This study explored latent profiles of Health Information-Seeking Behavior (HISB) among stroke patients and analyzed its influencing factors. In this cross-sectional study, 311 stroke participants fro Show more
This study explored latent profiles of Health Information-Seeking Behavior (HISB) among stroke patients and analyzed its influencing factors. In this cross-sectional study, 311 stroke participants from two tertiary care hospitals in Gansu Province, China, were recruited between January and May 2025 using convenience sampling. Data were collected using a general information questionnaire, the Health Information-Seeking Behavior Scale, and the Health Behavior Decision-Making Assessment Scale for Stroke Patients. Latent profile analysis (LPA) was employed to identify distinct HISB profiles. Three latent profiles were identified: the high-demand low-barrier positive group, the moderate-balanced group, and the low-demand high-barrier negative group. Key predictors of profile membership included age, education level, monthly personal income, and the presence of comorbid chronic diseases. The identification of three distinct HISB trait types provides an evidence-based foundation for developing personalized health education and tailored decision support interventions. Healthcare professionals can leverage this classification system to customize communication strategies for patients with different traits, deliver tiered information support, and ultimately empower patients to achieve better health behaviors and health outcomes. Show less
Demyelination diseases are characterized by injury to large (A-type) myelinated nerve fibers, and by secondary damage to small (C-type) sensory fibers, which leads to chronic pain symptoms, such as al Show more
Demyelination diseases are characterized by injury to large (A-type) myelinated nerve fibers, and by secondary damage to small (C-type) sensory fibers, which leads to chronic pain symptoms, such as allodynia. The mechanisms underlying the interactions between the two fiber types are not clear. This study aims to investigate the role of lysophosphatidic acid (LPA) signaling in satellite glial cells (SGCs) within the dorsal root ganglia (DRG) in demyelination-induced chronic pain. A demyelination model was established by injecting cobra venom into the tibial nerve of 8-10-week-old Sprague-Dawley rats to selectively damage A-fiber myelin. Myelin morphology was observed via transmission electron microscopy (TEM) at 1, 3, 7, and 14 days post-injection. Pain behaviors (mechanical hypersensitivity, thermal hyperalgesia, and spontaneous pain) were assessed to evaluate progression. In vivo electrophysiology was performed to analyze sensory conduction and excitability changes in A- and C-type neurons. Immunofluorescence staining assessed SGC activation, LPA1 receptor (LPA1R) expression, and connexin 43 (Cx43) dynamics in the L4 DRG over time. Pharmacological interventions targeting LPA1R and SGC activation were applied to evaluate their effects on pain behaviors, cytokine release, and neuronal excitability using RT-PCR, ELISA, and spinal electrophysiology. Cobra venom induced a selective A-fiber demyelination and persistent pain in rats. It also upregulated the expression of LPA1R on SGCs that surround large DRG neurons, which normally mediate non-noxious input, and increased gap junction-mediated coupling via Cx43, leading to the activation of SGCs surrounding small nociceptive neurons. The activated SGCs released inflammatory mediators that increased nociceptive neuron excitability, driving chronic pain. In support of these results, pharmacological inhibition of LPA1R-mediated SGCs activation reversed this process. Our study demonstrates that LPA-LPA1R signaling in SGCs drives A-fiber demyelination-induced neuropathic pain by promoting Cx43-mediated SGC-neuron crosstalk and cytokine release. Targeting this pathway may represent a promising strategy to alleviate demyelination-associated chronic pain. Show less
To determine whether lipoprotein(a) [Lp(a)] and cumulative Lp(a) (CumLp(a)) are associated with adverse outcomes in patients with acute myocardial infarction (AMI). This cohort study included 2,634 ho Show more
To determine whether lipoprotein(a) [Lp(a)] and cumulative Lp(a) (CumLp(a)) are associated with adverse outcomes in patients with acute myocardial infarction (AMI). This cohort study included 2,634 hospitalized patients diagnosed with AMI who underwent coronary angiography at Zhongda Hospital, Southeast University, from July 2013, to December 2021. The main outcome was major adverse cardiac and cerebrovascular events (MACCE), defined as cardiovascular (CV) death, non-fatal myocardial infarction, non-fatal stroke, or unplanned revascularization—occurring singly or in combination. We used Cox proportional hazards models, with subgroup and sensitivity analyses, restricted cubic spline (RCS) modeling, and threshold-effect assessment to evaluate the relationships between Lp(a), CumLp(a), and prognosis. Across a median 55.2-month follow-up, 907 participants (34.40%) experienced a MACCE, 342 (13.00%) patients had CV death, 177 (6.70%) patients had non-fatal MI, 202 (7.70%) patients had non-fatal stroke, 399 (15.10%) patients underwent unplanned revascularization, and all-cause death occurred in 547 (20.80%) patients. Multivariable Cox regression models demonstrated a significantly increased risk of MACCE, CV death, non-fatal MI, and non-fatal stroke in both the higher Lp(a) and higher CumLp(a) groups compared with the lower groups (HRs for Lp(a): 1.652, 2.157, 3.455, and 1.930; HRs for CumLp(a): 1.697, 1.675, 3.759, and 2.032), and every one-unit rise in CumLp(a), the risk of MACCE, CV death, non-fatal MI and non-fatal stroke increased by 1.3%, 1.4%, 1.9% and 1.2%, respectively. The majority of subgroup and sensitivity checks consistently supported a stable link between Lp(a)/CumLp(a) and the risks of MACCE, CV death, non-fatal MI, and stroke. Analyses using RCS and threshold models revealed that Log Higher levels of Lp(a) and CumLp(a) are linked to a greater risk of poor outcomes among patients with AMI as the index event, highlighting their potential value for risk stratification and guiding clinical decision-making. The online version contains supplementary material available at 10.1186/s12944-025-02800-6. Show less
Pulmonary embolism is a potentially fatal cardiovascular condition that demands prompt and accurate diagnostic imaging. Traditional single-energy computed tomography pulmonary angiography (CTPA), whil Show more
Pulmonary embolism is a potentially fatal cardiovascular condition that demands prompt and accurate diagnostic imaging. Traditional single-energy computed tomography pulmonary angiography (CTPA), while widely used, is associated with high radiation doses and substantial volumes of contrast agents, which may increase the risks of radiation-induced tissue damage and contrast-induced nephropathy (CIN), respectively. Dual-energy CTPA (DE-CTPA) presents a promising alternative, though challenges, including elevated image noise at low kilo-electron volt (keV) levels (e.g., 40 keV), persist. The primary aim of this study is to evaluate and compare the image quality of 40 keV virtual monoenergetic images (VMI) reconstructed using deep learning image reconstruction (DLIR) and Adaptive Statistical Iterative Reconstruction-V (ASIR-V) algorithms within the context of low-dose DE-CTPA protocols. This prospective study enrolled patients who underwent DE-CTPA between January and April 2025. Using a Revolution CT scanner, 40 keV VMI were reconstructed with four distinct algorithms: ASIR-V 50%, ASIR-V 70%, Deep learning image reconstruction with medium setting (DLIR-M), and deep learning image reconstruction with high setting (DLIR-H). Iodixanol (350 mgI/mL) was administered at a dose of 0.4 mL/kg. The image quality was assessed through both objective measures [image noise, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR)] and subjective evaluation via a Likert scale. Statistical analysis was conducted using SPSS 27.0, employing analysis of variance (ANOVA) for normally distributed data and the Kruskal-Wallis test for non-normally distributed data. A total of 75 patients with clinical suspicion of pulmonary embolism were included in the study. The mean effective dose (ED) was 3.76±1.02 mSv, with a mean CT volume dose index (CTDIvol) of 6.13±1.69 mGy and a mean dose-length product (DLP) of 221.12±59.85 mGy·cm. The mean contrast agent volume was 26.0±5.0 mL. Statistical analysis of image quality revealed significant differences between the four groups in terms of image noise, CNR, and SNR, measured at the levels of the main pulmonary artery, left pulmonary artery, and right pulmonary artery (P<0.001). Post-hoc analysis demonstrated that the DLIR-H algorithm provided the highest image quality, significantly reducing noise while enhancing CNR and SNR relative to both ASIR-V and DLIR-M (P<0.001). Compared with ASIR-V 50%, DLIR-H reduced image noise by 45% at the PA [24.25±16.18 The DLIR-H algorithm significantly enhances the image quality of 40 keV VMI images under low-dose DE-CTPA scanning protocols. It outperforms DLIR-M, ASIR-V 50%, and ASIR-V 70%, making it a promising tool for improving image quality in CTPA, particularly in clinical settings where minimizing radiation dose and contrast agent volume is essential. Show less
Ting Yi, Shimeng Dai, Jingrui Tao+4 more · 2025 · Journal of professional nursing : official journal of the American Association of Colleges of Nursing · Elsevier · added 2026-04-24
Undergraduate nursing students face significant academic and practical challenges, with their responses reflecting their academic resilience. However, most studies have overlooked the differences in t Show more
Undergraduate nursing students face significant academic and practical challenges, with their responses reflecting their academic resilience. However, most studies have overlooked the differences in their levels of academic resilience and the factors contributing to these differences. To identify the latent profiles of undergraduate nursing students' academic resilience and to analyze their influencing factors. A cross-sectional study was carried out among 1795 undergraduate nursing students from November 2022 to October 2023 by employing the general information questionnaire, the academic resilience questionnaire for college students, and the brief 2-way social support scale. Latent profile analysis (LPA) was used to analyze the latent profiles of academic resilience, and multiple logistic regression was utilized to explore the factors associated with the identified profiles. Four potential profiles were identified: low academic resilience group, moderate academic resilience group, high academic resilience but low focus and dissociation group, and high academic resilience group. Residence, attitude towards the nursing profession, self-directed study duration, academic performance rank, received and provided instrumental support were found to be associated with the different profiles. These findings highlight the heterogeneity in academic resilience and support tailored educational interventions based on students' specific academic resilience profiles. Show less
Cardiovascular-Kidney-Metabolic (CKM) syndrome is characterized by the interrelatedness of chronic kidney disease, cardiovascular disease, and metabolic disorders. Although physical activity is widely Show more
Cardiovascular-Kidney-Metabolic (CKM) syndrome is characterized by the interrelatedness of chronic kidney disease, cardiovascular disease, and metabolic disorders. Although physical activity is widely acknowledged as an effective intervention for improving the prognosis of chronic diseases, its impact on all-cause mortality among patients with CKM syndrome remains unclear. To investigate the impact of physical activity on all-cause mortality among patients with CKM syndrome. Data from the 2011 wave of the China Health and Retirement Longitudinal Study were used as the baseline, with follow-up conducted until 2013. According to the International Physical Activity Questionnaire criteria, weekly physical activity levels were divided into three categories: light-volume physical activity (LPA), moderate-volume physical activity (MPA), and vigorous-volume physical activity (VPA). Cox proportional hazards regression models were employed to assess the impact of varying levels of physical activity on all-cause mortality. Restricted cubic spline analysis was used to explore possible nonlinear relationships. A total of 3343 patients with CKM syndrome were enrolled in this study. During the 2-year follow-up period, 44 deaths were recorded. After adjusting for potential confounders, VPA was associated with a 54% lower risk of all-cause mortality (adjusted hazard ratios, 0.46; 95% confidence interval: 0.24-0.89). Dose-response relationships demonstrated that all-cause mortality decreased as physical activity increased, with a 5.8% reduction in all-cause mortality risk for every 1000 MET-min/week increment in physical activity levels. VPA was significantly associated with reduced all-cause mortality in patients with CKM syndrome. Encouraging patients with CKM syndrome to engage in increased physical activity may improve clinical outcomes. Key messages What is already known on this topic: Cardiovascular-Kidney-Metabolic (CKM) syndrome involves a complex interplay between cardiovascular disease, metabolic disorders, and chronic kidney disease. While prior studies have established that physical activity can decrease mortality risk in the general population as well as in patients with cardiovascular and metabolic syndromes, the evidence regarding its impact on individuals with CKM syndrome remains limited. Additionally, there is a lack of detailed dose-response analyses of physical activity specifically targeting this high-risk population. What this study adds: This study provides novel evidence indicating that vigorous-volume physical activity (>3000 MET-minutes/week) significantly decreases all-cause mortality by 54% among patients with CKM syndrome, whereas moderate-volume, and light-volume physical activities show no significant effects. Notably, a linear dose-response relationship was established, demonstrating that each 1000-MET increment corresponds to a 5.8% reduction in mortality risk. These findings address a critical knowledge gap by quantifying both the threshold and incremental benefits of physical activity specifically for individuals with CKM syndrome, a population characterized by unique multisystem pathophysiology. How this study might affect research, practice, or policy: The findings of this study have the potential to substantially impact clinical practice by offering evidence-based thresholds for physical activity recommendations in the management of CKM syndrome. The benefits associated with vigorous-volume physical activity (>3000 MET-minutes/week) may encourage guideline committees to formulate more precise exercise prescriptions tailored to this high-risk population. Additionally, these results can be incorporated into a multidisciplinary care framework designed for managing complex chronic conditions. Show less
We investigated the association between lipoprotein(a) [Lp(a)] levels and stroke recurrence in type 2 diabetes mellitus (T2DM) patients with recent acute ischemic stroke or transient ischemic attack ( Show more
We investigated the association between lipoprotein(a) [Lp(a)] levels and stroke recurrence in type 2 diabetes mellitus (T2DM) patients with recent acute ischemic stroke or transient ischemic attack (TIA). This study included 3,311 T2DM patients with recent acute ischemic stroke or TIA and complete Lp(a) data from the Third China National Stroke Registry. The patients were categorized into three groups based on the 40th and 70th percentiles of the Lp(a): ≤13.1, 13.1 to 29.2 and ≥ 29.2 mg/dL. The primary outcome was stroke recurrence within one year, with incident cases further classified as either ischemic or hemorrhagic. Cox proportional hazards regression and restricted cubic splines were used to evaluate these associations. A total of 3311 patients (2142 men, 64.69%, median age 63) were analyzed. Restricted cubic spline analysis revealed a U-shaped relationship between Lp(a) levels and the risk of stroke recurrence. After adjusting for cardiovascular risk factors, patients with Lp(a) levels ≤ 13.1 mg/dL or ≥ 29.2 mg/dL had hazard ratios of 1.34 (95% confidence interval (CI), 1.02-1.76) and 1.35 (95% CI, 1.01-1.79), respectively, for total stroke compared to those with Lp(a) levels between 13.1 and 29.2 mg/dL. The corresponding hazard ratios were 1.36 (95% CI, 1.02-1.81) and 1.36 (95% CI, 1.01-1.83) for ischemic stroke and 0.88 (95% CI, 0.37-2.09) and 0.77 (95% CI, 0.31-1.94) for hemorrhagic stroke, respectively. Both low and high levels of Lp(a) are associated with an increased risk of stroke recurrence in T2DM patients with a recent history of acute ischemic stroke or TIA, demonstrating a U-shaped relationship. Show less
Objective To investigate the effect and mechanism of baicalin on blood lipid metabolism and immune function in rats with gestational diabetes mellitus (GDM). Methods Female rats fed with high-fat and Show more
Objective To investigate the effect and mechanism of baicalin on blood lipid metabolism and immune function in rats with gestational diabetes mellitus (GDM). Methods Female rats fed with high-fat and high-sugar diet and male rats fed with ordinary diet were caged together to prepare pregnant rats, and the GDM rat model was established by intraperitoneal injection of streptozotocin (35 mg/kg). GDM rats were randomly divided into a model group, a fasudil (FA) (RhoA/RocK inhibitor) group (10 mg/kg), low-dose (100 mg/kg) and high-dose (200 mg/kg) baicalin groups, and a high-dose baicalin combined with LPA (RhoA/RocK activator) group (200 mg/kg baicalin+1 mg/kg LPA ), with 12 rats in each group. Another 12 pregnant rats fed with high-fat and high-sugar diet were selected as the control group. After 2 weeks of corresponding drug intervention in each group, the level of fasting blood glucose (FBG) was detected by blood glucose meter. The level of fasting insulin (FINS) in serum was detected by ELISA, and the insulin resistance index (HOMA-IR) was calculated. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) in serum, and the levels of immunomodulator tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and IL-10 in peripheral blood were detected by the kit. The histopathological changes of liver were observed by HE staining. The proportion of T lymphocyte subsets in peripheral blood was detected by flow cytometry. The mRNA and protein expressions of Ras homolog gene family member A (RhoA), Rho associated coiled-coil forming protein kinase 1 (ROCK1), and ROCK2 in liver tissue were detected by real-time quantitative PCR and Western blot. Results Compared with the control group, the levels of FBG, FINS, HOMA-IR, ALT, AST, TG, TC, and LDL-C in serum, the levels of TNF-α, IL-6, the percentage of CD8 Show less
This cross-sectional study aims to describe the characteristics of physical activity, sedentary time, sleep quality, and resting EEG among college students with mild depressive symptoms, and further e Show more
This cross-sectional study aims to describe the characteristics of physical activity, sedentary time, sleep quality, and resting EEG among college students with mild depressive symptoms, and further explore pairwise correlations between behavioral patterns, resting EEG, and mild depressive symptoms. This study included 75 college students with mild depressive symptoms (MDS) and 75 college students without depressive symptoms (ND) as research subjects. Physical activity (vigorous physical activity (VPA), moderate physical activity (MPA), and low physical activity (LPA)) and sedentary time（ST） were measured using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Resting EEG power values were collected from subjects in a quiet, eyes-closed state using an electroencephalography (EEG) device. (1) Characteristic analysis revealed that compared with the ND group, the MDS group exhibited reduced MPA and VPA scores, elevated ST scores, and increased total PSQI scores along with elevated scores across its subdimensions. Their behavioral patterns (Moderate-to-Vigorous Physical Activity (MVPA), Sedentary Behavior (SB), Poor Sleep Quality (PSQ) may have changed, including a decrease in the proportion of MVPA, an increase in the proportion of SB, and an increase in the proportion of PSQ. Analysis of resting EEG revealed increased Alpha2 (α2) band power in the temporal regions (T3 and T5) and increased Beta1 (β1) band power in the frontal region (Fp1) in the MDS group (all p College students with mild depressive symptoms may exhibit altered behavioral patterns and abnormal neural activity in the frontal and temporal regions. Their changed behavioral patterns may correlate with mild depressive symptoms, and recognition models based on certain resting EEG indicators demonstrate preliminary application potential. The association between specific sleep issues and localized EEG activity in this population may provide evidence for further elucidating the mechanistic pathways linking their behavior and brain activity. Future longitudinal studies are recommended to explore causal relationships among these variables. Show less
Gestational exposure to micro- and/or nanoparticles (M/NPs) may be closely associated with adverse maternal and offspring outcomes involving multiple organ dysfunctions. Organ functional change is ach Show more
Gestational exposure to micro- and/or nanoparticles (M/NPs) may be closely associated with adverse maternal and offspring outcomes involving multiple organ dysfunctions. Organ functional change is achieved through metabolic adaptation in response to changes in the external environment; yet, intricacies of these organ dysfunctions and underlying metabolic changes remain poorly understood, particularly at spatial suborgan level. Using a pregnant mouse model exposed to polystyrene (PS)-M/NPs (sizes: 100 nm, 5 μm, 10 mg/L in drinking water) from gestation day 1 to 18, we construct a comprehensive multisub-organ lipid metabolic landscape. This analysis integrates MALDI-mass spectrometry imaging with histological assessment to monitor changes in maternal suborgans-placenta-fetus unit. Our findings reveal distinct metabolic responses between maternal and fetal organs to gestational PS-M/NPs exposure. We identify potential targeted suborgans and spatial biomarkers associated with PS-M/NPs exposure according to histological damage and metabolic remodeling, including placental junctional and labyrinth zone (e.g., phosphatidylserine, phosphatidylethanolamine [PE]), renal cortex of maternal kidney (e.g., ceramide [Cer], PE, sphingomyelin [SM], phosphatidylglycerol [PG], phosphatidylserine), ventricular muscular layer and interventricular septum of maternal heart (e.g., PE, lysophosphatidylethanolamine [LPE], lysophosphatidic acid [LPA]), fetal brain and spinal cord (e.g., Cer), and fetal liver (e.g., Cer). Furthermore, phosphatidylserine synthesis and glycolipid metabolism pathways are found to be exclusively enriched following PS-NP and PS-MP exposure in the multiorgan network, respectively. We propose an M/NPs scale-exposed suborgan effect framework, which provides a molecular foundation and potential spatial biomarkers for elucidating intersub-organ interactions in response to M/NPs exposure and their role in mediating pregnancy state. Show less
Cardiovascular disease (CVD) is the leading cause of mortality in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), yet traditional risk predictors remain limited in clin Show more
Cardiovascular disease (CVD) is the leading cause of mortality in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), yet traditional risk predictors remain limited in clinical practice. To develop machine learning (ML) models for classifying prevalent atherosclerotic cardiovascular disease (ASCVD) risk in MASLD patients, and to enhance model interpretability using SHapley Additive exPlanations (SHAP). Methods: This retrospective study included 590 MASLD patients diagnosed at the Affiliated Hospital of Qingdao University between December 2019 and December 2024. Patients were randomly divided into a training set (n=413) and a validation set (n=177), and further stratified based on ASCVD status. Least absolute shrinkage and selection operator (LASSO) regression was used for feature selection. Six ML models were developed and evaluated using sensitivity, specificity, accuracy, area under the receiver operating characteristic curve (AUC), and F1 score. SHAP analysis was performed to interpret feature contributions. ASCVD was present in 434 of 590 patients (73.6%). The Gradient Boosting (GB) model achieved the best performance, with AUCs of 0.918 (95% CI: 0.890-0.944) in the training set and 0.817 (95% CI: 0.739-0.883) in the validation set. SHAP analysis identified the top predictors as the Cholesterol-HDL-Glucose (CHG) index, Castelli Risk Index II (CRI-II), lipoprotein(a) [Lp(a)], serum creatinine (Scr), and uric acid (UA). The GB model demonstrated strong high accuracy in identifying existing ASCVD in MASLD patients and may serve as a useful tool for early risk stratification in clinical settings. Show less
Physical activity (PA), sedentary behaviour (SB) and sleep (SLP)-key components of 24-h movement behaviours-have each been independently linked to motor development in preschool children. However, the Show more
Physical activity (PA), sedentary behaviour (SB) and sleep (SLP)-key components of 24-h movement behaviours-have each been independently linked to motor development in preschool children. However, the lack of understanding regarding their integrated and mutually exclusive nature has limited research on their combined impact on early health outcomes. This study employed compositional data analysis (CoDA) to examine the relationships between these behaviours and fundamental movement skills (FMS), as well as potential changes in FMS resulting from isotemporal reallocation. A cross-sectional study was conducted with 292 preschool children (3-6 years old; 149 boys and 143 girls). SB, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured using accelerometers, whereas sleep duration was parent-reported. FMS, including locomotor skills, object-control skills and total motor skills (total MS), were assessed using the third edition of the Test of Gross Motor Development (TGMD-3). CoDA was used to analyse the relationship between 24-h movement behaviours and FMS. After adjusting for gender, age, family socioeconomic status (SES) and the number of children in the household, a higher proportion of MVPA was significantly positively associated with both total MS (β = 9.39, p = 0.008) and locomotor skills (β = 6.69, p = 0.003). In a 15-min isotemporal reallocation model, substituting MVPA for other behaviours resulted in significant improvements in both total MS and locomotor skills. Dose-response analysis revealed that reallocating even a small amount of time (e.g., 15 min) to MVPA resulted in meaningful benefits for FMS. Notably, this relationship was asymmetric: The negative impact of reducing MVPA outweighed the gains from increasing MVPA. These findings highlight the importance of prioritizing MVPA within the 24-h movement behaviours framework to optimize motor development in preschool-aged children. Show less
Pancreatic cancer (PC) represents a highly lethal malignancy characterized by diagnostic challenges owing to nonspecific early symptoms and insufficiently sensitive biomarkers. This investigation soug Show more
Pancreatic cancer (PC) represents a highly lethal malignancy characterized by diagnostic challenges owing to nonspecific early symptoms and insufficiently sensitive biomarkers. This investigation sought to identify novel PC biomarkers through lipidomic profiling, an emerging metabolomics methodology examining lipid pathways in disease pathogenesis. We established a humanized murine PC model. Small-molecule oxidized lipid metabolites in primary pancreatic tumors and hepatic metastases were quantitatively analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) integrated with a comprehensive metabolomics platform. Multivariate statistical approaches including principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) were systematically applied. Analysis identified 64 differentially expressed oxidized lipids structurally classified as unsaturated fatty acid derivatives. Comparative assessment of metabolic profiles revealed a pronounced reduction in prostaglandins (PGE Our findings establish prostaglandins PGE Show less
Acquired renal cysts (ARC) are associated with kidney function decline, necessitating novel dietary pattern (DP) analyses in large cohorts. This UK Biobank prospective cohort study (2006-2010) include Show more
Acquired renal cysts (ARC) are associated with kidney function decline, necessitating novel dietary pattern (DP) analyses in large cohorts. This UK Biobank prospective cohort study (2006-2010) included participants with ≥2 dietary records, excluding those with severe kidney damage. The constructed comprehensive dietary pattern integration (CDPI) utilized reduced rank regression (RRR) and latent profile analysis (LPA). ARC cases (ICD-10: N28.1) were assessed via Cox regression for risk and dose-response, with NMR metabolites examined as mediators. Among 119,709 participants (median follow-up: 10.57 years), 850 ARC cases were identified. Lipid-rich and hyperglycemic diets increased ARC risk [e.g., HRs for G1.DP1: 1.080 (1.024, 1.139); G1.DP2: 1.144 (1.048, 1.249)], while micronutrient-rich diets showed weak protective effects [G4.DP1: 0.943 (0.892, 0.998)]. LPA confirmed RRR findings, and 7/251 NMR metabolites had significant mediating effects. Diets high in fat (cheese, butter, pizza) and sugar (chocolate, sugary drinks) elevated ARC risk, whereas micronutrient- and fiber-rich diets (vegetables, fruit, lean poultry, nuts, eggs) were protective. Key mediators included branched-chain amino acids, IGF-1, and RBC distribution width. Show less
Human papillomavirus (HPV) infection is a global public health issue, and HPV-related stigma can affect cervical cancer prevention. But no validated tools exist to assess HPV stigma in Chinese adult w Show more
Human papillomavirus (HPV) infection is a global public health issue, and HPV-related stigma can affect cervical cancer prevention. But no validated tools exist to assess HPV stigma in Chinese adult women infected with HPV. This study aimed to adapt and validate the HPVsStigma scale (HPV-SS) in the Chinese context. A cross-sectional study was conducted from December 2024 to February 2025 among 501 HPV-infected women in Shenzhen, China. The HPV-SS was adapted from a 12-item HIV stigma scale. Demographic characteristics, HPV-related variables, and data on mental health were collected. Factor analyses (FA) were used to assess the scale's factorial structure, reliability, and validity. The bi-factor model was used to determine the score-reporting method of the scale. Item response theory (IRT) was employed to assess the relationship between participants' stigma levels and scale scores. Latent profile analysis (LPA) was conducted to classify the participants with different HPV stigma characteristics and determine the optimal cut-off value for HPV-SS. FA showed that the 3-factor model (personalized stigma, public-disclosure concerns, and negative self-image) had the best fit among the nested models, with good reliability and validity. The bi-factor model analysis indicated that the total scale score was more meaningful than dimension scores. IRT analysis confirmed that higher HPV-SS scores represented higher stigma levels. LPA identified a 2-class model as optimal, and the optimal cut-off value of the scale for high HPV stigma was 35. This study validated the 12-item HPV-SS for Chinese women infected with HPV, with good reliability and validity. The scale can be used to evaluate HPV stigma levels, facilitating targeted interventions to improve cervical cancer prevention and the psychological well-being of affected women. Show less
Xian Chen, Sichen Xia, Xue Han+4 more · 2025 · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · Springer · added 2026-04-24
Cervical cancer incidence in China has risen to 13.83/100,000, particularly affecting younger women. Following recent family policy changes, reproductive concerns among cervical cancer patients have i Show more
Cervical cancer incidence in China has risen to 13.83/100,000, particularly affecting younger women. Following recent family policy changes, reproductive concerns among cervical cancer patients have intensified. While fertility-sparing treatments show good survival rates, many patients still experience significant anxiety about future fertility. This study aims to examine distinct reproductive concern profiles and their influencing factors in cervical cancer patients of childbearing age. We studied 247 patients from a Nanjing tertiary hospital between October 2023 and October 2024. Participants completed surveys including a demographic questionnaire, Reproductive Concerns After Cancer Scale, Patient Health Questionnaire-9, Benefit Finding Scale, and Fear of Cancer Recurrence Scale. Latent profile analysis (LPA) was conducted to identify reproductive concerns. Latent profile analysis revealed three distinct reproductive concern profiles: (1) a low-concern group with reproductive expectations (27.94%), (2) a moderate-concern group with self and child health preoccupations (49.39%), and (3) a high-concern group with impaired reproductive adaptation (22.67%). Significant influencing factors included age, number of children, residential location, depressive symptoms, and fear of cancer recurrence. These cross-sectional findings emphasize the need for careful consideration of individualized, multiple-disciplinary care for young women with cervical cancer. Benefit finding was associated with lower reproductive concerns. Show less
The study aimed to characterise presenteeism among nurses and identify nurses' presenteeism associated with distinct latent profiles. This study employed a cross-sectional descriptive approach. From J Show more
The study aimed to characterise presenteeism among nurses and identify nurses' presenteeism associated with distinct latent profiles. This study employed a cross-sectional descriptive approach. From July to December 2024, data were collected from 404 Chinese clinical nurses across four tertiary hospitals in Sichuan Province, Southwest China, using demographic questionnaires, the Stanford Presenteeism Scale (SPS-6), and the Challenge- and Hindrance-Related Self-Reported Stress Scale (C-HSS). A latent profile analysis was conducted on SPS-6 scores using Mplus 8.3, followed by univariate analyses to compare characteristics across subgroups. The total mean score of nurses' presenteeism is (16.13 ± 4.46), with approximately 59.4% classified as having a high level of presenteeism. Four latent profiles of nurses' presenteeism were identified through LPA: low fatigue-low work constraint (19.8%), low fatigue-high work constraint (33.9%), high fatigue-low work constraint (18.8%), and high fatigue-high work constraint (27.5%). Nurses demonstrated moderately severe presenteeism, with LPA revealing four distinct phenotypes characterised by divergent fatigue- work constraint configurations. This heterogeneity underscores the need for stratified interventions addressing unique risk profiles across subgroups. Administrators should adopt targeted interventions according to the characteristics of nurses in different profiles to minimise nurses' loss of productivity. This study addresses the evidence gap regarding the significant heterogeneity of presenteeism among nurses and the lack of precise identification, and identifies four distinct latent profiles of presenteeism. The findings provide critical evidence for nursing managers to design and implement differentiated intervention strategies tailored to groups with different risk characteristics. The study followed the STROBE guideline. This study did not include patient or public involvement in its design, conduct or reporting. Show less
Inflammation and hyperlipidaemia contribute with similar magnitude to the risk of future atherothrombotic events. However, the relative importance of high-sensitivity CRP (hsCRP) and lipoprotein(a) (L Show more
Inflammation and hyperlipidaemia contribute with similar magnitude to the risk of future atherothrombotic events. However, the relative importance of high-sensitivity CRP (hsCRP) and lipoprotein(a) (Lp[a]) as determinants of risk of major adverse cardiovascular events (MACE) are not well defined among patients aged 75 years or older with established atherosclerotic cardiovascular disease (ASCVD). The present study prospectively enrolled 2,333 patients aged 75 years or older diagnosed with ASCVD with measurement of hsCRP and Lp(a) at Fuwai Hospital. The primary endpoint was MACE, defined as a composite of all-cause death, myocardial infarction (MI), stroke or ischaemia-driven coronary revascularisation. The median follow-up time was 3.0 years (interquartile range [IQR]: 2.5-3.2 years). hsCRP was significantly associated with an increased risk of MACE (adjusted hazard ratio [aHR]: 1.05, 95% confidence interval [CI]: 1.03-1.08 per 1 mg/l increment, P < 0.001; highest versus lowest quartile: aHR: 1.70 [1.22-2.38]), whereas there was no significant association between Lp(a) and MACE risk (aHR: 1.02 [0.98-1.06] per 10 mg/dl increment, P = 0.341; highest versus lowest quartile: aHR: 1.06 [0.77-1.47]). Risks of MACE were significantly higher in participants with hsCRP ≥2 mg/l than in those with hsCRP <2 mg/l, irrespective of Lp(a) strata (aHR: 1.41 [1.12-1.79]; P = 0.004). Concomitant elevation of hsCRP (≥2 mg/l) and Lp(a) (≥30 mg/dl) was associated with the greatest risk of MACE (aHR, 1.54 [1.13-2.12]; P = 0.007). Inflammation assessed by hsCRP predicted risk of future cardiovascular events more strongly than Lp(a) in patients aged 75 years or older with established ASCVD. These results provided real-world evidence on older patients potentially benefit by targeted anti-inflammatory strategies for secondary ASCVD prevention. Show less
Certain parents of children with febrile seizures have a high sense of perceived vulnerability, which may lead to overprotective behaviors. This study aimed to measure the latent profile types of perc Show more
Certain parents of children with febrile seizures have a high sense of perceived vulnerability, which may lead to overprotective behaviors. This study aimed to measure the latent profile types of perceived vulnerability in parents of children with febrile seizures and investigate the factors affecting these different profiles. A cross-sectional study was conducted from October 2023 to December 2024. Participants were surveyed using a general data questionnaire, the child vulnerability scale (CVS), parents' perception of uncertainty scale (PPUS), and perceived social support scale (PSSS). Latent profile analysis (LPA) was conducted to identify different types of perceived vulnerability among parents of children with febrile seizures. The influencing factors for each profile were identified using univariate and multivariate logistic regression analysis. In total, 400 participants were included in this study. The perceived vulnerability among parents of children with febrile seizures was divided into three latent profiles: "General Low Perceived Vulnerability Group" (37.9%), "Moderate Perceived Vulnerability Group" (32.8%), and "High Perceived Vulnerability Group" (29.3%). Multivariate analysis indicated that relationship with children, parents' age, educational attainment, marital status, body temperature during febrile seizures, PPUS, and PSSS were the factors affecting perceived vulnerability in parents of children with febrile seizures. The perceived vulnerability in parents of children with febrile seizures exhibited significant heterogeneity. To minimize the perceived vulnerability, medical professionals should provide tailored mental health counseling and intervention based on vulnerability characteristics. Show less
Assessing white matter hyperintensity (WMH) is essential for the diagnosis, treatment, and prognosis of multiple sclerosis (MS) and neuromyelitis optical spectrum disorder (NMOSD). MS and NMOSD presen Show more
Assessing white matter hyperintensity (WMH) is essential for the diagnosis, treatment, and prognosis of multiple sclerosis (MS) and neuromyelitis optical spectrum disorder (NMOSD). MS and NMOSD present dispersed small lesions alongside larger aggregated lesions that are irregularly shaped, posing challenges for the automatic segmentation of WMH on magnetic resonance images. Furthermore, research on NMOSD brain WMH segmentation is limited due to the rare nature of the disease. This study aims to propose a deep learning method for MS and NMOSD brain WMH segmentation. In this study, we propose a 2.5D Fourier Convolutional ResUnet (FrC-ResUnet). It utilizes a spectral encoder to extract global information, enabling accurate segmentation of scattered lesions. Additionally, the model incorporates the selective features module (SFM) and the convolutional block attention module (CBAM) to enhance lesion-background differentiation and outline the lesions distinctly. We evaluated our approach on the MS public and local datasets of MS and NMOSD. Compared to U-Net, ResUNet, FC-DenseNet, AttentionUNet, lesion prediction algorithm (LPA) and Sequence Adaptive Multimodal SEGmentation (SAMSEG), the 2.5D FrC-ResUnet achieved the highest Dice similarity coefficient (DSC) on three different datasets, with values of 0.710, 0.667, and 0.822, respectively. The 2.5D FrC-ResUnet demonstrates accurate and robust segmentation of NMOSD brain WMH. Meanwhile, the model excels in segmenting MS brain WMH, particularly when confronted with irregularly shaped and dispersed lesions. Show less
Many studies have revealed the observational associations between lipoprotein(a) (Lp(a)) concentrations and the incidence of cardiovascular diseases (CVDs). However, the causal associations remain unc Show more
Many studies have revealed the observational associations between lipoprotein(a) (Lp(a)) concentrations and the incidence of cardiovascular diseases (CVDs). However, the causal associations remain unclear. Public summary data were analyzed using a Mendelian randomization (MR) design to assess the causal associations between Lp(a) levels and risks of nine CVDs and evaluate the potential impact of aspirin on Lp(a) levels. The principal analysis was conducted employing the random-effects inverse-variance weighted (IVW) method. Furthermore, the weighted median and MR-Egger approaches were used as the sensitivity analysis. Additionally, the significantly associated single nucleotide polymorphisms (SNPs) in salicylic acid (INTERVAL and EPIC-Norfolk, n = 14,149) were chosen to assess the potential effects of aspirin on lowering Lp(a) levels. The IVW analysis showed that the per standard deviation (SD) increment in Lp(a) level was causally associated with a higher risk of coronary artery disease (odds ratio (OR), 1.237; 95% confidence interval (CI), 1.173-1.303), atrial fibrillation (OR, 1.030; 95% CI, 1.011-1.050), heart failure (OR, 1.074; 95% CI, 1.053-1.096), hypertension (OR, 1.006; 95% CI, 1.004-1.008), and peripheral artery disease (OR, 1.001; 95% CI, 1.001-1.001) (all A causal nexus was discerned between Lp(a) levels and an increased risk of conditions including coronary artery disease, atrial fibrillation, heart failure, hypertension, and peripheral artery disease. Furthermore, administering aspirin may be a potential therapeutic to reduce these CVD risks among individuals with elevated Lp(a) levels. Show less
Although light-intensity physical activity (LPA) has been suggested to be associated with a lower risk of mortality, the minimal and optimal volumes of LPA remain unclear. We aimed to examine the mini Show more
Although light-intensity physical activity (LPA) has been suggested to be associated with a lower risk of mortality, the minimal and optimal volumes of LPA remain unclear. We aimed to examine the minimal and optimal volumes of LPA associated with the risks of mortality and disease incidence (i.e., cardiovascular diseases and cancer). Data were derived from the population-based UK Biobank cohort study, including 69,492 adults aged 43-78 years. Accelerometer-measured LPA was defined using a validated, published machine learning-based Random Forest activity method, which was categorized into 4 quartile groups. All-cause and cause-specific mortality (cardiovascular disease- and cancer-specific) were determined according to the International Classification of Diseases, 10th version codes. Disease incidence was defined based on primary care, hospitalization, or death records. During a median follow-up period of 8.04 years, 2024 adults died from all causes, 539 from cardiovascular disease, and 1175 from cancer. For all-cause mortality, compared with participants in the lowest quartile of LPA (<3.9 h/day), the hazard ratios (HRs) and 95% confidence intervals (95%CIs) were 0.82 (95%CI: 0.73‒0.93) for those with 3.9 to <5.0 h/day, 0.75 (95%CI: 0.66‒0.85) for those with 5.0 to <6.1 h/day, and 0.77 (95%CI: 0.68‒0.88) for those with ≥6.1 h/day, respectively. There was an inverse non-linear dose-response association between LPA and all-cause mortality, with an optimal dose of 5.72 h/day (95%CI: 5.45‒6.41; HR = 0.63, 95%CI: 0.56‒0.71) and a minimal dose of 3.59 h/day (95%CI: 3.53-8.56; HR = 0.81, 95%CI: 0.78‒0.86), with the 5th percentile as the reference. Similar patterns were observed for cause-specific mortality and disease incidence (cardiovascular disease and cancer). Engaging in LPA for ∼3.5 h/day was conservatively associated with lower risk of mortality and disease incidence, with further risk reductions observed up to an optimal dose of ∼6.0 h/day. These findings suggest that sufficient LPA offers important health benefits, which can inform the development of future PA guidelines. Show less
Incontinence-associated dermatitis (IAD) is a common nursing challenge in clinical practice, imposing a significant burden on both patients and healthcare providers. Studies have reported that nurses' Show more
Incontinence-associated dermatitis (IAD) is a common nursing challenge in clinical practice, imposing a significant burden on both patients and healthcare providers. Studies have reported that nurses' preventive attitudes toward IAD significantly influence its prevalence, and there may be a potential association between achievement motivation and these attitudes. Previous research on nurses' preventive attitudes toward IAD has primarily focused on overall levels, overlooking potential heterogeneity within the population. This study aimed to investigate the heterogeneity in clinical nurses' preventive attitudes toward IAD using a person-centered approach and to identify the influencing factors for different subgroups. A secondary aim was to utilize Self-Determination Theory (SDT) to elucidate the relationship between the identified attitude profiles and nurses' achievement motivation, thereby providing targeted strategies to enhance their preventive attitudes. This study selected 1058 clinical nurses from a tertiary hospital in Fujian, China, as research participants from September to October 2024. The study utilized the following instruments: a general information questionnaire, the Attitude Toward the Prevention of Incontinence-Associated Dermatitis Instrument, and the Achievement Motivation Scale. Latent profile analysis (LPA) was employed to identify the latent profiles of nurses' attitudes toward IAD prevention. At the same time, Two subgroups of nurses' attitudes toward IAD prevention were identified: the low-level group (63.42%) and the high-level, low-personal-responsibility group (36.57%). A significant correlation was found between nurses' attitudes toward IAD prevention and achievement motivation. Nurses with a more positive preventive attitude scored higher on the motivation for success dimension, while those with a less positive attitude scored higher on the motivation to avoid failure dimension. Factors influencing nurses' attitudes toward IAD prevention included position, department, number of participants in wound/ostomy/incontinence care training, satisfaction with the work atmosphere, and achievement motivation scores. This study revealed heterogeneity in nurses' attitudes toward IAD prevention. Nurses with positive attitudes tended to adopt a success-driven approach, while those with relatively negative attitudes leaned toward a failure-avoidance strategy, reflecting two fundamentally distinct coping mechanisms. Nursing managers should address these individual differences by targeting achievement motivation as an intervention point. Management strategies should be tailored to the distinct profiles; for instance, interventions for the "low-level group" should prioritize building competence through structured training, while strategies for the "high-level, low-personal-responsibility group" should focus on enhancing autonomy and personal accountability. By adopting such targeted approaches, managers can more effectively enhance nurses' preventive attitudes, thereby improving care quality and reducing IAD incidence. Show less
Impaired decidualization is associated with recurrent implantation failure (RIF) and lysophosphatidic acid (LPA) is known to play an important role in decidua formation. However, the specific impact o Show more
Impaired decidualization is associated with recurrent implantation failure (RIF) and lysophosphatidic acid (LPA) is known to play an important role in decidua formation. However, the specific impact of LPA in endometrial decidualization during RIF remains unclear. Metabolomics analysis was performed to identify differentially expressed metabolites (DEMs) in RIF patients Expression of the LPA receptor subtypes, LPAR1-6, was detected in both GEO datasets and clinical endometrial samples. An LPA was identified as a pivotal metabolite in RIF. Among the LPA receptors, LPAR1 and LPAR6 were highly expressed during LPA plays a significant role in the decidualization process of hESCs by regulating LPAR6, rather than LPAR1, providing insights into potential therapeutic target for RIF. Show less
Lp(a) (lipoprotein [a]) and coronary artery calcium score (CACS) are independently associated with atherosclerotic cardiovascular disease (ASCVD) risk. This study aimed to investigate sex-specific pro Show more
Lp(a) (lipoprotein [a]) and coronary artery calcium score (CACS) are independently associated with atherosclerotic cardiovascular disease (ASCVD) risk. This study aimed to investigate sex-specific prognostic differences between Lp(a) and CACS in ASCVD risk. We analyzed 4651 participants from the Multi-Ethnic Study of Atherosclerosis, grouped by sex. Multivariable Cox regression analysis was performed to evaluate the prognostic value of Lp(a) and CACS for ASCVD risk in both sexes. The predictive performance of these factors was compared in men and women. During a median follow-up of 13.84 years, 465 ASCVD events were recorded (272 in men and 193 in women). Multivariable Cox regression analysis revealed that both elevated Lp(a) and CACS were independent predictors of ASCVD risk in both sexes. The C-index analysis demonstrated that CACS provided incremental prognostic value over Lp(a) in men (C-index: 0.732 versus 0.714; Although both Lp(a) and CACS independently predict ASCVD risk in both sexes, the predictive value of Lp(a) varies significantly between men and women across different CACS categories. These findings may inform sex-specific strategies for primary prevention of ASCVD. Show less
Premature coronary artery disease (PCAD) is characterized by early onset, rapid progression, and poor prognosis, which seriously affects patients' health and quality of life. In this study, we analyze Show more
Premature coronary artery disease (PCAD) is characterized by early onset, rapid progression, and poor prognosis, which seriously affects patients' health and quality of life. In this study, we analyzed the proteomic network and biological pathways of PCAD patients by bioinformatics methods, and mined out the key differential proteins, which provided a theoretical basis for clinical intervention. Patients who attended the heart center of the First Affiliated Hospital of Xinjiang Medical University from January 2023 to December 2024 and completed coronary angiography were selected. According to the relevant inclusion and exclusion criteria, a total of 129 patients were included, including 69 in the PCAD group and 60 in the control group. The clinical baseline data of the patients were systematically analyzed. Plasma protein extraction, trypsin digestion and mass spectrometry were completed. The mass spectrometry data were initially separated with the help of proteomics software, and the differential proteins were functionally enriched by RStudio software. Protein interaction networks were constructed by STRING platform and core differential proteins screened were visualized using Cytoscape software (MCODE plug-in). Differences in gender, smoking, alcohol consumption, hypertension, diabetes, HDL-C, Glu, FIB, LPa, NT-pro-BNP, PCT, and IL-6 were statistically significant (P < 0.05). Sex (P = 0.009, OR = 6.782,95% CI: 1.600-28.746), FIB (P = 0.001, OR = 2.662,95% CI: 1.471-4.818), and LPa (P = 0.041, OR = 1.002,95% CI: 1.000-1.004) were independent risk factors for PCAD. A total of 348 up-regulated proteins and 92 down-regulated proteins were screened by bioinformatics analysis. The occurrence of PCAD is associated with protein synthesis, intercellular communication, molecular interactions, ribosomal metabolism, glyoxylate and dicarboxylic acid metabolic pathways. Ribosomal and translational proteins influence the development of PCAD. In this study, we found that gender, FIB, and LPa are risk factors for PCAD. The analysis identified 348 up-regulated and 92 down-regulated proteins. Among them, the differentially expressed proteins DHX9, F7, APCS, and PROC were closely related to the biological process of PCAD. The screened ribosomal and translational proteins showed high-frequency associations in protein-protein interaction networks, providing potential differentially expressed proteins for a deeper understanding of the disease. Show less
Patients with maintenance hemodialysis (MHD) present endothelial dysfunction (ED), which is characterized by impaired vasodilation and a pro-inflammatory state. Lipoprotein(a) (Lp(a)) has pro-inflamma Show more
Patients with maintenance hemodialysis (MHD) present endothelial dysfunction (ED), which is characterized by impaired vasodilation and a pro-inflammatory state. Lipoprotein(a) (Lp(a)) has pro-inflammatory and pro-atherogenic properties. No study has investigated the association between serum Lp(a) and ED in patients with MHD. This study was conducted to address this issue. We collected serum specimens from 123 fasting MHD patients. The endothelial function was measured using the vascular reactivity index (VRI) determined by digital thermal monitoring, and VRI values of ≥ 2.0, 1.0 to <2.0, and < 1.0, indicated good, intermediate, and poor vascular reactivity, respectively. Lp(a) levels were measured by enzyme-linked immunosorbent assay. Of the 123 MHD patients, 54 (43.9%) had good VRI, 51 (41.5%) had intermediate VRI, and 18 (14.6%) had poor VRI. Serum Lp(a) levels ( The serum Lp(a) level had a negative correlation with the VRI, and it may serve as a potential biomarker for early detection of ED in MHD patients. Show less
Zhige Yan, Xiajun Guo, Ying Hu+2 more · 2025 · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · Springer · added 2026-04-24
To elucidate the accurate roles of dysfunctional sleep beliefs in modulating cancer-related fatigue (CRF), identify distinct sleep hygiene profiles, and assess whether and how these profiles serve as Show more
To elucidate the accurate roles of dysfunctional sleep beliefs in modulating cancer-related fatigue (CRF), identify distinct sleep hygiene profiles, and assess whether and how these profiles serve as mediators in lung cancer patients undergoing chemotherapy. This study recruited 396 lung cancer patients receiving chemotherapy between May and December 2023. Participants completed the Sleep Hygiene Index, Brief Fatigue Inventory, and Dysfunctional Beliefs and Attitudes about Sleep Scale. Latent profile analysis (LPA) was conducted to identify profiles of sleep hygiene, and mediation analysis was performed to explore the impacts of sleep hygiene profiles and dysfunctional sleep beliefs on CRF. LPA revealed three distinct sleep hygiene profiles: normal (33.3%), excellent (50.3%), and poor (16.4%). Family monthly disposable income, radiotherapy, and performance status were identified as influential factors distinguishing these profiles. Additionally, the dimensions of dysfunctional sleep beliefs and sleep hygiene profiles showed different correlations with CRF. With the normal sleep hygiene group as reference, mediation analysis revealed that poor sleep hygiene serves as a mediator between sleep worry of dysfunctional sleep beliefs and CRF (SE = 0.010, 95% CI [0.006, 0.047]). This study contributes to understanding the heterogeneity in sleep hygiene in lung cancer patients undergoing chemotherapy and elucidates the underlying mechanisms of the relationship between sleep worry of dysfunctional cognitions and CRF. Clinical healthcare providers developing targeted interventions in terms of sleep beliefs and sleep hygiene might be helpful to alleviate CRF in this population. Show less
The competency of specialist nurse clinical educators is crucial for the effectiveness of specialist nurse training programmes. However, variability in teaching competency and training needs among edu Show more
The competency of specialist nurse clinical educators is crucial for the effectiveness of specialist nurse training programmes. However, variability in teaching competency and training needs among educators remains insufficiently studied, especially in the context of rapidly evolving healthcare education in China. This study aimed to identify distinct core competency profiles among clinical educators for specialist nurses, examine associated socio-demographic factors, and explore differences in training needs across profiles. A cross-sectional online survey was conducted with 3,945 specialist nurse clinical educators from 30 Chinese regions. The Chinese version of the Nurse Educator Core Competency Scale (NECCS) and a self-developed training needs questionnaire were used. Latent Profile Analysis (LPA) identified competency subgroups, while multinomial logistic regression and Kruskal-Wallis tests examined associated variables and training needs. Latent Profile Analysis identified three competency profiles: foundational (8.6%), intermediate (43.0%), and advanced (48.4%), with mean scores of 43.89, 68.24, and 91.68, respectively. Educators without prior training were significantly more likely to belong to the foundational (OR = 3.195, p < 0.001) and intermediate (OR = 1.676, p < 0.001) groups compared to those with training experience. Advanced-competency educators showed the highest demand for curriculum design training, with 75% rating it as highly necessary. In contrast, educators in the intermediate group identified clinical teaching methods and techniques as their top training need (58.7%). Those in the foundational group prioritised common pedagogical methods and instructional technologies (54.7%). Clinical educator competencies vary by background characteristics and training exposure. Tailored, competency-based training is needed to address these gaps and enhance the quality of specialist nursing education. Show less