👤 Zhen Sun

Skeletal muscle atrophy is a common complication of heart failure, with myocardial infarction (MI) being the primary cause. Yet, the mechanisms linking post-MI cardiac insufficiency to muscle atrophy have remained unclear. The molecular basis for the beneficial effects of exercise on exercise intolerance in MI patients also remains absent. Serum IL-27 levels were measured in 48 MI patients and correlated with cardiac injury markers. Along with this, a rat model of post-MI cardiac insufficiency was used to assess skeletal muscle mass, cross-sectional area (CSA) of muscle fibers, and the expression of atrophy-related (MAFbx, MuRF-1) and differentiation-related markers (MyoD, Myogenin). The impact of exercise on muscle atrophy, cardiac inflammation, and IL-27 expression was then evaluated, with a focus on macrophage polarization. Serum IL-27 level was significantly elevated in MI patients and that it was positively correlated with myocardial injury and cardiac insufficiency. In post-MI rats, skeletal muscle mass and CSA of muscle fibers were reduced. Meanwhile, the expression level of myogenic markers was downregulated, while that atrophy markers was upregulated. IL-27 treatment promoted catabolism in L6 myotubes, and of note, HIF-1α overexpression in macrophages enhanced IL-27 secretion, and increased MAFbx and MuRF-1 expression. IL-27 level was also elevated in the heart, serum, and gastrocnemius muscle of MI rats. Exercise counteracted these effects by promoting M2-like macrophage polarization and suppressing HIF-1α, thereby reducing IL-27 expression. Furthermore, exercise ameliorated IL-27-induced muscle atrophy via the WSX-1/gp130/pSTAT3 signaling axis. IL-27 contributes to muscle atrophy in post-MI cardiac insufficiency. Exercise attenuates IL-27-driven muscle wasting by modulating inflammation and promoting M2-like macrophage polarization. These findings provide insights into the mechanisms of MI-induced muscle atrophy and highlight the therapeutic potential of exercise in cardiac rehabilitation. [Image: see text] The online version contains supplementary material available at 10.1186/s12967-025-07527-7. Show less

Parkinson's disease (PD) involves heterogeneous neurodegenerative processes across brain cell types. The cell-type-specific effects of genetic risk remain unclear. We aimed to identify cell-type-specific causal genes for PD and to link genetic risk to molecular mechanisms and therapeutic opportunities. We performed the first cell-stratified Mendelian randomization integrating single-cell expression quantitative trait loci data from eight brain cell types with large PD genome-wide association studies datasets, followed by validation, neuropathological correlation, and postmortem expression analyses. Thirteen significant causal associations for four genes (ARL17A, ARL17B, KANSL1, LRRC37A) were identified across seven cell types, with consistent replication. ARL17A increased risk, whereas ARL17B, KANSL1, and LRRC37A were protective. Gene expression correlated with disease severity and showed cell-type-specific dysregulation. Drug-gene interaction screen highlighted US Food and Drug Administration-approved agents including raloxifene and dorzolamide as potential therapeutic modulators. This study contributed to cell-type-specific genetic mechanisms in PD, linking risk variants to molecular alterations and nominating therapeutic targets. © 2026 International Parkinson and Movement Disorder Society. Show less

In recent years, the impact of lipoprotein(a) (Lp(a)) on the prognosis of coronary heart disease has been increasingly recognized. Lp(a) is an independent risk factor for cardiovascular disease, and studies have shown that homocysteine (HCY) may influence the association between Lp(a) and the risk of recurrent cardiovascular events. This study investigates the association between Lp(a) levels and recurrent cardiovascular events in patients with varying HCY concentrations. We conducted a 36-month follow-up on 530 patients with coronary heart disease and divided them into low-Lp(a) and high-Lp(a) groups based on Lp(a) levels. The incidence rates of major adverse cardiovascular events (MACE) and acute coronary events (ACE) were compared between the two groups. The association between elevated Lp(a) and cardiovascular risk in different subgroups(based on HCY concentration) was analyzed using Kaplan-Meier curves and Cox proportional hazards models. Elevated Lp(a) remained a significant risk factor for both MACE (HR = 2.07, 95% CI = 1.37-3.12, P = 0.001) and ACE (HR = 2.83, 95% CI = 1.67-4.81, P = 0.001) overall. In subgroup analyses, elevated Lp(a) in patients with moderate-to-high HCY levels constituted a high-risk cohort for MACE and ACE occurrence (HR = 1.87, 95% CI = 1.01-3.46, P = 0.046;HR = 2.85, 95% CI = 1.32-6.18, P = 0.008). Among those with low HCY levels, elevated Lp(a) showed no association with either MACE or ACE (P > 0.05). When HCY is elevated, patients with increased Lp(a) experience amplified risk of recurrent cardiovascular events. This association shifts when HCY is at low levels. Future efforts should emphasize combined assessment of Lp(a) and HCY and explore targeted intervention strategies to reduce residual cardiovascular risk. Show less

Obesity results from the interaction of polygenic susceptibility and environmental factors. Given this complex etiology, physical activity (PA) remains a cornerstone of cost-effective intervention strategies. This longitudinal natural experiment investigated how PA modifies the effects of genetic predisposition on obesity in Chinese youth. We conducted a 4-year natural experiment leveraging curriculum-driven PA disparities in a specialized arts school (n = 591), creating distinct high-PA (HPA) and low-PA (LPA) exposure groups. Weighted genetic risk scores (WGRSs) were calculated from 13 Asian-derived obesity-related single-nucleotide polymorphisms. Annual anthropometric, metabolic, and lifestyle data were analyzed using generalized linear mixed models to assess gene-PA interactions on obesity. The WGRS predicted baseline obesity measures, with each unit increase associated with a 0.21-kg/m² higher BMI. Over the natural experiment period, BMI increases in the HPA group were smaller than in the LPA group. After adjusting for age, sex, ethnicity, and dietary factors, significant WGRS-PA interactions were observed for BMI trajectories. Participants with higher genetic risk for obesity experienced greater BMI and weight reduction benefits from sustained long-term PA. In summary, the present study identified a significant interaction effect between PA levels and WGRS in modifying BMI trajectories. Genetic susceptibility significantly modifies the protective effects of long-term PA on BMI progression in this cohort of Chinese youth. Show less

The quality of informal care for people with dementia (PwD) has gained increasing importance, as most PwD prefer home-based care over institutional placement. However, evidence-based intervention programs tailored to distinct care quality profiles remain limited. Additionally, the absence of clear thresholds to identify PwD receiving low-quality informal care poses a challenge for research and clinical practice. Thus, this study aimed to identify the profiles of quality of care (QoC) among informal caregivers of PwD, explore influencing factors of different profile, and determine the optimal cut-off score of the Exemplary Care Scale (ECS). A cross-sectional survey was conducted. A total of 213 dyads of PwD and their informal caregivers were recruited from memory clinic, rehabilitation clinic, and neurological clinic of a tertiary hospitals and communities in Wuhan, Hubei, China, between July 15, 2023, and July 14, 2024. Latent profile analysis (LPA) was employed to identify QoC profiles. Multinomial logistic regression was performed to explore influencing factors of profile membership. Receiver Operating Characteristic (ROC) analysis was conducted to determine the ECS cut-off score. Three distinct QoC profiles were identified: high (24.41%), moderate (44.60%), and low (30.99%). Among informal caregivers, lower monthly income, insufficient social support, and higher perceived overload were associated with low QoC profile, whereas, better quality of pre-illness relationship with PwD and greater activities of daily living (ADL) of PwD were associated with high QoC. ROC analysis yielded an optimal ECS cut‑off score of 15, with high sensitivity (0.993) and specificity (0.955). This study identified three distinct QoC profiles among caregivers of PwD, underscoring the heterogeneity of informal care quality. The identified predictors and the validated ECS cut‑off score of 15 provide an empirical basis for developing tailored screening tools and targeted interventions for high‑risk caregiver subgroups. Show less

Enzyme immobilization is critical for enhancing enzyme stability and reusability. Catalytically active inclusion bodies (CatIBs) have emerged as a promising immobilization strategy due to their straightforward production, ease of separation, and high purity. Unlike traditional cross-linked enzyme aggregates (CLEAs) that require a precipitation step, CatIBs form through carrier-free self-aggregation during expression. To overcome the limitations of conventional methods, a novel technique has been developed in this study, focusing on L-phenylserine aldolase (LPA) as the model enzyme. A hybrid tag (HLHLHL) was fused to the N-terminus of LPA to generate 3HL-LPA, which promotes the formation of active inclusion bodies. Based on structural prediction and surface properties, the active aggregation process of 3HL tags through electrostatic interactions and hydrophobic interactions was analyzed. Innovatively, we combined CatIBs and CLEAs technologies to develop novel CatIBs-CLEAs. For comparison, a control was prepared by fusing a hexahistidine tag (HHHHHH) to LPA's N-terminus (6H-LPA) to enhance soluble expression, followed by conventional CLEAs preparation. Results showed that CatIBs-CLEAs achieved an activity recovery of 69.87% after glutaraldehyde crosslinking, significantly higher than the 48.1% for conventional CLEAs. CatIBs-CLEAs also exhibited superior thermal stability across temperatures, high stability between pH 5-9, and retained over 70% activity after seven batch cycles. The integrated CatIBs-CLEAs technology combines the production advantages of CatIBs with the stability benefits of CLEAs, offering a promising strategy for designing efficient, robust industrial biocatalysts with broad application potential. Show less

Capillary zone electrophoresis (CZE)-mass spectrometry (MS) has attracted tremendous attention in top-down proteomics (TDP). However, its reproducibility and long-term repeatability for TDP remain concerns, most likely due to capillary coating. Here, we present an improved procedure for making linear polyacrylamide (LPA) coating, the most widely used coating in CE-MS-based proteomics, to boost the reproducibility and long-term repeatability of CZE-MS-based TDP. We focused on the step of degassing the polymerization solution, a critical step for achieving consistent LPA coating quality. The CZE-MS system using LPA-coated capillaries prepared with the optimal degassing procedure produced excellent reproducibility and repeatability for proteoform analysis. The 210 CZE-MS runs of three protein samples (a standard protein mixture, an Show less

To evaluate the predictive value of novel lipid parameters for coronary lesion severity in pCAD and to develop a nomogram-based prediction model. Patients newly diagnosed with pCAD at Qingdao Municipal Hospital (2021-2024) were enrolled and randomly assigned to training and validation cohorts in a 7:3 ratio. Coronary lesion severity was assessed using the Gensini score (GS), with patients stratified into mild or significant stenosis groups. Spearman correlation analysis was performed between GS and lipid parameters. Key predictors were selected using LASSO regression, and independent risk factors were identified by multivariable logistic regression to construct the nomogram model. The model's discrimination, calibration, and clinical utility were evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Lp(a), non-HDL-C, RC, FFA, and BAR were positively correlated with GS (r = 0.34, 0.34, 0.18, 0.19, 0.18; all The proposed nomogram provides an effective tool for identifying pCAD patients with severe coronary artery stenosis, demonstrating robust predictive accuracy and potential clinical utility. Show less

Older adults typically have higher sedentary behaviour (SB) and lower physical activity (PA) than younger adults. Studies on replacing SB with PA in relation to all-cause mortality in racially diverse older adults remain limited. This study included 122 966 older adults from the China Kadoorie Biobank (CKB) and 207 212 older adults from the UK Biobank (UKB). SB and PA were assessed using baseline questionnaires, with PA classified as light (LPA), moderate (MPA) or vigorous (VPA) based on metabolic equivalents. Cox proportional hazards models and isotemporal substitution models were used to examine the associations between replacing SB with different PA intensities and all-cause mortality. Longer SB (per 30 min/day increase) was associated with a higher risk of all-cause mortality in both cohorts (CKB: HR 1.013, 95% CI 1.010 to 1.017; UKB: HR 1.012, 95% CI 1.009 to 1.015). PA of any intensity was associated with a reduced risk of all-cause mortality. In the CKB, replacing 30 min/day of SB with an equivalent duration of PA showed comparable protective associations (LPA: HR 0.963, 95% CI 0.958 to 0.968; MPA: HR 0.967, 95% CI 0.961 to 0.972; VPA: HR 0.965, 95% CI 0.960 to 0.971). In the UKB, replacing 30 min/day of SB with VPA was associated with the largest reduction in mortality risk (HR: 0.950, 95% CI 0.931 to 0.970). Replacing SB with PA of any intensity was associated with reduced all-cause mortality risk in older adults, with variations across populations. These findings highlight the need for population-specific PA recommendations to promote healthy ageing. Show less

Cardiovascular disease (CVD) is the leading cause of death among older adults, with sedentary behavior (SB) as a key modifiable risk factor. While physical activity (PA) is associated with cardiovascular health, evidence remains limited on the specific effects of replacing SB with PA of varying intensities. To systematically review evidence on the cardiovascular effects of substituting SB with PA in adults aged 65 and older using isotemporal substitution modeling (ISM). Following PRISMA guidelines, seven databases were searched up to April 2025. Risk of bias was assessed using the JBI tool, and a narrative synthesis was conducted. Eighteen observational studies (15 cross-sectional, 3 cohorts) using ISM were included. Replacing 10-60 min of SB with moderate-to-vigorous PA (MVPA) was associated with more favorable in blood pressure, triglycerides, waist circumference, inflammatory markers (CRP, IL-6, GDF-15), and insulin sensitivity (HOMA-IS, Matsuda-ISI). Light-intensity PA (LPA) showed modest associations, particularly among frail or mobility-limited individuals. A daily substitution of 30 min was identified as a feasible reference window, with ≥60 min linked to additional vascular and autonomic benefits. Replacing SB with PA, especially MVPA, was consistently associated with favorable cardiovascular profiles in older adults. Even brief substitutionsmay be beneficial, supporting intensity-stratified public health strategies and refinement of physical activity guidelines for aging populations.Because most included studies were cross-sectional, these findings should be interpreted as associations rather than definitive causal effects, and reverse causation remains a plausible concern. https://www.crd.york.ac.uk/prospero/view/CRD420251021829/1/0, PROSPERO CRD420251021829. Show less

Flourishing is a key positive psychological construct that has been linked to favorable health-related outcomes in patients with inflammatory bowel disease in prior research. However, current research often overlooks the variations in flourishing levels within this population, as well as the mechanisms through which flourishing interacts with disease progression. This study aimed to identify latent categories of flourishing among patients with inflammatory bowel disease and to analyze the potential influencing factors. This study employed a cross-sectional, descriptive exploratory design involving 316 patients diagnosed with inflammatory bowel disease. Data collection was carried out using a general information questionnaire, the Flourishing Scale (FS), the IBD Self-Efficacy Scale (IBD-SES), the Resilience Scale for Inflammatory Bowel Disease (RS-IBD), and the Social Support Rating Scale (SSRS). Latent profile analysis (LPA) was utilized to identify potential subgroups exhibiting flourishing, while multiple logistic regression analysis was conducted to evaluate the influencing factors. The flourishing of individuals with inflammatory bowel disease was classified into three latent groups: the low flourishing-low support beneficiary group ( Patients with inflammatory bowel disease demonstrate three distinct latent categories of flourishing. Healthcare professionals should implement more accurate and targeted intervention measures based on the characteristics and influencing factors of different potential categories, in order to improve the flourishing levels of patients with inflammatory bowel disease. Show less

High-grade serous ovarian cancer (HGSC) is the most aggressive subtype of ovarian epithelial cancer (OEC), with characters of late-stage diagnosis, high recurrence rate, and poor survival outcomes. Fucosyltransferase 8 (FUT8) is responsible for α1,6-core fucosylation biosynthesis, and aberrant FUT8/α1,6-core fucosylation level is involved in tumor progression. However, the roles and mechanisms of protein FUT8 and α1,6-core fucosylation in HGSC tumorigenesis and progression remain elusive. Here, our study confirms that elevated levels of FUT8/α1,6-core fucose in the tissues and serum of HGSC patients, and the elevation is associated with poor patient prognosis. By applying glycoproteomic assay, we globally screen and identify NCEH1 as the specific scaffold protein of α1,6-core fucosylation. Alpha 1,6-core fucose modification stabilizes NCEH1 by preventing its degradation through proteasomal pathway. Importantly, combined with non-targeted metabolomics analysis, α1,6-core fucosylated NCEH1 facilitates LPA secretion, driving M2-like polarization of tumor-associated macrophages in the tumor microenvironment, thus leading to oncogenesis and peritoneal metastasis of HGSC in vitro and in vivo. These findings broaden the understanding of FUT8/α1,6-core fucosylation/NCEH1 in HGSC progression and metastasis, and offer glycosylated diagnostic indicators and targets for therapeutic strategies in HGSC. Show less

Autotaxin (ATX), the enzyme responsible for generating lysophosphatidic acid (LPA), is a validated target for fibrosis and cancer immunotherapy. Current ATX inhibitors face challenges related to insufficient efficacy or safety concerns, reflecting trade-offs between zinc engagement and selectivity. Here, we report a rigid triazolyl-azabicyclo[3.1.0]hexanyl-oxadiazolyl-pyrimidine scaffold developed through structure-based design, designed to potentially enhance ATX selectivity by promoting defined binding geometry. Systematic studies identified 14e as the most potent inhibitor (IC Show less

This study aimed to identify heterogeneous profiles of self-neglect (ESN) and their associated factors among rural Chinese older adults with chronic diseases. A cross-sectional survey was conducted among 719 rural older adults with chronic diseases in Sichuan, China, from January to June 2020. The questionnaire included sociodemographic and health-related characteristics, as well as the Three-Item UCLA Loneliness Scale (UCLALS-3), the Social Support Rating Scale (SSRS), the Scale of Older Adults Self-Neglect (SESN), the Five-Item Geriatric Depression Scale (GDS-5), and the Short Portable Mental Status Questionnaire (SPMSQ). Latent profile analysis (LPA) was conducted to identify distinct patterns of patterns of self-neglect among older adults (ESN). Four profiles were identified: low-level neglect (35.0%), selective mild neglect (37.7%), moderate neglect (14.7%), and severe neglect (12.5%). Compared with the low-level neglect group, selective mild neglect was more common among participants with poorer economic status, poor sleep quality, and alcohol consumption. The moderate neglect profile was associated with older age, lack of regular physical examinations, smoking, pain, cognitive impairment, and lower social support. Severe neglect was marked by the absence of grandchild caregiving, higher loneliness, smoking, and depression. Pairwise comparisons indicated stage-dependent patterns, with reversed associations for social support (protective in moderate neglect but a risk marker in severe neglect) and pain (a risk factor in moderate neglect, whereas its absence indicated higher risk in severe neglect). ESN among older adults with chronic diseases in rural China is heterogeneous and comprises distinct latent profiles with stage-dependent risk factors. For selective mild neglect, interventions should emphasize economic and lifestyle support. For moderate neglect, priorities include routine monitoring, regular physical examinations, and health literacy promotion. For severe neglect, intensive psychosocial interventions should address depression and loneliness and promote alternative engagement in family roles, particularly among older adults who do not provide grandchild caregiving. Integrating these profile-specific strategies into rural primary care may help reduce self-neglect and improve health outcomes in this vulnerable population. Show less

Influenza vaccination coverage among older adults in China is low. We sought to identify latent vaccine-hesitancy profiles and their correlates. This community-based cross-sectional survey from May to July 2025 involved 1773 older adults from various areas in Jiangsu province. Data were collected via Wenjuanxing and included demographics, the Influenza Vaccine Hesitancy Scale, and the vaccine literacy scale. Group differences were examined using chi-square tests and one-way ANOVA; latent profile analysis (LPA) identified vaccine hesitancy subgroups, and multinomial logistic regression estimated correlates of profile membership. Three profiles emerged: Low Hesitancy (23.0%), Moderate Hesitancy (35.0%), and High Hesitancy (42.0%). Rural residence predicted Moderate (OR = 2.030) and High (OR = 2.993) hesitancy. Lower household income and chronic disease were associated with the Moderate Hesitancy profile, whereas male sex was associated with the High Hesitancy profile. Higher interactive (OR = 0.686) and critical (OR = 0.599) vaccine literacy were inversely associated with High hesitancy.Concerns about vaccine quality predicted both Moderate (OR = 1.433) and High (OR = 1.376) groups; knowledge gaps and fear of adverse reactions concentrated in the High group. Older adults show heterogeneous vaccine hesitancy phenotypes. Uptake efforts should move beyond one-size-fits-all messaging toward segmented strategies. These strategies should integrate cost-related measures with literacy-sensitive, trust-oriented communication, prioritizing rural residents, older men, and those with chronic conditions. The reported proportions of hesitancy profiles reflect our sample only and should not be viewed as nationally representative. Show less

This study examined heterogeneous patterns of trauma-related adaptation among Chinese adolescents during the post-COVID-19 recovery phase, focusing on the co-occurrence of posttraumatic distress (PTD) and posttraumatic growth (PTG). We also investigated how modifiable psychosocial protective and vulnerability factors were associated with membership in different adaptation profiles. A large-scale cross-sectional survey was administered to 5, 044 students (aged 9-17 years; 46.6% male) from 15 primary and secondary schools in Wuhan, China. Validated instruments assessed posttraumatic stress symptoms (PCL-C), posttraumatic growth (PTGI), depressive symptoms (CES-D), and anxiety (SAS). Protective and vulnerability factors included resilience (CD-RISC), perceived social support (SSRS), physical activity (PARS-3), school belonging (PSSM), adaptive coping (SCSQ), and trait anxiety (TAI). Latent profile analysis (LPA) was used to identify adaptation profiles, and multinomial logistic regression examined how modifiable psychosocial factors were associated with profile membership. LPA revealed four empirically derived profiles: a High Distress/High Growth-Moderate PTSD profile (76.9%), a Low Distress-High Growth profile (4.8%), a Low Growth-Moderate Distress profile (3.9%), and a High Distress/High Growth-High PTSD profile (14.4%). The vast majority of adolescents showed some degree of both PTD and PTG, consistent with dual-process perspectives. In multinomial models, higher resilience, social support, school belonging, adaptive coping, and physical activity were associated with greater likelihood of belonging to the Low Distress-High Growth profile rather than more distressed profiles, whereas higher trait anxiety was associated with increased odds of membership in profiles characterized by greater distress. In this large school-based sample of Chinese adolescents, distress and growth frequently co-occurred and clustered into distinct adaptation profiles that differed systematically in psychosocial resources. Resilience, social connectedness, school belonging, and physical activity emerged as promising targets for trauma-informed, school-based support, whereas trait anxiety appeared to mark heightened vulnerability. Given the cross-sectional and single-region design, these findings should be interpreted as exploratory, and longitudinal and cross-cultural studies are needed to clarify temporal and contextual influences on adolescent trauma adaptation. Show less

Lipoprotein(a) [Lp(a)] has been recognized as a genetically determined and independent contributor to atherosclerotic cardiovascular disease. However, its role in lower extremity arterial disease (LEAD) among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remains insufficiently studied. Given the overlapping metabolic disturbances in both conditions, such as insulin resistance and lipid abnormalities, a potential relationship between Lp(a) and peripheral vascular injury in MASLD is biologically plausible. This study aimed to investigate the cross-sectional association between circulating Lp(a) concentrations and the presence of LEAD in a well-characterized MASLD population. A total of 468 MASLD patients undergoing routine health check-ups were included. Lp(a) levels were stratified into three categories: <10 mg/dL, 10–30 mg/dL, and ≥ 30 mg/dL. LEAD was diagnosed using duplex ultrasonography. Multivariable logistic regression models were used to assess the relationship between Lp(a) levels and the presence of LEAD, with adjustments for demographic variables, metabolic conditions, and lipid-related parameters. Subgroup analyses were conducted to assess potential effect modification. LEAD was diagnosed in 61.5% ( Elevated Lp(a) levels were associated with a higher prevalence of LEAD in patients with MASLD. Although the magnitude of association per unit increase was modest, higher Lp(a) concentrations were associated with greater LEAD prevalence. These findings should be interpreted cautiously and viewed as hypothesis-generating, particularly with respect to subgroup analyses. Prospective studies are needed to clarify causality and clinical relevance. The online version contains supplementary material available at 10.1186/s12872-026-05600-7. Show less

Inadequate childbirth readiness can adversely affect the birthing experience of pregnant women and may even influence their willingness to have further children. This study aimed to explore the determinants of childbirth readiness and the network relationships among these factors, thereby providing evidence to improve childbirth readiness. This cross-sectional study surveyed 350 pregnant women attending Wuxi Maternity and Child Health Care Hospital. Latent profile analysis (LPA) was first performed using the four domains of the Childbirth Readiness Scale to identify subgroups of childbirth readiness, and potential associated factors were then screened using univariate analysis and multinomial logistic regression. A Bayesian network model was employed to construct the structural relationships of factors influencing childbirth readiness. Childbirth readiness was categorised into three levels: poor (26%), good (30.9%), and complete (43.1%). Univariate analysis revealed significant differences across the three categories in relation to age, parity, pregnancy complications, antenatal exercise, planned pregnancy, self-efficacy, eHealth literacy, fear of childbirth, and family support ( Previous studies on childbirth readiness have mainly relied on regression models, which are unable to elucidate the intrinsic interconnections among influencing factors. By constructing a Bayesian model, this study demonstrated that women with high self-efficacy, no fear of childbirth, high eHealth literacy, and multiparity had the highest probability of achieving complete childbirth readiness (83.3%). Show less

TyHGB is a novel insulin resistance (IR)-related indicator, and its association with coronary heart disease (CHD) remains unclear. Additionally, studies have shown a close correlation between the diagonal earlobe crease (DELC) and CHD, yet it has not been fully applied in clinical practice to date. Therefore, this study constructed and validated a diagnostic model for CHD by combining TyHGB and DELC. A total of 1664 patients suspected of CHD who underwent coronary angiography (CAG) in the Department of Cardiology, Chengde Central Hospital from September 2021 to April 2025 were recruited for this study. Participants were categorized into a CHD group ( Age, sex, hypertension, diabetes, CR, Lp(a), TyHGB, and DELC were identified as independent risk factors for CHD through multivariate logistic regression analysis ( Both TyHGB and DELC have been identified as independent risk factors for CHD, with a linear relationship observed between TyHGB levels and CHD risk. A diagnostic model for CHD, developed by integrating TyHGB, DELC, and traditional risk factors, demonstrates strong diagnostic efficacy. The online version contains supplementary material available at 10.1186/s12944-026-02880-y. Show less

Lysophosphatidic acid acyltransferase (LPAAT) is a pivotal enzyme in the de novo biosynthesis of phosphatidic acid (PA), playing a central role in glycerophospholipid assembly and triacylglycerol (TAG) accumulation. Myrmecia incisa is a green microalga notable for its high content of arachidonic acid (ArA), yet the molecular mechanism underlying ArA enrichment in TAG remains unclear. In this study, a putative LPAAT gene from M. incisa, designated MiLPAAT, was identified and cloned, followed by systematic structural and functional characterization. Sequence analysis revealed that MiLPAAT contains a conserved PlsC domain and the characteristic H(X)₄D and EGTR motifs. Bioinformatic predictions identified at least one transmembrane domain at the N-terminus, supporting its identity as an integral membrane protein. This was further confirmed by membrane fractionation and Western blot analysis, which demonstrated its association with the membrane fraction. Phylogenetic analysis further demonstrated its close evolutionary relationship to LPAAT homologs in other green algae. Heterologous expression in Escherichia coli, coupled with in vitro enzymatic assays, confirmed that the recombinant MiLPAAT protein possesses LPAAT activity, catalyzing the acylation of LPA with various acyl-CoAs. Among the substrates tested, MiLPAAT exhibited the highest catalytic efficiency toward ArA-CoA (104.8 ± 3.2 nmol/mg/min), followed by oleoyl-CoA (81.5 ± 2.7 nmol/mg/min) and palmitoyl-CoA (68.4 ± 2.1 nmol/mg/min), consistent with the ArA-rich TAG composition observed in M. incisa. Immunogold labeling and immunohistochemical localization experiments revealed that MiLPAAT is predominantly localized at the plasma membrane. Findings of the present study suggest that MiLPAAT plays a critical role in PA biosynthesis and assembly of ArA into TAG in M. incisa, providing a novel target for microalgal lipid metabolic engineering. Show less

Postoperative symptoms in lung cancer patients are complex and dynamic, yet recovery is highly heterogeneous. Traditional analyses often fail to capture individual recovery trajectories, limiting the ability to provide personalized care. This study aimed to identify distinct postoperative symptom trajectories and their clinical predictors using a person-centered approach. We conducted a prospective longitudinal study with 394 patients undergoing uniportal video-assisted thoracoscopic surgery (uniportal VATS) for early-stage non-small cell lung cancer. Patient-reported symptoms were collected at 1, 7, 14, and 30 days postoperatively. Latent Profile Analysis (LPA) was used to identify distinct symptom profiles, and Latent Transition Analysis (LTA) modeled the transitions between these profiles over time. Multinomial logistic regression was used to identify predictors of these transitions. LPA identified two distinct recovery profiles: a "Rapid Recovery" group (C1) and a "High-Symptom, Slow Recovery" group (C2). The first postoperative week was a critical window, with 73.0% of patients in the High-Symptom, Slow Recovery group transitioning to the Rapid Recovery group. This transition rate slowed significantly in subsequent weeks. A higher ASA classification, use of a thicker chest tube, and extensive lymph node dissection predicted a slower recovery. Conversely, better pulmonary function (FEV1%, MVV%) facilitated a faster transition, while postoperative complications were associated with a negative trajectory shift. Postoperative recovery in lung cancer patients follows predictable, heterogeneous trajectories. This person-centered approach enables the early identification of high-risk patients based on preoperative and surgical factors. Understanding these distinct pathways allows for a shift from a one-size-fits-all model to staged, personalized interventions designed to optimize symptom management and enhance patient recovery. Show less

Speed capability is critical for early childhood development, but troubling patterns are emerging in the motor fitness of Chinese preschoolers (3-6 years). This study investigated how compositional 24-h movement behaviours (sleep, sedentary behaviour [SB], light physical activity [LPA] and moderate-to-vigorous physical activity [MVPA]) relate to speed capability. Via compositional data analysis and isotemporal substitution modelling, we assessed relationships between 24-h movement behaviours (sleep, SB, LPA and MVPA) and speed capability in 275 preschoolers (mean age 4.98 ± 0.76 years). Participants completed 20-m sprint tests and 7-day accelerometry. Time-reallocation effects were quantified through pairwise behavioural substitutions (5- to 30-min durations), with all models adjusted for age, sex and BMI z scores (z-BMI). Higher relative MVPA time significantly predicted faster sprint times (β = -1.302, p < 0.001), while higher LPA predicted slower times (β = 1.570, p = 0.003). Reallocating 15 min from sleep, SB or LPA to MVPA reduced sprint times by 0.176, 0.201 and 0.385 s, respectively (all p < 0.05). Conversely, reallocating MVPA to other behaviours worsened performance. The effects exhibited asymmetry: displacing time away from MVPA impaired speed capability to a greater extent than equivalent gains in MVPA time improved it. MVPA is the strongest positive predictor of speed capability in preschoolers. Optimizing 24-h movement patterns by reallocating time from LPA or SB to MVPA is associated with enhanced speed performance, supporting targeted interventions for early childhood development. Show less

The process model of emotion regulation highlights affect's ebb and flow in daily life in response to external events or internal processes, such as stress. Collectively daily stress and affect can shape daily experiences and influence long-term health. Understanding the dynamics of the stress-affect relationship requires examining intensity (average level), inertia (autoregression), and variability (residual variances), yet few studies simultaneously consider both arousal (high vs low, denoted as H vs L) and valence (positive vs negative, denoted as PA vs NA) dimensions of affect. Participants (N = 424; 72.4 % women, M Show less

Suicidal ideation (SI) and behavior are complex phenotypes, with multiple contributing risk-factors. This study used longitudinal data from the Million Veteran Program Mental Health Survey to identify SI profiles among Veterans based on trajectories of ideation and depression severity and compared them to a non-suicidal (no-SI) control group. Latent profile analysis (LPA) was performed to identify SI profiles using data from Veterans (n = 34,322) endorsing SI in their electronic health record. LPA identified four highly reproducible SI profiles: mild ideators with and without depression, variable ideators, and persistent ideators. Veterans across the SI profiles were significantly more likely to have diagnoses of suicidal ideation or behavior, mental disorders, and TBI compared to Veterans with no-SI. The variable ideators showed higher rates of comorbid conditions. The mild ideators without depression and persistent ideators had a significantly higher proportion of deaths by suicide than the no-SI Veterans. European and African American GWAS and pan-ancestry meta-analyses of SI profiles compared to no-SI controls were also performed, which identified genome-wide significant loci across all SI profiles proximal to genes implicated in auditory and vestibular functioning, Alzheimer's, diabetes, and asthma. In summary, SI profiles identified were associated with novel genetic variants not identified by previous suicide GWAS studies. Additionally, Veterans within the mild SI profile that did not present with high-risk comorbidities had the highest rate of suicide deaths, indicating the need for upstream suicide risk prevention interventions across the SI risk continuum. Show less

Pregnant women have a high incidence of perinatal mood and anxiety disorders (PMADs). To explore the influence factor on perinatal psychology, we analysed the SCFAs, lipids, cognition, emotion, and cytokines in the late pregnant women. The mood, cognition, SCFAs of the non-pregnant group were compared to those in the late pregnancy. The differences in SCFAs, lipids, cognition, and cytokines between the high-risk and low-risk groups for affective disorders among women in the late pregnancy were analysed, and the risk factors were sought. Compared with the non-pregnant group, the pregnant group scored lower on the SDMT (P < 0.001), DST (P = 0.035), VRT (P = 0.001), and VFT (P < 0.001), and took longer on the TMTA (P = 0.004). Acetate (P = 0.001) and butyrate (P = 0.002) were higher, while propionate (P < 0.001) and isobutyrate (P = 0.001) were lower in the pregnant group than in the non-pregnant group. Among the pregnant women, CRP was higher in the high-risk group for mood disorders than in the low-risk group (P = 0.048). Meanwhile, HDL was positively associated with DST (P = 0.000), VRT (P = 0.015), and VFT (P < 0.001). Longer TMTA completion times were associated with reduced propionate (P = 0.072) and LPa (P = 0.022). Longer TMTB completion time was associated with lower life satisfaction (P = 0.037), as well as decreased cholesterol (P = 0.026). Pregnant women experience changes in cognition and SCFAs. CRP is a sensitive indicator for monitoring affective disorder. Regulation of SCFAs and lipids may be beneficial for cognition and affect. Show less

To develop a deep-learning model for segmenting and classifying adrenal nodules as either lipid-poor adenoma (LPA) or nodular hyperplasia (NH) on contrast-enhanced computed tomography (CECT) images. This retrospective dual-center study included 164 patients (median age 51.0 years; 93 females) with pathologically confirmed LPA or NH. The model was trained on 128 patients from the internal center and validated on 36 external cases. Radiologists annotated adrenal glands and nodules on 1-mm portal-venous phase CT images. We proposed Mamba-USeg, a novel state-space models (SSMs)-based multi-class segmentation method that performs simultaneous segmentation and classification. Performance was evaluated using the mean Dice similarity coefficient (mDSC) for segmentation and sensitivity/specificity for classification, with comparisons made against MultiResUNet and CPFNet. From per-slice segmentation, the model yielded an mDSC of 0.855 for the adrenal gland; for nodule segmentation, it achieved mDSCs of 0.869 (LPA) and 0.863 (NH), significantly outperforming two previous models-MultiResUNet (LPA, p < 0.001; NH, p = 0.014) and CPFNet (LPA, p = 0.003; NH, p = 0.023). Classification performance from per slice demonstrated sensitivity of 95.3% (95% confidence interval [CI] 91.3-96.6%) and specificity of 92.7% (95% CI: 91.9-93.6%) for LPA, and sensitivity of 94.2% (95% CI: 89.7-97.7%) and specificity of 91.5% (95% CI: 90.4-92.4%) for NH. The classification accuracy for patients from external sources was 91.7% (95% CI: 76.8-98.9%). The proposed multi-class segmentation model can accurately segment and differentiate between LPA and NH on CECT images, demonstrating superior performance to existing methods. Question Accurate differentiation between LPA and NH on imaging remains clinically challenging yet critically important for guiding appropriate treatment approaches. Findings Mamba-Useg, a multi-class segmentation model utilizing pixel-level analysis and majority voting strategies, can accurately segment and classify adrenal nodules as LPA or NH. Clinical relevance The proposed multi-class segmentation model can simultaneously segment and classify adrenal nodules, outperforming previous models in accuracy; it significantly aids clinical decision-making and thereby reduces unnecessary surgeries in adrenal hyperplasia patients. Show less

The polyphenols in grains are highly active, but some polyphenols in highland barley are in a bound form and have extremely low bioavailability. Fermentation by lactic acid bacteria (LAB) is capable of altering the functionality of foods. This research investigated the effects of fermentation with different LAB, such as Lactobacillus acidophilus (LAC), Lactobacillus casei (LCA), Lactobacillus rhamnosus (LRH), Lactobacillus plantarum (LPL), and Lactobacillus bulgaricus (LBU), on the hypoglycemic activity and mechanism of polyphenols in highland barley. The hypoglycemic activity of the fermentation products was measured by in vitro antioxidant, enzyme activity, and glucose consumption experiments. Untargeted metabolomic analysis used UHPLC-Q Exactive HF-X/MS to reveal distinct metabolic profiles among the fermented groups. Molecular docking and western blot experiments were conducted to elucidate the mechanism underlying the hypoglycemic effect of fermentation products. Polyphenolic antioxidant activity in highland barley and its inhibitory activities against α-glucosidase and α-amylase were increased after LAC fermentation. Furthermore, the fermented extracts improved glucose consumption in HepG2 cells. The content determination and metabolomic analysis showed that fermented highland barley polyphenols were increased, and 113 differential phenolic metabolites were identified and annotated, among which 44 exhibited a significant upregulation compared with raw highland barley polyphenols. At the molecular level, the polyphenol extract upregulated PI3K and phosphorylated Akt expression in HepG2 cells. Overall, the results indicate that fermentation by LAC biotransformed highland barley polyphenols into smaller molecules with improved hypoglycemic activities, thereby enhancing their bioavailability. Show less

This study integrates fluorescence resonance energy transfer (FRET) and small-angle X-ray scattering (SAXS) to elucidate, in real time, how triacylglycerol (TAG) self-assembly dynamics in human milk regulate digestion and absorption. Among three major human milk TAGs-1-oleoyl-2-palmitoyl-3-linoleoyl-glycerol (OPL), 1,3-dioleoyl-2-palmitoyl-glycerol (OPO), and 1,3-dilinoleoyl-2-palmitoyl-glycerol (LPL)-OPL showed ∼20% faster lipolysis and more rapid micelle formation (I Show less

Intramuscular fat (IMF) is a key determinant of meat quality, influencing tenderness, juiciness, and flavor. Previous studies have reported that the deposition of IMF is controlled by various factors. However, there is a shortage of research exploring the variations in IMF deposition across age groups from a microbial perspective. This study evaluated the differences in IMF deposition between yearling (1-year-old) and mature (4-year-old) Longdong Cashmere goats and analyzed its association with gut microbiota. The results revealed that the IMF content in shoulder meat and blood lipid levels increased with age (p < 0.05). Conversely, the contents of lipoprotein lipase (LPL) in the liver and duodenum significantly decreased with age. Microbial diversity differed between the two age groups, with specific microbiota identified from the gut of goats involved in the lipid metabolism pathway. The concentrations of valeric and isovaleric acids in the rumen, as well as acetic, propionic and isovaleric acids in the colon, were higher in yearling goats than in mature goats (p < 0.05). Spearman correlation analysis of IMF deposition indicators with gut microbiota revealed that, within the rumen, the abundances of CAG-791 and Sodaliphilus were positively correlated with IMF content in shoulder meat and TG levels, while exhibiting a negative correlation with the contents of valeric acids. Furthermore, the abundance of Clostridium_R showed a positive association with IMF content in shoulder meat and with the abundances of CAG-791and Sodaliphilus. In contrast, the abundance of Bact₁₁ was negatively correlated with IMF content in shoulder meat, TG levels, and the abundances of CAG-791, Sodaliphilus and Clostridium_R. Within the abomasum, the abundances of UMGS and Hylemonella₅₈₂₃₀₈ were correlated with IMF content in the shoulder meat, as well as serum LDL and VLDL levels. This study provides significant insights into the age-dependent gut microbiota associated with intramuscular fat deposition in goats and identifies several potential gut microbiota for further research on their impacts on IMF deposition. Show less