 53.8% girls). Results identified five stable parent-child attachment network profiles, each showing moderate but decreasing stability. Notably, adolescents who were grouped into an attachment network characterized by secure maternal attachment but insecure paternal attachment, similar to those in attachment networks with both insecure maternal and paternal attachment, scored higher levels of problematic mobile phone use than those who were grouped into attachment networks with both secure maternal and paternal attachment. Our findings fill empirical gaps and provide strong evidence supporting attachment-based interventions to reduce problematic mobile phone use. Show less
Family caregivers ('carers') bear the highest care burden during the postoperative survivorship period of pancreatic cancer, given its poor prognosis. Most carers report unmet needs when taking on car Show more
Family caregivers ('carers') bear the highest care burden during the postoperative survivorship period of pancreatic cancer, given its poor prognosis. Most carers report unmet needs when taking on caregiving responsibilities during this period. Thoroughly investigating carers' needs is essential for helping families address practical care challenges. However, this important topic remains underexplored. To assess the need levels and identify need subgroups among carers of patients with pancreatic cancer 6 months after surgery and demographic predictors contributing to heterogeneity. Cross-sectional study. Participants were recruited from the pancreas centres of four tertiary A-level comprehensive hospitals in Jiangsu Province, China. 240 patients with pancreatic cancer and their carers ('dyads') participated in the survey. Carers completed the Comprehensive Needs Assessment Tool in Cancer for Carers, the Activities of Daily Living Scale for patients, and the General Demographic Information Questionnaire for dyads. Latent profile analysis (LPA) was used to categorise carers' needs. Non-parametric and chi-square tests were used to examine differences in need scores and sociodemographic characteristics among subgroups. Multiple logistic regression (MLR) was used to analyse sociodemographic impacts. Six months post-surgery, the total carers' need score was 41.83 ± 22.65 points, indicating a moderate level, with the highest needs reported for healthcare personnel, information and knowledge, and facilities and services. The LPA results revealed that carers were divided into five distinct subgroups based on differing levels of need across the domains assessed by the Comprehensive Needs Assessment Tool in Cancer for Carers, with proportions of 8.8 %, 22.5 %, 8.3 %, 55 %, and 5.4 %. Subgroup membership was predicted by four factors: carers' sex (odds ratio [OR]: 11.08, 95 % confidence interval [CI]: 1.64, 74.99, We have highlighted the complex individualised needs of carers of patients with pancreatic cancer. Through LPA and MLR, we identified distinct need subgroups and their predictors. Healthcare professionals may be able to improve dyads' health by tailoring support to each subgroup's specific needs and issues. Registration number: ChiCTR2400079415, registered 03/01/2024, first recruitment 04/02/2024. Show less
Calcific aortic valve stenosis (CAVS) can lead to cardiac adverse outcomes; however, currently, no effective pharmacological interventions are available to prevent or delay disease progression. Emergi Show more
Calcific aortic valve stenosis (CAVS) can lead to cardiac adverse outcomes; however, currently, no effective pharmacological interventions are available to prevent or delay disease progression. Emerging evidence has identified significant associations between CAVS and key biomarkers, including Lp(a) (lipoprotein [a]), low-density lipoprotein cholesterol, and PCSK9 (proprotein convertase subtilisin/kexin type 9). However, robust evidence from randomized controlled trials is still lacking to substantiate these associations. The EPISODE (Effect of PCSK9 Inhibitors on Calcific Aortic Valve Stenosis) trial is a prospective, evaluator-blinded, randomized controlled trial designed to assess the therapeutic efficacy of PCSK9 inhibitors in patients with CAVS. A total of 160 patients with mild-to-moderate or asymptomatic severe CAVS will be randomly assigned to receive either statin monotherapy or a combination of statins and PCSK9 inhibitors. Participants will undergo follow-up assessments at 3-month intervals for 24 months, including transthoracic ultrasonic cardiogram, computed tomography, and quality-of-life evaluations using the EuroQol-5 Dimension-3 Level questionnaire. The primary end point is the annualized change in peak aortic jet velocity, whereas secondary end points encompass changes in aortic valve area, calcification score, incidence of heart valve surgery, and quality of life. Safety end points include all-cause mortality and cardiovascular events. The trial aims to evaluate the efficacy of PCSK9 inhibitors in modulating disease progression, reducing adverse cardiovascular events, and improving clinical outcomes in patients with CAVS. The anticipated findings are expected to provide critical insights for developing novel therapeutic strategies for early intervention in CAVS. URL: https://www.clinicaltrials.gov; Unique Identifier: NCT04968509. Show less
Pulmonary fibrosis (PF) is a progressive and fatal disease, and recent studies have revealed its key role in the autotaxin (ATX)-lysophosphatidic acid (LPA) signaling pathway, revealing the therapeuti Show more
Pulmonary fibrosis (PF) is a progressive and fatal disease, and recent studies have revealed its key role in the autotaxin (ATX)-lysophosphatidic acid (LPA) signaling pathway, revealing the therapeutic potential of targeting ATX. Herein, starting from PAT-409, a series of novel ATX inhibitors containing the 4,5,6,7-tetrahydro-7H-pyrazolo[3,4-c]pyridin-7-one core were designed to improve the pharmacological activity and physicochemical properties. The most promising compound 19 exhibited potent ATX inhibition (IC Show less
Xin Zhang, Yun-Teng Xu, Xi Chen+4 more · 2025 · Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica · added 2026-04-24
This study aims to investigate the effect and mechanism of naringin on anti-osteoporosis by regulating lipid-bone balance. Thirty healthy female SD rats(8-week-old, SPF grade) were selected and random Show more
This study aims to investigate the effect and mechanism of naringin on anti-osteoporosis by regulating lipid-bone balance. Thirty healthy female SD rats(8-week-old, SPF grade) were selected and randomly divided into a sham group, an ovariectomy group, and a naringin group. Except for the sham group, postmenopausal osteoporosis models were established for both the ovariectomy group and the naringin group by removing bilateral ovaries. Rats in the naringin group were given a naringin suspension at a dose of 100 mg·kg~(-1), while those in sham and ovariectomy groups were administered an equivalent volume of saline. Following the treatment once daily for 12 weeks, an enzyme-linked immunosorbent assay(ELISA) was used to detect the changes in the content of serum estradiol(E₂₎ and bone metabolism biomarkers, including procollagen type Ⅰ N-terminal propeptide(PINP), osteocalcin(OC), and tartrate-resistant acid phosphatase 5(TRACP5). Micro-CT analysis was performed to assess structural alterations in the femoral trabeculae of rats and analyze morphometric parameters of the bone. Hematoxylin-eosin(HE) and Masson staining were used to observe the histopathological changes in the bone tissue. Western blot was employed to analyze the protein expression level of osteogenesis-and adipogenesis-related factors, including peroxisome proliferator-activated receptor gamma(PPARγ), lipoprotein lipase(LPL), RUNT-related transcription factor 2(RUNX2), osterix(OSX), farnesoid X receptor(FXR), and fibroblast growth factor 19(FGF19). Additionally, immunohistochemistry was employed to evaluate the expression of key metabolic pathway proteins FXR and FGF19. After 12-week treatment, compared with the sham group, the ovariectomy group exhibited a significantly reduced level of serum E₂, PINP, and OC, alongside significantly elevated TRACP5. Compared with the ovariectomy group, the levels of serum E₂, PINP, and OC in the naringin group were significantly increased, while the level of TRACP5 was significantly decreased. Compared with the sham group, the ovariectomy group exhibited a decrease in trabecular number and continuity, sparse and disorganized arrangements, and partial formation of voids. The group also showed decreased bone mineral density(BMD), bone volume fraction(BV/TV), trabecular number(Tb.N), and trabecular thickness(Tb.Th), coupled with increased trabecular separation(Tb.Sp). Compared with the ovariectomy group, naringin intervention resulted in improved bone microarchitecture, characterized by increased trabecular number and continuity, more compact arrangements, and a significant reduction in voids. Quantitatively, this was reflected in elevated levels of BMD, BV/TV, Tb.N, and Tb.Th, alongside a significant decrease in Tb.Sp. Under light microscopy, fragmented trabeculae, uneven collagen staining, disorganized arrangements, and an expanded number and size of marrow adipocyte vacuoles were observed in the ovariectomy group, whereas naringin administration attenuated these pathological alterations. Compared with the sham group, the ovariectomy group showed a significant increase in the expression of adipogenic proteins PPARγ and LPL, alongside significant decreases in the expression of osteogenic proteins(RUNX2 and OSX) and of FXR and FGF19 proteins. In contrast, the naringin group exhibited a reversal of these trends compared to the ovariectomy group, with decreased PPARγ and LPL expression and increased RUNX2, OSX, FXR, and FGF19 expression. These findings demonstrate that naringin modulates lipid-bone metabolism homeostasis in postmenopausal osteoporotic rats, ameliorating trabecular microstructure and attenuating bone marrow adipogenesis, with its therapeutic effects mechanistically linked to the FXR/FGF19 signaling pathway. Show less
To explore the optimal row-ratio in mechanized hybrid rice seed production, a field experiment was conducted in 2024 at Qionglai and Mianzhu using 'Tiantai A' × 'Taihui 808'. Three row-ratio treatment Show more
To explore the optimal row-ratio in mechanized hybrid rice seed production, a field experiment was conducted in 2024 at Qionglai and Mianzhu using 'Tiantai A' × 'Taihui 808'. Three row-ratio treatments (H1: 18:6, H2: 24:6, and H3: 30:6) were tested using agricultural unmanned aerial vehicles (AUAVs) for pollination assistance. The results showed that row-ratio had little effect on sterile line flowering dynamics. The index of flowers meeting (IFM) was 0.71-0.72 at Qionglai and 0.81-0.86 at Mianzhu, with 11 to 12 days of flowering duration. As the row-ratio increased, total pollen quantity in the panicle layer and grain filling rate (GFR) decreased, while grain infection rate (GIR) increased. The responses of grain blighted rate (GBR), grain empty rate (GER), and fertilization success rate (FSR) to row-ratio varied between sites. Pollen density and GFR followed the pattern of near region (NR) > central region (CR) > far region (FR). Within the panicle, pollen density was generally highest in the upper panicle layer (UPL), followed by the middle (MPL) and lower (LPL) layers, with partial exceptions observed in the H2 and H3 treatments at Mianzhu. The vertical distribution of GFR varied by site: at Qionglai, it was apical parts of panicle (APP) > median parts (MPP) > basal parts (BPP), whereas at Mianzhu the order was MPP > APP > BPP. With wider row-ratios, yield per unit area (YUA) and GFR declined (H1 > H2 > H3), while 1,000-grain weight increased or decreased and then increased. Under H1, yields reached 2,107.50 kg ha Show less
This study investigated the effects of dietary carbohydrate levels on growth performance, body composition, and hepatic expression of metabolic genes in Chinese hook snout carp (
Intensive aquaculture frequently utilizes high-fat diets (HF) as a cost-effective strategy, yet this practice often induces hepatic steatosis, oxidative stress, and chronic inflammation in carnivorous Show more
Intensive aquaculture frequently utilizes high-fat diets (HF) as a cost-effective strategy, yet this practice often induces hepatic steatosis, oxidative stress, and chronic inflammation in carnivorous fish. Betaine, a natural methyl donor, has shown potential as a functional feed additive, but its comprehensive protective mechanisms under HF stress remain to be fully elucidated. Juvenile largemouth bass (Micropterus salmoides) were fed one of four isonitrogenous diets for 8 weeks: a normal-fat control (Control), a high-fat diet (HF), and two high-fat diets supplemented with 0.5% (HFB0.5) or 1.0% (HFB1) betaine. Growth performance, digestive enzyme activities, serum biochemical parameters, hepatic antioxidant capacity, and the expression of genes related to antioxidant defense, lipid metabolism, and inflammation were analyzed. The HF group exhibited significantly impaired growth, digestive function, and antioxidant capacity, along with elevated lipid peroxidation, dyslipidemia, and pro-inflammatory cytokine expression. Betaine supplementation restored growth performance and feed efficiency to control levels, ameliorated digestive enzyme activities (particularly enhancing lipase), and activated the hepatic Nrf2-Keap1 pathway, upregulating antioxidant genes (nrf2, sod1, cat, gpx, ho-1, gr) and enhancing enzyme activities. Betaine also improved serum lipid profiles, upregulated genes related to fatty acid oxidation (pparα, cpt-1) and lipolysis (lpl, hsl), suppressed lipogenic genes (srebp-1, fas), and rebalanced inflammatory cytokines by reducing tnf-α and il-1β while increasing tgf-β1 and il-10. Dietary betaine effectively counteracts HF-induced metabolic stress in M. salmoides through coordinated multi-pathway regulation. It enhances antioxidant defense, reprograms hepatic lipid metabolism toward catabolism, and restores inflammatory homeostasis. These findings underscore betaine's role as a multi-functional feed additive capable of mitigating HF-related metabolic disorders and promoting overall health in carnivorous fish aquaculture. Show less
(Co)doping luminescent center(s) in a host is a universal strategy to photoluminescence (PL) modulations for extensive applications, yet its mechanism and interactions between structure and behavior i Show more
(Co)doping luminescent center(s) in a host is a universal strategy to photoluminescence (PL) modulations for extensive applications, yet its mechanism and interactions between structure and behavior in many phosphors remain ambiguous. Herein, via a facile sol-gel reaction method, differently tendentious occupations of Ce Show less
Cancer cells fulfil their energy requirements by acquiring fatty acids (FAs) through both de novo synthesis and exogenous uptake. Although studies have focused on de novo FAs synthesis in papillary th Show more
Cancer cells fulfil their energy requirements by acquiring fatty acids (FAs) through both de novo synthesis and exogenous uptake. Although studies have focused on de novo FAs synthesis in papillary thyroid cancer (PTC), research on exogenous FAs uptake is scarce. Lipoprotein lipase (LPL), which enhances cellular FAs uptake, serves as the focal point of this study, which explored the role of LPL-mediated exogenous FAs uptake and FAs synthase (FASN)-mediated endogenous FAs synthesis in PTC cell proliferation. The expression of LPL was analyzed using databases including GTEx, GEO, and TCGA. Furthermore, its expression in PTC tissue samples and cell lines was confirmed. To observe the impact of the lipoprotein-deficient medium on PTC cells, EdU and TUNEL staining assays were conducted. CCK-8, colony formation, and TUNEL assays were performed to assess the effect of down-regulating LPL and/or FASN expression in PTC cells. Bioinformatics analysis revealed the upregulation of LPL mRNA in thyroid cancer. LPL expression was significantly elevated in PTC tissues and cell lines. Lipoprotein-deficient medium inhibited PTC cell proliferation and induced apoptosis. Similarly, silencing either LPL or FASN led to comparable outcomes. The combined inhibition of both LPL and FASN had a synergistic effect, enhancing the inhibition of PTC cell proliferation and the increase in apoptosis. Both the de novo synthesis and exogenous uptake of FAs are important for PTC cell proliferation. The combined inhibition of LPL and FASN inhibitors shows promise for PTC treatment. Show less
Adipogenic differentiation of adipose-derived stem cells (ADSCs) is fundamental to both adipose tissue homeostasis and clinical applications, particularly fat grafting. However, the global and stage-s Show more
Adipogenic differentiation of adipose-derived stem cells (ADSCs) is fundamental to both adipose tissue homeostasis and clinical applications, particularly fat grafting. However, the global and stage-specific transcriptional regulatory networks underlying ADSC adipogenesis remain incompletely elucidated. In this study, we integrated bulk and single-cell RNA-seq datasets across multiple time points of ADSC adipogenesis to identify core regulators of differentiation and maturation. A total of 41 genes were consistently upregulated during early differentiation, among which eight hub genes (FABP4, FASN, FABP5, ADIPOQ, PLIN1, LPL, CIDEC, and ACSL1) formed a tightly connected protein-protein interaction (PPI) module associated with lipid metabolism, lipid droplet formation, and adipocyte maturation. Further integration of differentially expressed lncRNAs and miRNAs led to the construction of a ceRNA network involving 7 mRNAs, 9 miRNAs, and 4 lncRNAs, comprising 34 predicted lncRNA-miRNA-mRNA regulatory axes. To identify temporal transcriptional regulators, we defined five genes (TTC14, MBNL2, UBR3, ABCD2, and SORT1) as early-stage inducers of adipogenesis, and four genes (UQCR11, NDUFB4, S100A10, and PRDX3) as late-stage regulators involved in maintaining the mature phenotype. These stage-specific regulators showed distinct temporal expression patterns and were validated by qPCR. GeneMANIA network analysis further revealed that early-stage regulators were enriched in lipid transport and lipase activity regulation, while late-stage regulators were associated with mitochondrial electron transport and energy metabolism. These findings highlight the stage-dependent transcriptional landscape of ADSC adipogenesis and provide candidate regulatory targets for modulating adipocyte differentiation and stability. Show less
Hyperlipidemia and its associated hepatic steatosis pose significant global health burdens, necessitating novel therapeutic strategies. High-fat diet (HFD)-fed C57BL/6 mice received TAC (2.5, 5.0, 10. Show more
Hyperlipidemia and its associated hepatic steatosis pose significant global health burdens, necessitating novel therapeutic strategies. High-fat diet (HFD)-fed C57BL/6 mice received TAC (2.5, 5.0, 10.0 g/L) or simvastatin for 2 weeks. Metabolic parameters, serum lipid profiles, hepatic function markers, and histopathology were systematically analyzed. Molecular pathways were interrogated through qPCR, Western blot, and pharmacological inhibition of AMPK (Compound C) and PPARα (GW6471). TAC treatment demonstrated significant dose-dependent improvements across multiple parameters. Compared to HFD controls, TAC reduced body weight by 21.3% and liver index by 18.7%, while lowering fasting blood glucose levels by 32.4%. Serum analyses showed substantial reductions in total cholesterol (46.2%), triglycerides (38.5%), and LDL-cholesterol (52.1%), accompanied by a 29.8% increase in HDL-cholesterol. Hepatic function improved markedly, with ALT and AST levels decreasing by 57.3% and 49.6% respectively. Histopathological examination revealed a 68.4% reduction in hepatic lipid accumulation. At the molecular level, TAC treatment resulted in a 2.7-fold increase in AMPK phosphorylation while significantly reducing HMGCR expression by 63.1% and nuclear SREBP-1c levels by 71.5%. Concurrently, TAC upregulated PPARα and LXRα expression by 3.1-fold and 2.4-fold respectively, leading to enhanced expression of lipolytic enzymes LPL and HL by 2.8-fold and 2.1-fold. These beneficial effects were completely abolished by co-treatment with pathway-specific inhibitors. TAC ameliorates hyperlipidemia and hepatic steatosis through dual modulation of AMPK/SREBP-1c-mediated lipid synthesis and PPARα/LXRα-driven lipolysis, presenting a multifaceted therapeutic approach for metabolic disorders. Show less