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 straig Show more
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
Based on self-determination theory (SDT), this study aimed to identify latent profiles of health motivation characteristics among young and middle-aged individuals with prediabetes and to examine thei Show more
Based on self-determination theory (SDT), this study aimed to identify latent profiles of health motivation characteristics among young and middle-aged individuals with prediabetes and to examine their associations with self-management behaviours and metabolic risk indicators. This cross-sectional study recruited individuals with prediabetes from January 2024 to January 2025 using a convenience sampling method, enrolling 309 participants. Health behaviour motivation, basic psychological needs, prediabetes-related disease knowledge and self-management were assessed using validated questionnaires. Latent profile analysis (LPA) was conducted to identify distinct subgroups. Multinomial logistic regression was used to examine demographic, lifestyle and clinical factors associated with profile membership. Three types of health motivation characteristics were identified: high psychological need satisfaction-autonomous motivation profile (24.0%), moderate psychological need satisfaction-externally controlled motivation dominant profile (15.0%) and low psychological need satisfaction-low motivation profile (61.0%). After adjustment, BMI, comorbidity history and occupation were significantly associated with profile membership, whereas distance to primary healthcare facilities showed a non-robust pattern. Significant heterogeneity exists in health motivation characteristics among young and middle-aged individuals with prediabetes, with the low psychological need satisfaction-low motivation profile representing the largest proportion. Incorporating motivation-oriented stratification into diabetes prevention strategies may provide a useful framework for delivering tailored interventions and supporting more sustainable self-management. Show less
This study investigated the relationships between vacant land and key adverse health behaviors, including smoking, insufficient sleep, and no leisure-time physical activity (No LPA), across census tra Show more
This study investigated the relationships between vacant land and key adverse health behaviors, including smoking, insufficient sleep, and no leisure-time physical activity (No LPA), across census tracts in Chicago, Illinois. Using both global regression and geographically weighted regression (GWR), we evaluated whether neighborhood vacant land ratios (VLRs) were associated with the prevalence of these adverse health behaviors and assessed how these associations varied spatially across the city. We found significant spatial clustering in both vacant land and health behavior indicators, and the spatial clustering patterns of neighborhood vacancy and adverse health behaviors were broadly consistent. In global models, higher VLRs were associated with higher prevalence of adverse health behaviors; after accounting for spatially autocorrelated errors, the associations remained robust for smoking and insufficient sleep but were attenuated for No LPA. GWR results further revealed clear spatial non-stationarity, with stronger positive local associations concentrated in low-income neighborhoods on the south and west sides. When overlaid with Healthy Chicago Zones (HCZs), the strong vacancy-behavior associations aligned primarily with the West, Southwest, Near South, and Far South zones, highlighting these HCZs as priority areas where vacancy was most strongly linked to adverse health behaviors. Our findings support theories of neighborhood disorder and spatial inequality, emphasizing that vacant land is a potentially modifiable environmental determinant of health behaviors and calling for tailored interventions that consider local social and economic contexts to improve community health and advance health equity. Show less
To investigate the relationship between different physical activity (PA) patterns and stroke incidence among middle-aged and elderly populations in China. Data were drawn from the China Health and Ret Show more
To investigate the relationship between different physical activity (PA) patterns and stroke incidence among middle-aged and elderly populations in China. Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative prospective cohort encompassing 2011 to 2020. PA was calculated based on the International Physical Activity Questionnaire. Different patterns of PA included moderate-to-vigorous PA (MVPA, ≥ 150 min/wk vs. < 150 min/wk), vigorous PA (VPA, ≥ 75 min/wk vs. < 75 min/wk), moderate PA (MPA, ≥ 150 min/wk vs. < 150 min/wk), light PA (LPA, ≥ 300 min/wk vs. < 300 min/wk), and total PA (TPA, ≥ 600 metabolic equivalent of task [MET]-min/wk vs. < 600 MET-min/wk). Cox proportional hazards models evaluated stroke risk associations, while restricted cubic splines (RCS) characterized TPA dose-response effects. There were 5090 participants in total (mean age, 59.23 [standard deviation, 9.43] years; 54.5% were female), and 378 (7.4%) incident stroke cases were documented at a 9-year follow-up. Achieving the World Health Organization (WHO) guideline of ≥150 min/wk MVPA was associated with a 24% lower stroke risk (adjusted hazard ratio [HR] = 0.77, 95% confidence interval [CI] = 0.62-0.96, p = 0.019). No significant association was observed between VPA (HR = 0.79, 95% CI 0.63-1.01), MPA (HR = 0.82, 95% CI = 0.67-1.01), LPA (HR = 0.86, 95% CI = 0.70-1.07), or TPA (HR = 0.84, 95% CI = 0.65-1.08) and stroke risk. Additionally, RCS analysis demonstrated a non-significant dose-response relationship between TPA and stroke risk. This study validates WHO's MVPA guidelines (≥ 150 min/wk) for stroke prevention in Chinese elders. However, the predominantly self-reported and occupation-based PA in this cohort highlights the need for future research focusing on objective measurements of leisure-time PA. 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
The 24-h movement behavior framework includes all physical activity (PA), sedentary behavior (SB), and sleep as interdependent components of a full day. While evidence highlights the benefits of highe Show more
The 24-h movement behavior framework includes all physical activity (PA), sedentary behavior (SB), and sleep as interdependent components of a full day. While evidence highlights the benefits of higher PA, lower SB, and adequate sleep for health, the combined effects of these behaviors on mental and physical health remain unclear. This systematic review will explore the associations between 24-h movement behavior compositions and mental and physical health outcomes, providing insights for developing balanced movement behavior guidelines. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guideline. PubMed, PsycINFO, Embase, Web of Science, and Sport Discus will be searched for studies published between 2015 and 2025. Eligible studies must report 24-h movement behavior metrics-the composition of time allocated to sleep, sedentary behavior, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Included studies must also examine at least one mental (e.g., depression, anxiety) or physical (e.g., BMI, systolic blood pressure, all-cause mortality) health outcome. For each study, we will extract the time allocated to each behavior and effect estimates with 95% CIs (e.g., percent change in BMI, odds ratios for depression, hazard ratios for mortality) to quantify the magnitude and direction of associations. Screening, data extraction, and quality assessment will be conducted independently by two reviewers. The quality of evidence for each outcome will be assessed using the GRADE approach. Due to expected heterogeneity in study designs, a meta-analysis will not be performed. Instead, a structured narrative synthesis will be presented, stratified by age group and health condition, to summarize findings and identify key research gaps. The proposed systematic review will be the first to comprehensively review how combinations of PA, SB, and sleep are associated with mental and physical health using compositional data analysis. By emphasizing the interdependent nature of 24-h movement behaviors, the findings will provide a clearer understanding of how time spent among these behaviors influences health outcomes. The review aims to support evidence-based recommendations for optimizing daily movement behavior patterns to improve health across diverse populations. PROSPERO (CRD42023445730). Show less
This study explores the influence of congruence and incongruence in father-mother co-parenting on adolescent depression, as well as the mediating effect of self-esteem. A total of 1389 adolescents com Show more
This study explores the influence of congruence and incongruence in father-mother co-parenting on adolescent depression, as well as the mediating effect of self-esteem. A total of 1389 adolescents completed questionnaires assessing their levels of depression and self-esteem, while their fathers and mothers correspondingly reported on their own co-parenting behaviors using the Parental Co-parenting Scale in this cross-sectional study. Dates were analyzed using LPA, RSA, and mediation consecutively. The results show that: (1) We identified three distinct co-parenting profiles: positive parental co-parenting, negative parental co-parenting, and mixed parental co-parenting. (2) In cases of congruent parental co-parenting, high positive parental co-parenting was associated with lower adolescent depression, whereas high negative parental co-parenting was linked to higher depression, and the difference manifests in different forms among boys and girls. Girls showed nonlinear changes in depression while boys exhibited linear trends. (3) In cases of incongruence in parental co-parenting, mothers' co-parenting exerted a stronger influence on boys' depression, while girls were not affected by mothers' and fathers' discrepancies. (4) Self-esteem mediated the relationship between parental co-parenting (in)congruence and depression across both genders. This study provides evidence for the mechanism through which parental coparenting influences adolescent depression and offers a basis for future interventions targeting adolescent depression. Show less
Lipoprotein(a) [Lp(a)] is a genetically determined lipoprotein that has been established as an independent and causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic Show more
Lipoprotein(a) [Lp(a)] is a genetically determined lipoprotein that has been established as an independent and causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease (CAVD). Structurally composed of a low-density lipoprotein (LDL)-like particle covalently linked to apolipoprotein(a) [apo(a)], Lp(a) exhibits unique atherogenic, thrombogenic, and inflammatory properties, largely due to its role as a carrier of oxidized phospholipids (OxPL). Plasma Lp(a) concentrations are predominantly determined by the number of kringle IV type 2 (KIV-2) repeats in the LPA gene, with minimal influence from lifestyle or environmental factors. Despite substantial evidence linking elevated Lp(a) to cardiovascular risk, clinical testing remains underutilized, especially in East Asian countries. In Taiwan, although population-level Lp(a) concentrations are comparatively low, a significant subset exceeds risk thresholds, with local studies confirming its prognostic value in coronary artery disease and ischemic stroke. Barriers, including limited physician awareness, implementation barriers, and therapeutic nihilism, contribute to its under-recognition. This review highlights the molecular features of Lp(a), its pathogenesis of cardiovascular disorders, epidemiology, and current barriers and future advances in diagnostic testing, with a particular focus on implications for cardiovascular risk management in Taiwan. 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 Show more
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
Fang Chen, Juan Gao · 2026 · Journal of multidisciplinary healthcare · added 2026-04-24
This study aimed to identify distinct latent profiles (categories) of health behavior protection motivation among patients with type 2 diabetes using latent profile analysis. Subsequently, we compared Show more
This study aimed to identify distinct latent profiles (categories) of health behavior protection motivation among patients with type 2 diabetes using latent profile analysis. Subsequently, we compared e-health literacy levels across these patient categories and analyzed factors influencing protection motivation. The findings are intended to provide a scientific basis for precise diabetes management. From January to March 2025, a cross-sectional survey was conducted on a convenience sample of 253 patients, and data were collected using relevant scales such as the health-related behavior protection motivation assessment. LPA was performed using Mplus 8.3 to identify motivational profiles. Binary logistic regression was applied to determine influencing factors. A total of 253 valid questionnaires were collected. Two latent profiles of health-related behavioral protection motivation were identified: the "high perceived cost-incentive-dependent group" (n = 91, 35.97%) and the "high sensitivity-high efficacy group" (n = 162, 64.03%). The total eHealth literacy score of the "high perceived cost-incentive-dependent group" was 100.35 ± 17.89, which was significantly lower than that of the "high sensitivity-high efficacy group" (110.76 ± 13.78), with a statistically significant difference (t = -5.165, P < 0.001). Logistic regression analysis revealed that patients who monitored their blood glucose more than three times per week were 2.95 times more likely to have a higher level of protective motivation compared to those who did so three times or fewer (95% CI: 1.679-5.197, P < 0.001). There is population heterogeneity in health-related behavioral protection motivation among patients with type 2 diabetes. Frequency of blood glucose monitoring per week was identified as influencing factors of motivational profile membership. Differences in eHealth literacy levels were also observed between the two groups. Targeted interventions should be provided based on population characteristics to enhance motivation, improve electronic health literacy, and behavioral compliance. 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
We employed a causal inference framework to estimate the counterfactual dose-response effects of light-intensity physical activity (LPA) on mortality across low, medium and high moderate- to vigorous- Show more
We employed a causal inference framework to estimate the counterfactual dose-response effects of light-intensity physical activity (LPA) on mortality across low, medium and high moderate- to vigorous-intensity physical activity (MVPA) levels, and the lower and higher thresholds of current MVPA recommendations. Eligible participants from the UK Biobank (n=71 715) were included in the current study. LPA and MVPA were measured via accelerometers, and mortality data were derived from death registry. Flexible parametric survival models were used under the counterfactual framework to estimate the marginal predicted probability of death after 10 years of follow-up. During a median follow-up period of 8.0 years, 2195 deaths occurred. A non-linear dose-response effect of LPA on all-cause mortality was evident, and the effect diminished as MVPA level increased. If all participants achieved the lower threshold of the WHO recommended 22 min/day of MVPA, the 10-year probability of death would be expected to decrease from 9.5% at 60 min/day LPA to 4.2% at 360 min/day. If all participants achieved the higher threshold of 44 min/day of MVPA, the 10-year probability of death would be expected to decrease from 6.6% at 60 min/day of LPA to 3.7% at 345 min/day. Across the MVPA values examined, the optimal dose for LPA ranged from 195 to 225 min/day. LPA may complement MVPA to reduce risk of all-cause mortality, particularly among those with low MVPA or those unable to engage in higher-intensity activities. Our study highlights the potential for integrating LPA into public health strategies and future physical activity guidelines. Show less
Job satisfaction is a critical factor influencing workplace efficiency and employee well-being. In the context of Industry 5.0 transformation, understanding the latent profiles of job satisfaction and Show more
Job satisfaction is a critical factor influencing workplace efficiency and employee well-being. In the context of Industry 5.0 transformation, understanding the latent profiles of job satisfaction and their relationship with mental health outcomes, such as depression, anxiety, and digital-intelligence job insecurity, is critical for promoting employee well-being and organizational sustainability. This study aims to explore the latent profiles of job satisfaction among industrial workers and explore their associations with mental health outcomes. This study used cross-sectional data from 3,420 male frontline workers from a large automobile manufacturing enterprise in Jilin Province, China in April 2024. Latent profile analysis (LPA) was employed to identify distinct latent profiles of job satisfaction among industrial workers, while hierarchical linear regression analysis was used to analyze the relationship between job satisfaction and psychological health outcomes (depression, anxiety and digital-intelligence job insecurity). The score of job satisfaction among industrial workers in Jilin Province was 3.62 ± 0.90. Four profiles were identified: very low (5.97%), low-to-moderate (31.14%), moderately high (42.63%), and high job satisfaction (20.26%). Depression and anxiety showed a clear level-gradient pattern across profiles, whereas digital-intelligence job insecurity displayed a non-monotonic pattern with higher levels in the low-to-moderate and moderately high profiles. Work stress showed consistent associations with all outcomes, and job satisfaction profiles remained associated with depression and anxiety after covariate and stress adjustment; associations with digital-intelligence job insecurity were smaller but detectable. This study examined heterogeneity in job satisfaction among frontline industrial workers and its associations with mental health outcomes. Latent profile analysis identified four job satisfaction profiles. Job satisfaction profile membership remained strongly associated with depression and anxiety. Digital-intelligence job insecurity showed a non-monotonic pattern across profiles. These findings suggest that an individual-centered profile approach provides actionable differentiation of mental health symptom burden across distinct job satisfaction patterns, supporting more targeted workplace strategies. 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
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
This study, adopting a person-centered approach and using network analysis, explores latent subtypes of Junzi personality among college students and their links to Receptiveness to Opposing Views, off Show more
This study, adopting a person-centered approach and using network analysis, explores latent subtypes of Junzi personality among college students and their links to Receptiveness to Opposing Views, offering empirical backing for the ancient Chinese idea of "Junzi harmonize yet remain distinct." Traditional variable-centered methods often fail to fully expose the underlying typological structure due to the possible heterogeneous combinations in Junzi personality dimensions. Thus, a person-centered latent profile analysis (LPA) was used to pinpoint typical personality trait patterns. With 1116 college students as participants, the study employed the Junzi Personality Questionnaire Based on Confucian Thought and the Receptiveness to Opposing Views Scale. LPA identified three personality types: The Moderate Type (50%), The Daring-Aggressive Type (15%), and The Virtuously-Accomplished Type (35%). Regression analysis showed significant correlations between gender, age, and personality type, with The Virtuously-Accomplished Type scoring notably higher in Receptiveness to Opposing Views. Network analysis further revealed distinct differences in the network structures of Receptiveness to Opposing Views among the three types: The Moderate Type centered on "derogation of opponents," "refraining from what should not be done," and "respectfulness and propriety"; The Daring-Aggressive Type focused on "conversancy with righteousness and cherishment of benign rule," "derogation of opponents," and "respectfulness and propriety"; while The Virtuously-Accomplished Type highlighted "negative emotions" and "wisdom, benevolence, and courage," with "taboo issues" at the periphery in all datasets. The findings uncover the heterogeneity of Junzi personality and its varied associations with Receptiveness to Opposing Views, providing insights for understanding harmonious interactions in diverse settings. Show less
Snacktivity—brief, high-frequency bouts of moderate-to-vigorous physical activity (MVPA) integrated into daily routines—may interrupt prolonged sitting and help accumulate total activity. Step count i Show more
Snacktivity—brief, high-frequency bouts of moderate-to-vigorous physical activity (MVPA) integrated into daily routines—may interrupt prolonged sitting and help accumulate total activity. Step count is a practical proxy for this pattern, yet the cadence thresholds that map short-bout stepping to MVPA and the relevance of bout–cadence patterns to adiposity remain unclear. This study aimed to examine the associations between accelerometer-derived step metrics and adiposity and to identify pragmatic step-based thresholds in older women. We conducted a cross-sectional study of 1,109 community-dwelling older women in Yantai, Shandong Province, China, with a mean age of 64.93 years (SD = 2.82). Step-based metrics (daily steps, MVPA and light-intensity physical activity (LPA) steps, cadence, and bout patterns) were derived from a waist-worn triaxial accelerometer. adiposity was defined using body-fat-ratio (BFR) categories assessed by multi-frequency bioelectrical impedance analysis. Multiple linear regression estimated associations with progressive adjustment for sociodemographic, lifestyle, and health-related covariates, with additional adjustment for total sedentary time. Sensitivity analyses replaced BFR with BMI and examined visceral fat mass (VFM) using linear regression. Receiver operating characteristic (ROC) analyses identified pragmatic step and cadence cut-points. MVPA step counts and cadence were consistently and inversely associated with adiposity ( Among older women, MVPA-oriented step metrics—particularly ~ 1,846 MVPA steps/day and ~ 94.3 steps/min cadence—showed inverse associations with adiposity and outperformed LPA metrics. These thresholds may serve as pragmatic, low-barrier activity targets, but causal relationships require confirmation in longitudinal and experimental studies. The online version contains supplementary material available at 10.1186/s12889-026-26912-5. 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. Fu Show more
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
Hemodialysis, as one of the main alternative treatment methods for end-stage renal disease, has received much attention in recent years. Due to the particularity of hemodialysis treatment, patients ha Show more
Hemodialysis, as one of the main alternative treatment methods for end-stage renal disease, has received much attention in recent years. Due to the particularity of hemodialysis treatment, patients have a relatively high risk of infection during the treatment process. Hemodialysis nurses, who are the main executors of the treatment operations and have the most contact with patients, have a close relationship with the infection risk of patients. The level of their hospital infection prevention and control literacy is closely related to the infection risk of patients. To explore the current level of knowledge, attitudes, and practices (KAP) of hospital infection prevention and control among haemodialysis nurses in the Sichuan Province, China, and identified their potential categories. This provided evidence-based recommendations for improving infection control management in hemodialysis departments. A cross-sectional study was conducted From July 15 to August 15, 2025 using a convenience sampling method to survey 470 hemodialysis nurses from 78 hospitals in Sichuan Province. Participants were licensed nurses with over 3 months of hemodialysis experience. Data were collected using the A total of 460 valid questionnaires were collected, with an effective response rate of 97.87%. The average scores for knowledge, attitudes, and practices related to hospital infection prevention and control among haemodialysis nurses were 4.67 ± 0.43, 4.59 ± 0.43, and 4.74 ± 0.34, respectively. Three latent profile models were constructed, with the two-class model identified as the optimal solution, which were defined as the "Low KAP Group" (25.9%) and "High KAP Group" (74.1%). Logistic regression analysis revealed that sex, responsibility for infection control, hospital level, annual number of infection control training sessions, organizational support, and work engagement were significant influencing factors ( The KAP level of haemodialysis nurses in hospital infection prevention and control was relatively high. Hospital managers should tailor supportive work environments on the basis of the individual characteristics and work engagement of haemodialysis nurses to improve the KAP level of nosocomial infection prevention and control among haemodialysis nurses. Show less
Coronary artery calcification (CAC) signifies advanced atherosclerosis and portends increased cardiovascular risk. Lipoprotein(a) [Lp(a)] is a causal risk factor for atherosclerosis; however, its asso Show more
Coronary artery calcification (CAC) signifies advanced atherosclerosis and portends increased cardiovascular risk. Lipoprotein(a) [Lp(a)] is a causal risk factor for atherosclerosis; however, its association with in vivo lesion morphology and clinical outcomes in patients with symptomatic, advanced CAC remains incompletely characterized. This study aimed to investigate the association between elevated Lp(a) levels and both in vivo lesion morphology and clinical outcomes in this high-risk population. In this retrospective cohort, 292 patients with intravascular ultrasound(IVUS)-confirmed CAC were stratified into elevated (≥50 mg/dL,n = 77) or low (<50 mg/dL,n = 215) Lp(a) groups. The primary endpoint was major adverse cardiovascular events (MACEs). Associations were assessed via multivariable Cox models adjusted for clinical covariates. Patients in the elevated Lp(a) group presented a greater incidence of aortic valve calcification (p < 0.001). IVUS revealed constrictive remodeling with a smaller lumen and vessel dimensions. During a median follow-up of 17.2 months, the elevated Lp(a) cohort had a significantly higher MACE rate (37.7% vs. 15.8%; adjusted hazard ratio [aHR] 2.60, 95% CI 1.55-4.35, p < 0.001). Elevated Lp(a) independently predicted increased risks of ischemic stroke (aHR 7.14) and in-stent restenosis (aHR 2.78). In symptomatic patients with IVUS-confirmed CAC, elevated Lp(a) identifies a high-risk phenotype characterized by constrictive vascular remodeling and a markedly increased risk of MACEs, driven particularly by ischemic stroke and in-stent restenosis. These findings support the integration of routine Lp(a) testing into the risk stratification of patients with severe CAC, thereby identifying a precise high-risk phenotype that warrants intensified monitoring and represents an ideal target for emerging Lp(a)-lowering therapies. Show less
Xinyi Ma, Yang Xu, Yeqi Nian+9 more · 2026 · American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · Elsevier · added 2026-04-24
Carboxymethylcellulose (CMC), a common food emulsifier, induces microbiota dysbiosis and systemic inflammation; however, its impact on transplant immunity remains unclear. Allogenic heart rejection wa Show more
Carboxymethylcellulose (CMC), a common food emulsifier, induces microbiota dysbiosis and systemic inflammation; however, its impact on transplant immunity remains unclear. Allogenic heart rejection was observed in CMC-fed recipient mice, with increased abundance of lysophosphatidic acid (LPA)-producing bacteria and increased serum LPA concentration. CMC-induced transplant rejection was caused by the gut microbiota, as confirmed by fecal microbiota transplantation and gut microbiota depletion. Furthermore, LPA-treated macrophages demonstrated a proinflammatory ability to accelerate allograft rejection in cytotoxic T lymphocyte-associated protein 4 immunoglobulin-induced allograft survival by upregulating glycolysis. Conversely, the administration of a glycolysis inhibitor resulted in allograft survival and abrogated the detrimental effect of LPA. Mass spectrometry and single-cell RNA sequencing confirmed that transplant patients with rejection showed significantly elevated serum LPA levels and LPA receptor 6 (LPAR6) expression in graft-infiltrate macrophages. Mechanistically, LPA preferentially promoted LPAR6 expression, which interacted with Rho-associated protein kinase 2 to activate the mammalian target of rapamycin/hypoxia-inducible factor 1-alpha pathway, thereby enhancing glycolysis and inducing proinflammatory macrophage polarization. Treatment with Ki16425, an LPAR antagonist, prolonged allograft survival in CMC-fed recipients. Our findings reveal a major detrimental effect of CMC on macrophage physiology and suggest that controlling LPAR6 expression or glycolysis in macrophages may improve allograft survival in transplant recipients. Show less
To evaluate the current status and latent profiles of caregiver self-care contributions for patients with chronic obstructive pulmonary disease (COPD) and examine the associations between demographic Show more
To evaluate the current status and latent profiles of caregiver self-care contributions for patients with chronic obstructive pulmonary disease (COPD) and examine the associations between demographic characteristics, health literacy, confidence in self-care contributions, family intimacy, and profile membership. We recruited 275 dyads of patients with COPD and their family caregivers from five tertiary hospitals between May and November 2022 using convenience sampling. Latent profile analysis (LPA) was used to identify distinct profiles of caregiver self-care contributions. Univariate analysis and multinomial logistic regression were subsequently conducted to examine associations between participant characteristics and profile membership. LPA identified four distinct profiles of caregiver self-care contributions: low-contributing, under-monitored, maintenance-prioritized, and high-contributing. Significant differences were observed across these profiles in terms of patients' symptom severity, exacerbation frequency, number of hospitalizations, caregivers' education levels, caregiving duration, health literacy, confidence in self-management contributions, and family intimacy using univariate analysis. Multinomial logistic regression analysis revealed that caregivers' education levels, caregiving duration, confidence in self-management contributions, and health literacy were significant predictors of profile membership. Caregiver self-care contributions for patients with COPD can be characterized by four distinct profiles, with caregivers' educational level, health literacy, and confidence in self-management identified as key factors associated with profile membership. Show less
Lipoprotein(a) [Lp(a)] and diabetes mellitus (DM) are independent risk factors for worse outcomes in coronary artery disease (CAD) patients. Evidence of their joint association is limited. We aimed to Show more
Lipoprotein(a) [Lp(a)] and diabetes mellitus (DM) are independent risk factors for worse outcomes in coronary artery disease (CAD) patients. Evidence of their joint association is limited. We aimed to investigate the combined effect of elevated Lp(a) and DM on survival outcomes in CAD patients. This study included 65 547 CAD patients (62.6 ± 10.7 years, 27.7% female) from CIN-II and RED-CARPET cohorts. Patients were stratified into four groups by Lp(a) levels (< or ≥ 30 mg/dL) and DM status. Multivariable Cox regression models estimated associations with cardiovascular and all-cause mortality, examining additive and multiplicative interactions. During a median follow-up of 5.5 years, 10 686 (16.3%) patients died from all causes and 5106 (7.8%) died from cardiovascular causes. Patients with Lp(a) ≥ 30 mg/dL and DM were independently associated with cardiovascular mortality (adjusted hazard ratio [aHR]: 1.28, 95% CI: 1.20-1.35; aHR: 1.53, 95% CI: 1.44-1.62, all p < 0.001, respectively). Compared to patients with Lp(a) < 30 mg/dL without DM, the aHRs were 1.26 (95% CI: 1.16-1.36, p < 0.001), 1.51 (95% CI: 1.40-1.62, p < 0.001) and 2.00 (95% CI: 1.83-2.18, p < 0.001) for those with Lp(a) ≥ 30 mg/dL without DM, Lp(a) < 30 mg/dL with DM and Lp(a) ≥ 30 mg/dL with DM, respectively. Significant additive interaction between elevated Lp(a) and DM on cardiovascular mortality was observed, with 12% of the excess risk attributed. Similar associations were observed in all-cause mortality. In patients with CAD, elevated Lp(a) and DM act synergistically to increase the risk of cardiovascular and all-cause mortality, suggesting that both risks should be considered to integrate management. Show less
China's total fertility rate has reached a critically low level, dropping to approximately 1.0 by the end of 2023which is significantly below the population replacement level of 1.5. This decline refl Show more
China's total fertility rate has reached a critically low level, dropping to approximately 1.0 by the end of 2023which is significantly below the population replacement level of 1.5. This decline reflects a marked reduction in fertility intention among reproductive-aged women, exacerbating population aging and threatening long-term labor supply and social sustainability. Despite policy adjustments and governmental support initiatives, intended outcomes have not been realized. Current literature largely focuses on isolated determinants of fertility intention, overlooking heterogeneity within the population. Moreover, the pathways through which psychosocial factors operate across different subgroups remain poorly understood. Data for this study were derived from the 2021 Psychological and Behavioral Investigation of Chinese Residents (PBICR 2021), a nationally representative cross-sectional survey. Latent profile analysis (LPA) was employed to identify subtypes of fertility intention among reproductive-aged women, followed by multinomial logistic regression, which examined factors associated with different profiles. Among 2,973 reproductive-aged female participants, three distinct fertility intention profiles were identified via latent profile analysis: the Fertility Intention Decline Group (25.1%), the Low Fertility Intention Group (51.3%), and the High Fertility Intention Group (23.6%). Multinomial logistic regression analysis revealed that, compared with the Fertility Intention Decline Group, the Low Fertility Intention Group was significantly associated with family type, aged 20-40 years, residential location, having 2 children, and retirement status (all Fertility intention among reproductive-aged women demonstrates significant heterogeneity. This study identified three distinct latent profiles, each characterized by unique patterns of influencing factors. The findings highlight the necessity of moving beyond one-size-fits-all policy approaches and emphasize the importance of developing tailored interventions that account for the specific characteristics and determinants of each subgroup. Show less
Ashen L Vidanage, Tianyu Xu, Zihao Chen+9 more · 2026 · International journal of cardiology. Cardiovascular risk and prevention · Elsevier · added 2026-04-24
Serum lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for cardiovascular disease. However, whether hypertension modifies the association between Lp(a) and adverse outcomes in acute Show more
Serum lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for cardiovascular disease. However, whether hypertension modifies the association between Lp(a) and adverse outcomes in acute decompensated heart failure (ADHF) remains unclear. We investigated how hypertension status influences the relationship between Lp(a) and all-cause mortality in ADHF. We conducted a single-center retrospective observational study including 2610 patients hospitalized with ADHF. We normalized the distribution of Lp(a) by a logarithmic transformation and assessed the risk of all-cause mortality with Lp(a), using Cox regression with adjustment for potential confounders. Among 2610 patients (39.0% women; mean age, 68.8 years), 1606 (61.5%) had hypertension. Over 4.1 years (median), 1287 deaths occurred. In all patients, log-transformed Lp(a) was significantly associated with mortality (adjusted HR 1.21; 95% CI, 1.05-1.39; Increased admission Lp(a) levels were associated with a higher risk of all-cause mortality in ADHF patients with hypertension. Further studies are needed to explore the mechanistic links among Lp(a), hypertension and ADHF. Show less
This study aims to identify the 24-h movement behavior patterns of preschool children using Latent Profile Analysis based on Compositional Data Analysis (CoDA), and to examine their associations with Show more
This study aims to identify the 24-h movement behavior patterns of preschool children using Latent Profile Analysis based on Compositional Data Analysis (CoDA), and to examine their associations with physical fitness. The study employs a cross-sectional design. A total of 329 healthy children aged 4-6 years were selected. Accelerometers (ActiGraph wGT3-BT, Pensacola, FL, USA) were used to measure light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB), while sleep was assessed through parent and teacher questionnaires. The assessment of physical fitness was conducted in accordance with the "Chinese National Physical Fitness Test Standards" (Preschooler Section). To address the multicollinearity problems among components of physical activity (PA), CoDA was first applied, subsequently, Latent Profile Analysis was utilized to categorize 24-h movement behavior patterns, while a Generalized Ordered Logit Model (GOLM) was applied to investigate their associations with physical fitness. Three distinct behavioral patterns emerged from the analysis: the "brown bear group" (moderate PA and SB, high SP, N = 176, 53.5%), the "cheetah group" (high PA/MVPA, low SB, moderate SP, N = 102, 31%), and the "koala group" (low PA, high SB, lower SP, N = 51, 15.5%). After adjusting for potential confounding factors, it was found that compared with the "koala group", the "brown bear group" and the "cheetah group" exhibited higher levels of physical fitness, with the probability of improving their physical fitness rating being 3.69 times and 6.36 times that of the "koala group," respectively. This study highlights the significant impact of active and healthy activity patterns on the physical fitness of preschool children, providing a foundation for formulating personalized preventive and interventional approaches in early childhood. Show less
Lipoprotein(a) [Lp(a)] is a well-established independent risk factor for cardiovascular disease. However, the long-term effects of Lp(a) on coronary plaque phenotype remain unclear. To explore the pot Show more
Lipoprotein(a) [Lp(a)] is a well-established independent risk factor for cardiovascular disease. However, the long-term effects of Lp(a) on coronary plaque phenotype remain unclear. To explore the potential association between Lp(a) levels and coronary plaque volume, composition, and progression using coronary computed tomography angiography (CCTA). Patients with available data for Lp(a) and underwent baseline CCTA examinations between January 2009 to December 2015 and subsequently underwent a follow-up coronary CTA were retrospectively enrolled. Quantitative CCTA analyses measured plaque length, total plaque volume and composition volume. Patients were categorized into an elevated Lp(a) group (≥30 mg/dL) and a normal Lp(a) group (<30 mg/dL). The association between Lp(a) and baseline plaque characteristic and progression were investigated in linear mixed-effects models adjusted for clinical factors. Subgroup analyses were also conducted. Among 453 patients (mean age 64.7 years, 77.7% male) with a median follow-up of 6.15 years. elevated Lp(a) was linked to higher baseline plaque burden (all Elevated Lp (a) level was associated with high coronary artery plaque burden at baseline and rapid progression of LAP at follow-up. Lp(a) may serve as a significant residual risk factor in seemingly "low-risk" populations. Show less
Digital literacy has become a core competency for nursing professionals, enabling them to adapt to modern healthcare environments and engage effectively with emerging technologies. It is closely linke Show more
Digital literacy has become a core competency for nursing professionals, enabling them to adapt to modern healthcare environments and engage effectively with emerging technologies. It is closely linked to innovative behavior, which is essential for problem solving and advancing nursing practice. Despite its importance, limited research has examined differences in digital literacy among undergraduate nursing students and how these differences influence innovation. A cross-sectional study was conducted using a convenience sample of 450 undergraduate nursing students from four universities in Anhui Province, China. Participants completed a general information questionnaire, the Undergraduate Digital Literacy Scale, and the Innovative Behavior Scale. Latent profile analysis (LPA) was employed to classify students into distinct digital literacy profiles, while logistic regression and one-way ANOVA were used to explore factors influencing profile membership and the relationship between digital literacy and innovative behavior. Three latent profiles were identified: a "Low Digital Literacy" group (34.1%), a "Moderate Digital Literacy" group (15.9%), and a "High Digital Literacy" group (50.0%). Significant differences were observed across profiles in relation to gender, age, academic year, and frequency of artificial intelligence (AI) use in the past 6 months. Importantly, students with higher digital literacy consistently exhibited stronger innovative behavior ( Digital literacy among undergraduate nursing students is heterogeneous and shaped by demographic and experiential factors. Targeted educational interventions tailored to distinct literacy profiles are needed to bridge gaps, promote equity, and strengthen innovation. By integrating AI and advanced digital tools into nursing curricula, educators can enhance students' competencies and better prepare them to thrive in an increasingly digital and intelligent healthcare landscape. Show less
This study aims to examine the health characteristics of female sex workers (FSWs) in entertainment venues and to investigate the relationship between these characteristics and sleep quality. This stu Show more
This study aims to examine the health characteristics of female sex workers (FSWs) in entertainment venues and to investigate the relationship between these characteristics and sleep quality. This study employed a cross-sectional design and was conducted from January to April 2024 in Wuhan, China. Participants were FSWs recruited through snowball sampling from entertainment venues, including hotels, restaurants, nightclubs, karaoke bars and dance halls. Data were collected via structured questionnaires covering sociodemographic information, work experience, psychological stress, health status, sleep quality and circadian rhythms. Latent profile analysis (LPA) was employed to identify health characteristic profiles among FSWs, and multivariate logistic regression was used to examine the associations between these profiles and sleep quality. Among the 1,036 FSWs surveyed, 45.1% had poor sleep quality. LPA classified FSWs’ health characteristics into three profiles: the high overall functioning group, the lower physical–emotional functioning group and the lower psychosocial functioning group. Multivariate logistic regression analysis showed that FSWs in the lower physical–emotional functioning group had higher odds of poor sleep quality (OR = 2.184) compared with those in the high overall functioning group. FSWs in the lower psychosocial functioning group had substantially higher odds of poor sleep quality (OR = 7.755) than that in the high overall functioning group. FSWs demonstrate substantial heterogeneity in health characteristics and exhibit lower overall sleep quality compared with the general population. Psychological and physiological factors are major influencing factors for their sleep quality, suggesting the importance of prioritising mental and physical health in this population. Show less