Elevated lipoprotein(a) [Lp(a)] is associated with a higher risk of atherosclerotic cardiovascular disease (ASCVD). Although Lp(a) is a genetically determined risk factor, the plasma proteomic feature Show more
Elevated lipoprotein(a) [Lp(a)] is associated with a higher risk of atherosclerotic cardiovascular disease (ASCVD). Although Lp(a) is a genetically determined risk factor, the plasma proteomic features associated with Lp(a) and whether they provide information about ASCVD risk beyond Lp(a) concentration are not well characterized. We sought to identify plasma proteomic features associated with Lp(a) concentration and to evaluate whether an Lp(a)-associated proteomic signature is associated with ASCVD phenotypes in young, healthy adults. In the Coronary Artery Risk Development in Young Adults (CARDIA) study, we measured Year 7 Lp(a) and 184 cardiovascular proteins using the Olink proximity extension assay in 3,920 participants without prior coronary heart disease. Lp(a)-associated proteomic signatures were derived using LASSO regression in a split-sample design and tested for association with coronary artery calcification (CAC), incident CHD, and hs-CRP over 27 years of follow-up. External replication was performed in the UK Biobank (n=37,996). Lp(a) was associated with CAC (OR 1.23 [1.13-1.34]; p<0.0001) and incident CHD (HR 1.23 [1.07-1.41]; p=0.004). Lp(a) correlated with proteomic features reflecting immune activation, coagulation, and vascular dysfunction. A quantitative Lp(a) proteomic score was independently associated with incident CAC (standardized beta = 0.40, p<0.0001) and hs-CRP (standardized beta = 0.11, p = 0.00015) after adjustment for Lp(a) concentration. In the UK Biobank, a recalibrated Lp(a)-associated proteomic score was associated with CRP, incident CHD, and all-cause mortality. In young adults, Lp(a) is associated with distinct proteomic features that independently predict ASCVD phenotypes beyond Lp(a) concentration, generating hypotheses regarding biological pathways linked to Lp(a)-related cardiovascular risk. Show less
Insufficient physical activity is prevalent among perinatal women, and digital health interventions offer a promising avenue to promote engagement in physical activity within this population. However, Show more
Insufficient physical activity is prevalent among perinatal women, and digital health interventions offer a promising avenue to promote engagement in physical activity within this population. However, previous studies have relied heavily on self-reported data, lacking a systematic synthesis based on objective measurements. This study aims to systematically evaluate the effects of digital health interventions on objectively measured physical activity and sedentary behavior in perinatal women. A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library databases from inception to December 20, 2025. Fourteen randomized controlled trials (RCTs) involving 2,101 participants were included. The Risk of Bias 2.0 (RoB 2.0) tool was used to assess bias risk, random-effects models were employed to pool effect sizes, and the quality of evidence was evaluated using the GRADE system. The meta-analysis showed that, following the exclusion of outliers via sensitivity analysis, digital health interventions significantly increased daily step counts (MD = 0.68, Digital health interventions can effectively and robustly enhance daily baseline activity levels in perinatal women, with the observed increments potentially reaching the minimal effective dose for improving metabolic health. However, current intervention designs face challenges in driving high-intensity behavior change and disrupting sedentary habits. Future research should explore more targeted and personalized intervention strategies. This systematic review and meta-analysis has been registered in PROSPERO (www.crd.york.ac.uk/prospero), identifier CRD420261280936. Show less
With the widespread use of smartphones among adolescents, smartphone addiction has become a growing mental health concern. Adolescents' limited self-regulation makes them particularly vulnerable to us Show more
With the widespread use of smartphones among adolescents, smartphone addiction has become a growing mental health concern. Adolescents' limited self-regulation makes them particularly vulnerable to using smartphones to escape real-life stress, heightening addiction risk. However, the heterogeneity of addictive behaviors and the dynamic role of experiential avoidance have been underexplored. This 6-month longitudinal study surveyed 547 Chinese primary and secondary students using the Smartphone Addiction Scale (SAS) and the Acceptance and Action Questionnaire-II (AAQ-II). Latent profile analysis (LPA) and latent transition analysis (LTA) were applied to identify subgroups and examine transitions between these subgroups. Cross-lagged panel network analysis (CLPN) revealed key symptom interactions between experiential avoidance and addiction. The study identified two addiction subgroups: a stable "low-risk group" (84.9 percent) and a "high-risk group," 51.4 percent of whom transitioned to low risk over time. Logistic regression showed that experiential avoidance significantly predicted high-risk membership (odds ratios [OR] = 1.083-1.102) and deterioration within the low-risk group (OR = 1.036). The CLPN identified "online intimacy" (SPA-3) and "hesitation and overcautious" (EA-7) as driver nodes, with "withdrawal symptoms" (SPA-2) serving as a central node. These findings emphasize the crucial role of experiential avoidance in adolescent smartphone addiction and suggest symptom-level targets for early intervention. The results support acceptance and commitment therapy (ACT) as a promising approach for reducing smartphone addiction among youth. Show less
We examined whether the excess cardiovascular disease (CVD) risk among adults with steatotic liver disease (SLD) subtypes could be reduced or eliminated through joint control of low-density lipoprotei Show more
We examined whether the excess cardiovascular disease (CVD) risk among adults with steatotic liver disease (SLD) subtypes could be reduced or eliminated through joint control of low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) [Lp(a)], and high-sensitivity C-reactive protein (hs-CRP). This prospective cohort study included 291,995 participants from the UK Biobank, comprising 77,187 with metabolic dysfunction-associated steatotic liver disease (MASLD), 22,190 with metabolic dysfunction and alcohol-associated liver disease (MetALD), 5474 with alcohol-associated liver disease (ALD), and 187,144 without SLD. Cox proportional hazards models were used to assess CVD risk associated with numbers of LDL-C, Lp(a), and hs-CRP controlled within the target range. During 12 years of median follow-up, 24,251 CVD events were documented, with 19,661 coronary heart disease and 5600 stroke. Among individuals with various SLD subtypes, those with all three factors controlled had the lowest risks of CVD, with HRs (95% CIs) of 0.65 (0.58, 0.72) in MASLD, 0.61 (0.49, 0.76) in MetALD, and 0.57 (0.35, 0.93) in ALD when comparing to zero-factor control. In addition, among individuals with SLD subtypes achieving all three factors within target ranges, the HRs (95% CIs) of CVD were 0.97 (0.88, 1.07) in MASLD, 0.90 (0.75, 1.08) in MetALD, and 0.63 (0.42, 0.95) in ALD, as compared with non-SLD controls. Similar association patterns were observed for coronary heart disease and stroke. Participants with various SLD subtypes who had optimally controlled LDL-C, Lp(a), and hs-CRP showed no excess or even lower risk of CVD as compared with the general population. Not available. 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 s Show more
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
To explore the associations between accelerometer-measured physical activity patterns and cardiovascular diseases (CVD), CVD-cause mortality, and all-cause mortality in people with osteoarthritis (OA) Show more
To explore the associations between accelerometer-measured physical activity patterns and cardiovascular diseases (CVD), CVD-cause mortality, and all-cause mortality in people with osteoarthritis (OA). OA participants from the UK biobank with ≥36 h of accelerometer data, collected over one-week, were analyzed. Moderate to vigorous physical activity (MVPA) patterns were classified as: 'weekend warriors' (≥150 min/week, >50% on 1-2 days), active regular (>150 min/week), or inactive (<150 min/week). Mean min per week of light physical activity (LPA) were categorized into quartiles based on the distribution in the analytical sample. Among 10 210 study participants (mean age 58.1 ± 7.1 years; 64.5% female) followed for a median of 6.9 years, there were 1,538 incident cases of CVD, and 358 deaths, including 90 from CVD. Compared with inactive MVPA, both weekend warrior (adjusted hazard ratio, aHR (95% CIs); 0.73 (0.64-0.82)) and active regular MVPA (0.75 (0.65-0.87)) significantly lowered the risks of incident CVD. Notably, only the weekend warrior group showed significant reductions in CVD-cause mortality (0.55, 0.33-0.92), and all-cause mortality (0.75 (0.59-0.96)). Higher levels of LPA may link to lower CVD, CVD-cause mortality, and all-cause mortality risks in a dose-response manner. Subgroup analysis indicated that more prominent associations were found in individuals with a body mass index >30 or those aged over 60. Engaging in a weekend warrior pattern may confer unique survival benefits for OA patients, especially among older adults and those with obesity. LPA may have dose-dependent protective effects for CVD and mortality risk in OA patients. Show less
Falls have long been a significant safety concern worldwide, not only compromising the physical and psychological health of older adults and limiting their social engagement but also imposing substant Show more
Falls have long been a significant safety concern worldwide, not only compromising the physical and psychological health of older adults and limiting their social engagement but also imposing substantial economic and caregiving burdens. Evidence on fall risk perception among Chinese community-dwelling older adults remains limited, especially for those transitioning to community living after hospital discharge. This research examined the subtypes of fall risk perception of Chinese community-dwelling older adults in the post-discharge transition and to explore subgroup characteristics and associated factors. A cross-sectional survey was conducted between January 2024 to March 2025 in Hangzhou, Zhejiang Province. A self-designed questionnaire was used to collect demographic and health-related information, The Fall Risk Perception Scale for Community-dwelling Older Adults was used to assess the fall risk perception, the objective fall risk was assessed by Morse Fall Scale. Latent profile analysis (LPA) was performed to extract latent classes of fall risk perception, and multinomial regression analyses were used to identify differences between these categories. A total of 468 older adults were included, with 56.0% were male. Three fall risk perception subtypes were identified by LPA: Low Perception-Social Context Desensitized Type (29.2%), Moderate Perception - Balanced Type (43.4%), and High Perception - Bio-behaviorally Salient Type (27.4%). Individuals who were aged with 70-79 (OR = 0.46, 95% CI: 0.27-0.77), with college education or above (OR = 0.31, 95% CI: 0.13-0.76), those who underwent surgery during hospitalization (OR = 0.26, 95% CI: 0.15-0.43), reported difficulty falling asleep (OR = 0.40, 95% CI: 0.20-0.82), and those with a history of falls (OR = 0.44, 95% CI: 0.24-0.81) were significantly more likely to be in the High Perception - Bio-behaviorally Salient Type. Compared to objective fall risk level, a third of participants (31.4%) correctly estimated their fall risk, 23.1% overestimated it and 45.5% underestimated it. Most older adults possess a Moderate Perception - Balanced Type toward fall risk. Key determinants of heightened risk perception included advanced age, higher education, fall history, and recent surgical experience. Tailored, profile-specific risk communication strategies are essential to improve perceptual accuracy during the hospital-to-home transition may support post-discharge fall prevention. Show less
The purpose of this study was to explore the latent profiles of ambivalence over emotional expression (AEE) in breast cancer patients and its influencing factors. From July 2024 to June 2025, breast c Show more
The purpose of this study was to explore the latent profiles of ambivalence over emotional expression (AEE) in breast cancer patients and its influencing factors. From July 2024 to June 2025, breast cancer patients were recruited using a convenience sampling method from a tertiary hospital in China. A total of 388 participants completed demographic and clinical characteristic questionnaires, the Ambivalence Over Emotional Expression Questionnaire (AEQ), the Perceived Stress Scale-14 (PSS-14), the Social Support Rating Scale (SSRS), and the Irrational Beliefs Scale (IBS). Latent profile analysis (LPA) was used to identify AEE subgroups, followed by univariate analysis, ANOVA, and multinomial logistic regression to examine associated influencing factors. Based on the level of AEE, breast cancer patients were divided into 3 sub groups: "low conflict-active disclosure group " (34.5%), "moderate conflict-inhibition and regret group " (46.5%), and "high conflict-inhibition and regret group " (19.3%). The multivariate logistic regression analysis showed that retirement status, perceived stress, social support and irrational beliefs were factors influencing participants' AEE (P < .05). There was significant variability in AEE among 3 subgroups of breast cancer patients. Retirement status, perceived stress, social support, and irrational beliefs have an impact on AEE in breast cancer patients. It is crucial for healthcare professionals to promptly identify high-risk groups and implement targeted interventions to improve AEE. This study can help healthcare providers identify patients at high risk of AEE, enabling early intervention and targeted psychological nursing interventions. Healthcare providers can assist patients in establishing correct beliefs about their illness and alleviating perceived stress, thereby reducing the negative impact of AEE. Show less
Jianlei Liu, Yaling Cui, Hongyu Wang+2 more · 2026 · Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society · Blackwell Publishing · added 2026-04-24
With global population aging, the number of older adults in Chinese nursing homes is rising rapidly, and depression is the most prevalent mental health problem in this population. Most previous studie Show more
With global population aging, the number of older adults in Chinese nursing homes is rising rapidly, and depression is the most prevalent mental health problem in this population. Most previous studies assessed depression via total scale scores, ignoring individual heterogeneity of depressive symptoms. This study aimed to identify distinct depressive symptom profiles and their associated factors in this population. Data were derived from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), with 353 valid nursing home older adults included. Depressive symptoms, anxiety and functional status were assessed using the CESD-10, GAD-7 and IADL scales. Latent profile analysis (LPA), univariate tests and multinomial logistic regression were performed, with supplementary effect size and sensitivity analyses to verify result robustness. Three distinct depressive symptom profiles were identified: low level (39%, n = 135), medium level (52%, n = 187) and high level (9%, n = 31). Town residence and anxiety were risk factors for moderate depression, while good self-rated health, regular exercise and social activity participation were protective factors. Good self-rated health protected against severe depression, while occasional television/radio viewing and anxiety were risk factors. Anxiety was the only independent correlate of high-level versus medium-level depression (OR = 1.322, p < 0.001). Supplementary analyses confirmed the robustness of core findings. The CESD-10, as a screening tool, has limited diagnostic efficacy for clinical depression, and the cross-sectional design cannot confirm causal relationships. Depressive symptoms in Chinese nursing home older adults show significant heterogeneity with three distinct latent profiles. Early screening and targeted stratified interventions should be implemented for this population to improve quality of life and promote healthy aging. Show less
Frailty is associated with increased risks of falls, disability, hospitalization, and mortality. The 24-h movement behaviors (24HMB) framework conceptualizes sleep, sedentary behavior (SB), light-inte Show more
Frailty is associated with increased risks of falls, disability, hospitalization, and mortality. The 24-h movement behaviors (24HMB) framework conceptualizes sleep, sedentary behavior (SB), light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) as mutually constrained components of daily time use and may inform frailty prevention and management. This scoping review maps evidence on associations between 24HMB and frailty and identifies methodological gaps to inform future research and nursing practice. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and follows Joanna Briggs Institute (JBI) guidance. We searched PubMed, Embase, CINAHL, and Web of Science. We included observational studies of adults aged ≥18 years. Exposures were objectively measured or validated self-reported sleep, SB, LPA, and MVPA, including step counts, breaks in SB, isotemporal substitution models (ISM), and compositional data analysis (CoDA). Outcomes were frailty or prefrailty assessed using validated instruments. Quality was appraised with JBI tools. Thirty-three studies showed good methodological quality. Longer SB, particularly prolonged, uninterrupted bouts, was associated with higher frailty. Greater MVPA was consistently associated with lower frailty. Light-intensity physical activity was generally beneficial but often attenuated when MVPA or total activity volume was modeled. Sleep fragmentation and poor sleep quality were associated with frailty. Isotemporal substitution models and compositional data analysis indicated that reallocating sedentary time to MVPA would yield the largest theoretical benefit, followed by reallocating to LPA. Higher daily step counts and more frequent or higher-intensity breaks in SB were associated with lower frailty. Evidence supports a 24-h integrated movement-behavior approach centered on MVPA, combined with reducing prolonged SB and improving sleep quality, for the prevention and nursing management of frailty. The study design and analytical protocol were prospectively registered on the Open Science Framework (OSF). The unique identifier is S39Y4, and the publicly accessible URL is https://doi.org/10.17605/OSF.IO/S39Y4. Show less
Lipoprotein(a) [Lp(a)] is a genetically determined cardiovascular risk factor. Additionally, Lp(a) levels are affected by dietary saturated fat (SFA) reduction. We previously reported an Lp(a) increas Show more
Lipoprotein(a) [Lp(a)] is a genetically determined cardiovascular risk factor. Additionally, Lp(a) levels are affected by dietary saturated fat (SFA) reduction. We previously reported an Lp(a) increase in response to SFA reduction in both white and black cohorts. However, less is known whether diets impact Lp(a)'s oxidized phospholipids (OxPL) and lipid components. We assessed responses of Lp(a)-OxPL concentration, Lp(a)-OxPL subspecies abundance, and the Lp(a)-lipidome to SFA reduction [from 16% energy with the average American diet (AAD) to 6% energy with a DASH-type diet] in 166 African-Americans. Responses by variability in Lp(a) levels and apolipoprotein(a) [apo(a)] sizes were tested. Mean age was 35 years; 70% were women; mean BMI was 28 kg/m Show less
Kuiliang Li, Lei Ren, Rui Lang+7 more · 2026 · Stress and health : journal of the International Society for the Investigation of Stress · Wiley · added 2026-04-24
Compared with non-left-behind children (NLBC), left-behind children (LBC) face a higher risk of academic stress, depression, and anxiety symptoms due to separation from their parents; however, the het Show more
Compared with non-left-behind children (NLBC), left-behind children (LBC) face a higher risk of academic stress, depression, and anxiety symptoms due to separation from their parents; however, the heterogeneity of academic stress profiles and their relationships with the symptom network remain insufficiently explored. To address this gap, a cross-sectional survey of 10,524 Chinese children compared LBC (n = 2487) and NLBC. Latent profile analysis (LPA) was first conducted to identify academic stress subgroups among LBC. Subsequently, depression-anxiety symptom networks were estimated using Ising and Gaussian graphical models (GGM), with edge weights derived from regularised logistic regression (Ising) and partial correlation (GGM). Simulated interventions were further evaluated via the NodeIdentifyR algorithm (NIRA). Overall, compared to NLBC, LBC exhibited higher levels of academic stress, depression, and anxiety (ps < 0.001, Cliff's δ = 0.076; Cohen's d = 0.067). LPA revealed three academic stress subgroups: moderate (31.44%), high (9.17%), and low (59.39%). The severity of depression and anxiety symptoms increased with the level of academic stress. The high stress subgroup displayed a sparse network with stronger edges (e.g., A1 'Sudden Fear'-A4 'Physical Symptoms', edge weight = 2.10) compared to moderate- and low-academic stress subgroups. Core nodes with the strongest expected influence were A8 ('Decision Hesitation', moderate subgroup), A2 ('Worry', high subgroup), and D1/D6 ('Sadness' and 'Failure', low subgroup). Simulated interventions indicated that alleviating A8 'Decision Hesitation' or A2 'Worry' most effectively reduced symptom risk (16.66%-30.76%), whereas D8 'Motor' and A7 'Early Departure' were associated with maximal symptom aggravation. Taken together, by integrating LPA-derived academic stress profiles with symptom network analysis, this study reveals distinct symptom associations across subgroups. In the high stress subgroup, symptom A2 ('Worry') is a core intervention target; in the low stress subgroup, A7 ('Early Departure') holds preventive potential. These findings underscore subgroup-specific interventions tailored to individual stress profiles. Show less
Given that abnormal lipid metabolism is a hallmark of metabolic dysfunction-associated steatotic liver disease (MASLD), this study seeks to investigate the relationship between serum lipoprotein(a) [L Show more
Given that abnormal lipid metabolism is a hallmark of metabolic dysfunction-associated steatotic liver disease (MASLD), this study seeks to investigate the relationship between serum lipoprotein(a) [Lp(a)] levels and the progression or regression of MASLD. A total of 12,962 participants undergoing transient elastography at the Health Promotion Center of the First Affiliated Hospital of Nanjing Medical University were included in the first cross-sectional study (Study 1). The longitudinal study (Study 2) included 17,661 individuals from the same center, each with at least two health check-ups involving abdominal ultrasonography. Another cross-sectional study (Study 3) included 5,927 individuals from the UK Biobank cohort who had undergone both magnetic resonance imaging proton density fat fraction (MRI-PDFF) and Lp(a) testing. Cross-sectional analysis (Study 1) revealed that elevated Lp(a) levels were inversely correlated with the severity of both hepatic steatosis and fibrosis. Longitudinal data (Study 2) further demonstrated that baseline serum Lp(a) levels were decreased in participants with the incident of MASLD, while increased in participants with the regression of MASLD during the follow-up period. A lower baseline Lp(a) level was an independent factor for new-onset MASLD and non-regression of MASLD: the fully adjusted hazard ratios (HR) were 0.895 (95%CI 0.834-0.962, Serum Lp(a) levels are inversely associated with both the progression and regression of MASLD, indicating its potential role in reflecting disease dynamics. Show less
Executive function (EF) deficits are a core cognitive feature of autism spectrum disorder (ASD) and are closely associated with social responsiveness. Previous research has primarily focused on childr Show more
Executive function (EF) deficits are a core cognitive feature of autism spectrum disorder (ASD) and are closely associated with social responsiveness. Previous research has primarily focused on children with ASD, whereas how specific executive components relate to social functioning in adults remains less clear. This study examined whether patterns of association between EF and social responsiveness differ between children and adults with and without ASD. Data were obtained from the Autism Brain Imaging Data Exchange II (ABIDE II), including 423 participants aged 8-23 years (ASD = 184; controls = 239). EF was evaluated using the Behavior Rating Inventory of Executive Function (BRIEF/BRIEF-A), and social responsiveness was assessed with the Social Responsiveness Scale (SRS). Covariates of age, sex, and full-scale IQ (FIQ) were controlled using entropy balancing in children and multiple regression in adults. Hierarchical regression, moderated mediation analysis, and latent profile analysis (LPA) were conducted to examine the moderation, mediation, and heterogeneity effects, respectively. Across both child and adult samples, individuals with ASD exhibited significantly higher T-scores than controls on nearly all BRIEF and SRS subdomains after covariate adjustment (all adjusted p < 0.01), indicating widespread EF and social responsiveness impairments. Moderation analyses revealed no significant age group × EF interaction, indicating that the association between EF and social responsiveness was consistent across development. Mediation analysis revealed age-specific pathways, with EF broadly mediating social responsiveness in adults but showing more selective mediation in children. LPA identified four distinct subtypes, which were independent of age, sex, and FIQ. EF-social responsiveness associations were evident across development, but the functional contribution of specific executive components became more differentiated with age. Working memory showed greater relative prominence in adulthood. Latent profile analysis revealed heterogeneity in how executive difficulties align with social challenges, supporting developmentally informed assessment and clinical interpretation rather than direct treatment recommendations. Show less
To identify latent self-management profiles in people living with HIV (PLWH) with dyslipidemia and factors associated with profile membership, thereby facilitating targeted clinical intervention. A cr Show more
To identify latent self-management profiles in people living with HIV (PLWH) with dyslipidemia and factors associated with profile membership, thereby facilitating targeted clinical intervention. A cross-sectional survey was conducted from December 2024 to June 2025 among 333 PLWH with dyslipidemia at Nanjing Second Hospital. Data were collected via sociodemographic/disease-related questionnaire, the HIV Self-Management Scale (HIVSMS), and the Health Literacy Management Scale (HLMS). Latent profile analysis (LPA) was performed in Mplus 8.3, and multinomial logistic regression was used to examine factors associated with profile membership. Fit indices (entropy = 0.993) supported a three-profile solution: low self-management-low social support-seeking (C1, 42.3%), moderate self-management-stable (C2, 37.8%), and high self-management-emotion regulation dominant (C3, 19.8%). Seeking social support was relatively low across profiles. Compared with C1, C2 membership was significantly associated with higher education and income, lipid-lowering medication use (OR 3.735, 95% CI 1.597-8.736), and CD4 350-500 cells/μL, and was less likely among participants with VL >1000 copies/mL or chronic comorbidities (all P < 0.05). Compared with C1, C3 membership was significantly associated with HIV infection duration ≥5 years, higher education and income, CD4 >500 cells/μL, and higher HDL-C, and was less likely among those with VL >1000 copies/mL (OR 0.037, 95% CI 0.004-0.380) or chronic comorbidities (all P < 0.05). Compared with C2, C3 membership was independently associated with higher health literacy (HL) (OR 1.038 per point, 95% CI 1.012-1.064) and was less likely among those with LDL-C ≥3 mmol/L (P < 0.05). We identified three distinct self-management profiles among PLWH with dyslipidemia. Profile membership was significantly associated with HL and socioeconomic, HIV-related, lipid-related, and comorbidity factors, supporting the need for profile-tailored strategies to improve self-management. Show less
In recent years, the global incidence of Non-Suicidal Self-Injury (NSSI) has risen, posing a significant challenge in public health. Adolescents are the main group affected. A cross-sectional study wa Show more
In recent years, the global incidence of Non-Suicidal Self-Injury (NSSI) has risen, posing a significant challenge in public health. Adolescents are the main group affected. A cross-sectional study was conducted using a self-administered questionnaire to collect data from 6,311 adolescents in Hefei, China. This study employed the Compositional Isotemporal Substitution Model (CISM, a statistical method that estimates health effects of replacing time in one behavior with another while accounting for the interdependent, compositional nature of 24-h time-use data) to examine the impact of Screen Time (ST), Non-Screen-based Sedentary Time (NSST), Physical Activity, and Sleep Time on NSSI among adolescents. Compositional logistic regression analysis revealed that, relative to the remaining behavioral components, higher Light Physical Activity (LPA) ( The findings highlight those reasonably allocating adolescents' daily activities, reducing ST, can help lower the risk of NSSI among adolescents. 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 Municipa Show more
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
This study aims to identify distinct mindfulness profiles among young and middle-aged lymphoma patients and to examine the mediating role of psychological resilience in the relationship between these Show more
This study aims to identify distinct mindfulness profiles among young and middle-aged lymphoma patients and to examine the mediating role of psychological resilience in the relationship between these mindfulness profiles and social function deficits. From November 2024 to June 2025, a total of 324 young and middle-aged lymphoma patients were recruited using convenience sampling from a tertiary cancer hospital in Urumqi, Xinjiang, China. Participants completed the Mindful Attention Awareness Scale, the 10-item Connor-Davidson Resilience Scale, and the Social Dysfunction Screening Scale. We used latent profile analysis (LPA) to identify distinct mindfulness profiles and tested the mediating role of psychological resilience with the Bootstrap method. Latent profile analysis identified three distinct mindfulness profiles among the patients: a low mindfulness type (29.3%), a moderate mindfulness type (40.1%), and a high mindfulness type (30.6%). Furthermore, psychological resilience partially mediated the relationship between these mindfulness profiles and social function deficits. Young and middle-aged lymphoma patients exhibit heterogeneous mindfulness profiles. Higher mindfulness can enhance psychological resilience, which in turn alleviates social function deficits. Therefore, healthcare providers should develop personalized interventions targeting psychological resilience based on patients' specific mindfulness profiles to improve their social function. Show less
Phytate (phytic acid, or InsP6), the primary phosphorus storage compound in plants, plays essential roles in nutrient homeostasis and cellular signaling. However, its strong metal-chelating properties Show more
Phytate (phytic acid, or InsP6), the primary phosphorus storage compound in plants, plays essential roles in nutrient homeostasis and cellular signaling. However, its strong metal-chelating properties make cytosolic accumulation cytotoxic, necessitating its sequestration into vacuoles for safe storage. Here, we present the cryo-EM structures of the rice vacuolar phytate transporter, OsMRP5, captured in distinct functional states. These structures reveal the molecular basis of OsMRP5 function as an ATP-binding cassette (ABC) transporter. OsMRP5 employs a specialized substrate-recognition mechanism, uniquely adapted to bind the fully hydrophilic InsP6 through extensive electrostatic and hydrogen-bonding interactions within two distinct, highly polar binding sites in its central cavity. A distinctive electropositive tunnel, positioned above the central cavity, forms a continuous pathway connecting the InsP6-binding pocket to the vacuolar export site. This tunnel likely generates an electrostatic attraction that facilitates the movement of the highly anionic InsP6 through the transporter. By mapping mutations from low-phytic acid (lpa) crop variants onto the OsMRP5 structures, we pinpoint their conserved locations critical for transporter function and validate their impact experimentally. These results reveal how OsMRP5 recognizes and transports the highly charged InsP6 molecules into vacuoles, providing a molecular framework for targeted manipulation of this agriculturally important transporter. Show less
Nursing interns often face maladjustment during the early stages of clinical practice, which not only directly affects their physical and mental health as well as work efficiency but also significantl Show more
Nursing interns often face maladjustment during the early stages of clinical practice, which not only directly affects their physical and mental health as well as work efficiency but also significantly inhibits their proactive feedback-seeking behavior (FSB). As an active self-regulation strategy, FSB can enhance interns' work initiative and promote role transition. However, existing research has yet to thoroughly investigate the potential heterogeneity and categorical characteristics of FSB within this population, and the role of psychological resources such as career adaptability in shaping these patterns requires further investigation. To investigate the status of FSB in early-stage nursing interns, identify latent subgroups via latent profile analysis (LPA), and analyze associated factors, thereby providing evidence for targeted clinical educational interventions. Multicenter cross-sectional research. This study employed a multistage stratified cluster sampling to survey 1,308 early-stage nursing interns from nine universities in Hubei, China, between June and September 2024. Data were collected using a demographic questionnaire, Feedback-Seeking Behavior Scale, and Career Adapt-Abilities Scale. LPA was employed to delineate FSB profiles and multivariate logistic regression analysis to examine the associated predictors. A total of 1,370 questionnaires were distributed, with 1,308 valid responses, yielding an effective response rate of 95.47%. The mean score on the feedback-seeking behavior scale was 5.06 ± 1.08. LPA identified three distinct feedback-seeking profiles: low (20.87%), moderate (38.3%), and high (40.83%). Education level, student cadre experience, internship hospital type, and career adaptability were significant predictors of profile membership ( FSB among early-stage nursing interns exhibited heterogeneity. Nursing educators and managers should implement tiered interventions: for the low and moderate feedback-seeking groups, career guidance and feedback awareness cultivation should be strengthened; for the high feedback-seeking group, peer modeling should be encouraged. This strategy can enhance proactive FSB, supports role transition and professional identity, and promotes long-term nursing workforce stability. Show less
Fear of progression (FoP) is a prevalent psychological issue among stroke patients. Previous studies failing to distinguish characteristics of patient groups with varying FoP levels. Latent profile an Show more
Fear of progression (FoP) is a prevalent psychological issue among stroke patients. Previous studies failing to distinguish characteristics of patient groups with varying FoP levels. Latent profile analysis (LPA) classifies individuals into distinct subgroups via continuous FoP indicators, boosting classification accuracy by accounting for variable uncertainty. Given FoP's heterogeneity, investigating FoP profiles and their influencing factors in stroke patients is clinically significant for personalized psychological care and improved patient quality of life. A total of 366 stroke patients were selected as study subjects through convenience sampling, and a cross-sectional survey was conducted. FoP was assessed using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF, 2 dimensions, 12 items). Independent variables included demographic characteristics, clinical indicators, the Recurrence Risk Perception Scale for Stroke patients (RRPSS), and the Medical Coping Modes Questionnaire (MCMQ). LPA was performed on the FoP-Q-SF items to identify subgroups. The R3STEP method was used to analyze influencing factors of subgroup membership, and the BCH method was applied to compare differences in distal outcomes across subgroups. Statistical significance was set at The study sample had a mean age of 63.93 ± 10.58 years, with 70.5% males and 65.0% first-ever stroke patients. Two latent profiles were identified: Low-FoP Adaptive Type (C1, 48.6%) and High-FoP Sustained Type (C2, 51.4%). The R3STEP showed that age 18-59 years (OR = 0.476, 95%CI = 0.245-0.924, This study revealed significant heterogeneity in FoP among stroke patients. Age, hypertension comorbidity, excessive recurrence risk perception, MCMQ-confrontation, and MCMQ-avoidance were associated with high FoP. Healthcare providers should prioritize identifying high-risk individuals and develop tailored interventions to reduce FoP and improve rehabilitation outcomes. Show less
To identify latent classes based on symptom clusters and to explore the association between these distinct symptom experience subtypes and social isolation in older adults with comorbid diabetes melli Show more
To identify latent classes based on symptom clusters and to explore the association between these distinct symptom experience subtypes and social isolation in older adults with comorbid diabetes mellitus (DM) and coronary heart disease (CHD). A cross-sectional study was conducted among 337 older adults with DM and CHD recruited from the Department of Endocrinology and Cardiology of Nantong Sixth People's Hospital between February 2023 and October 2025. Data were collected using a general information questionnaire, the Chinese version of the Memorial Symptom Assessment Scale (MSAS), and the Lubben Social Network Scale-6 (LSNS-6). Exploratory factor analysis (EFA) was used to identify symptom clusters. Latent profile analysis (LPA) was then employed to classify patients into different symptom experience subtypes based on the symptom cluster scores. One-way ANOVA, Chi-square tests, and multiple linear regression were used to analyze the association between latent classes and social isolation. EFA extracted three symptom clusters (cardiopulmonary-fatigue, emotional-perceptual, and metabolic), accounting for 62.3% of the total variance. LPA identified three distinct latent classes: Class 1 "Low Burden-Balanced Pattern" (45.4%), Class 2 "Psycho-Somatic Co-dominant Pattern" (31.8%), and Class 3 "Metabolic-Physical Dominant Pattern" (22.8%). Univariate analysis revealed significant differences in social isolation scores (LSNS-6) across the three classes ( The findings reveal significant heterogeneity in symptom experiences among older adults with comorbid DM and CHD, which can be categorized into distinct latent classes. The subtype characterized by a Psycho-Somatic Co-dominant Pattern shows the strongest association with social isolation. In clinical practice, early identification of this high-burden subgroup may facilitate the provision of integrated interventions that address physical, psychological, and social dimensions. Show less
To assess the predictive value of serum lipoprotein(a) [Lp(a)] for contrast-induced nephropathy in patients with type 2 diabetes mellitus (T2DM). Consecutive T2DM patients who underwent coronary angio Show more
To assess the predictive value of serum lipoprotein(a) [Lp(a)] for contrast-induced nephropathy in patients with type 2 diabetes mellitus (T2DM). Consecutive T2DM patients who underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI) between January 2019 and December 2021 were enrolled. Baseline Lp(a) was measured before the operation. CIN was defined as an increase in serum creatinine of more than 25% or 44 μmol within 72 h of contrast administration. The relationship between Lp(a) and CIN risk was analyzed. A total of 928 T2DM patients were included. CIN developed in 11.1% (103/928) of patients. The Lp(a) level was significantly higher in patients with CIN than in non-CIN patients (311.12 ± 278.66 vs. 254.19 ± 274.56 mg/L, A higher serum Lp(a) level indicates an increased risk of CIN in T2DM patients undergoing CAG or PCI and can serve as an independent predictor of CIN in this population. This study's findings will aid in the clinical prevention and treatment of contrast agent-induced kidney disease. Show less
PurposeThis study aims to explore the latent classes of compassion fatigue among intensive care unit (ICU) nurses and identify the factors that influence their compassion fatigue.MethodsBetween Novemb Show more
PurposeThis study aims to explore the latent classes of compassion fatigue among intensive care unit (ICU) nurses and identify the factors that influence their compassion fatigue.MethodsBetween November 2024 and February 2025, 1029 ICU nurses were selected as study participants using convenience sampling. Data were gathered through general demographic questionnaires, the Chinese version of the Short Scale of Compassion Fatigue (CFSS), the Occupational Stress Scale, the Perceived Social Support Scale, as well as the Professional Identity Scale. A latent profile analysis (LPA) was conducted based on the three dimensions of the CFSS as observed indicators. Additionally, factors influencing outcomes were analyzed using both univariate and multivariate logistic regression methods.Ethical considerationsThis study was approved by the Institutional Review Board of the Affiliated Hospital of Qingdao University.ResultsA total of 1029 valid questionnaires were obtained, resulting in an effective response rate of 93.46%. The average score on the ICU Nurse Compassion Fatigue Scale was 60.00 ± 27.36 points. Three distinct profiles were identified: low compassion fatigue-low secondary trauma type (33.04%), moderate compassion fatigue-overall fluctuation type (48.30%), and high compassion fatigue-high burnout type (18.66%). Multivariate logistic regression analysis revealed that health status, sleep quality, highest education level, occupational stress, professional identity, and social support significantly influence the potential compassion fatigue profiles among critical care nurses ( Show less
Given the globalization of the nursing workforce, psychological empowerment represents a critical intrinsic determinant of nurses' mobility intentions, specifically regarding cross-border work. To ide Show more
Given the globalization of the nursing workforce, psychological empowerment represents a critical intrinsic determinant of nurses' mobility intentions, specifically regarding cross-border work. To identify latent profiles of nurses' psychological empowerment, examine associated factors, and explore the relationship between these profiles and cross-border working intention. A cross-sectional multicenter study was conducted from March to September 2023. Using convenience sampling, clinical nurses were recruited through liaisons from nursing societies in nine cities of Guangdong Province. Data were collected through questionnaires covering sociodemographic questionnaire, psychological empowerment, and cross-border working intention, with analyses including chi-square tests, logistic regression, and latent profile analysis (LPA) performed using SPSS 23.0 and Mplus 8.3. A total of 3671 valid questionnaires were collected, and 39.5% of the respondents reported cross-border intentions. LPA identified three psychological empowerment profiles among nurses, ranked from high to low: the core-driven empowerment profile (16.94%), the adaptive empowerment profile (70.42%), and the constrained empowerment profile (12.64%). The nurses with lower salary, intermediate title, and without specialist nurse qualification were more likely to fall into the constrained empowerment profile. Psychological empowerment was positively correlated with nurses' cross-border work intention. The core-driven profile showed the highest cross-border work intention (50.6%), followed by the adaptive (38.2%) and constrained profiles (31.7%). For cross-border work, the constrained profile prioritized salary (87.1%) as the key concern, while the core-driven profile focused more on good promotion opportunities (70.3%). Psychological empowerment exerts a positive impact on clinical nurses' cross-border work intention, with the three identified empowerment profiles exhibiting divergent motivational priorities and decision logics. These findings highlight the need for subgroup-specific strategies to balance nursing workforce mobility and stability. The findings support a differentiated human resource strategy based on nurses' psychological empowerment profiles. For core-driven nurses, institutions should provide international career development channels to strengthen their domestic job embeddedness. For adaptive nurses, tailored skill training and decision-making autonomy should be offered to guide their mobility aspirations. For constrained nurses, competitive compensation and family support services should be prioritized to address their stability needs and rebuild professional confidence. These targeted measures balance talent mobility and domestic workforce stability. Show less
While family resilience is a recognized determinant of adaptation following stroke, the distinct, empirically derived profiles of family resilience among Chinese stroke survivor-caregiver dyads have n Show more
While family resilience is a recognized determinant of adaptation following stroke, the distinct, empirically derived profiles of family resilience among Chinese stroke survivor-caregiver dyads have not been clearly delineated. Identifying these profiles and their determinants is crucial for developing targeted interventions. To identify latent profiles of family resilience and examine the socio-demographic and clinical factors associated with profile membership among stroke patient-caregiver dyads in China. In this cross-sectional study, a convenience sample of 773 stroke survivor-caregiver dyads was recruited from three hospitals in Zhejiang Province, China. Latent profile analysis (LPA) was conducted on the 20-item Family Resilience Questionnaire (FRQ). Multinomial logistic regression was used to determine factors associated with profile membership. LPA supported a four-profile solution: Profile 1 "Low-Functioning Families" (22%), Profile 2 "Moderately Resilient - Low Cohesive Families" (24%), Profile 3 "Highly Resilient - Well-Functioning Families" (31%), and Profile 4 "High-Functioning - Optimistically Resilient Families" (24%). Multinomial logistic regression revealed that lower caregiver competence (higher FCTI scores) was strongly associated with profile membership (standardized aORs ranged from 2.58 to 43.19), whereas higher perceived social support (PSSS) was a significant protective factor (standardized aORs ranged from 0.03 to 0.19). Caregiver relationship and payment source were also significantly associated with profile membership. Family resilience among Chinese stroke families manifests in four distinct profiles, which are differentiated predominantly by caregiver competence and perceived social support. Our findings advocate for a precision family support paradigm, shifting from one-size-fits-all approaches to interventions tailored to distinct resilience profiles. Given the strong association, intervention programs should prioritize enhancing core caregiver competencies as a primary leverage point for building family resilience. Show less
Adolescence is a critical period for rapid emotional and cognitive development. Depression and cognitive impairment frequently co-occur in this population, yet their comorbidity patterns and symptom-l Show more
Adolescence is a critical period for rapid emotional and cognitive development. Depression and cognitive impairment frequently co-occur in this population, yet their comorbidity patterns and symptom-level interactions remain insufficiently explored. A total of 2,244 students (mean age = 16.8 ± 0.84 years; 1,218 males, 1,026 females) from a high school in Heilongjiang Province, China, were recruited. Depressive symptoms and cognitive impairment were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Perceived Deficits Questionnaire–Depression (PDQ-D). Latent profile analysis (LPA) was applied to identify subgroups, followed by network analysis to examine central symptoms (expected influence, EI), bridge symptoms (bridge expected influence, BEI), and network differences (NCT). The optimal LPA model identified three comorbidity subgroups: low, moderate, and high. NCT revealed significant differences in network structure and global strength between the low–moderate (S = 1.514, Adolescent Depression and Cognitive Impairment can be classified into low, moderate, and high comorbidity subgroups. Somatic symptoms emerged as the central symptom, while prospective memory impairment and interpersonal problems were identified as key bridge symptoms, suggesting potential intervention targets for early screening and stratified treatment. Not applicable. The online version contains supplementary material available at 10.1186/s12888-026-07946-w. 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 Show more
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