To explore the latent profiles of self-stigma and their relationship with meaning in life among individuals with substance use disorders(SUDs). A total of 1001 participants were recruited from six dru Show more
To explore the latent profiles of self-stigma and their relationship with meaning in life among individuals with substance use disorders(SUDs). A total of 1001 participants were recruited from six drug rehabilitation centers in Sichuan Province between July and August 2025 and completed the self-stigma Scale for Drug Addicts (SSSDA) and the Meaning in Life Questionnaire (MLQ). Latent profile analysis (LPA) was used to identify latent profiles of self-stigma. Multinomial logistic regression was employed to analyze influencing factors, and analysis of variance (ANOVA) was used to compare differences in meaning in life across the different profiles. The self-stigma of individuals with SUDs can be categorized into four latent profiles: the "stigma-resistant profile"(10.0%), "moderate stigma-concealment profile"(46.3%), "internalized stigma profile"(19.5%), and "low internalization-adaptation profile"(24.3%). Among these, the "moderate stigma-concealment profile", "internalized stigma profile", and "low internalization-adaptation profile" represent categories with higher levels of self-stigma. Risk factors associated with these profiles include male sex, low income, a history of being left-behind children, low social support, multiple rehabilitation attempts, as well as mental illness or HIV infection. Statistically significant differences were found among the four profiles in the total score of meaning in life and its sub-dimensions-presence of meaning and search for meaning (p < 0.001). The "stigma-resistant profile" presented the highest level of MIL, whereas the "internalized stigma profile" presented the lowest level. Significant heterogeneity exists in self-stigma among individuals with substance use disorders (SUDs), and the level of self-stigma is significantly negatively correlated with MIL. 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
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
To investigate the association between quantitative retinal vascular parameters and coronary artery disease (CAD) and to evaluate the efficacy of a retinal phenotype-based diagnostic model as a non-in Show more
To investigate the association between quantitative retinal vascular parameters and coronary artery disease (CAD) and to evaluate the efficacy of a retinal phenotype-based diagnostic model as a non-invasive tool for early CAD screening. A retrospective cross-sectional study. A single-centre study conducted at the Cardiovascular Center of Beijing Tongren Hospital, Capital Medical University, China, between January and October 2024. 417 patients with suspected angina undergoing their first coronary angiography (CAG) were enrolled. Inclusion criteria were age >18 years and high-quality fundus photography within 24 hours pre-CAG. Major exclusions were prior coronary interventions, severe systemic/valvular heart diseases and ocular conditions impairing retinal vascular visualisation. The primary outcome was the association between quantitative retinal vascular parameters and the presence of CAD (defined as ≥50% stenosis). Secondary outcomes included the diagnostic performance area under the receiver operating characteristic curve (AUROC) of three predictive models: one based on quantitative retinal vascular parameters alone, one based on traditional risk factors and a combined model integrating both retinal and clinical variables. This study enrolled 417 patients undergoing initial CAG. Compared with non-CAD controls (n=190), patients with CAD (n=227) had higher prevalence of hypertension, dyslipidaemia and diabetes, along with elevated levels of fasting blood glucose, lipoprotein(a) (Lp(a)), triglyceride (TG) and glycated haemoglobin (HbA1c) (all p<0.05). Quantitative fundus analysis revealed that multiple retinal vascular parameters were independently associated with CAD after multivariable adjustment, including fractal dimension (FD), vessel density (VD) and specific zonal measures of vessel diameter and tortuosity (all p<0.05). Multivariable logistic regression incorporating both fundus and clinical variables identified the following independent predictors of CAD: a decrease in FD (OR=0.26, 95% CI 0.16 to 0.41, p<0.01), reduced optic disc long-to-short axis ratio (OR=0.04, 95% CI 0.004 to 0.46, p=0.01) and optic disc-to-macula distance (OR=0.91, 95% CI 0.86 to 0.97, p<0.01), male sex, dyslipidaemia and elevated levels of Lp(a), TG, low-density lipoprotein cholesterol and HbA1c (all p<0.05). The final diagnostic model achieved an AUROC of 0.802 (95% CI 0.76 to 0.845), with a sensitivity of 0.797 and a specificity of 0.679 at the optimal cut-off. Internal validation via bootstrap resampling (1000 iterations) confirmed the robustness of the identified predictors. Our findings, derived from an artificial intelligence-based fully automated quantitative retinal vascular parameters measurement method, revealed that multiple quantitative fundus parameters-including FD, VD and other morphological parameters were significantly associated with CAD risk. The CAD diagnostic model we developed demonstrates strong performance and high interpretability, making it suitable for early CAD screening and diagnosis. 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
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
Previous studies have indicated that Kinesiophobia is associated with adherence to exercise rehabilitation. Given the multifaceted impact of Kinesiophobia and the complex diversity of individual chara Show more
Previous studies have indicated that Kinesiophobia is associated with adherence to exercise rehabilitation. Given the multifaceted impact of Kinesiophobia and the complex diversity of individual characteristics, existing research struggles to identify the distinct features of Kinesiophobia. Latent Profile Analysis (LPA) identifies individuals’ latent traits based on their response patterns to observable measures, grouping individuals with similar symptom profiles into different categories, thereby better distinguishing differences among individuals. However, there is currently a lack of research on the kinesiophobia in the out-of-hospital early rehabilitation phase after Percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). Therefore, the aim of this study is to investigate kinesiophobia in the out-of-hospital early rehabilitation phase after Percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD), classify it based on latent profile analysis, and explore the related factors of Kinesiophobia in CHD patients across different categories. This study selected coronary heart disease patients who were in the early outpatient rehabilitation stage after receiving PCI treatment at a tertiary hospital as the survey subjects. Latent Profile Analysis (LPA) was employed to fit potential classes of kinesiophobia among these patients. Chi-square tests, Kruskal-Wallis tests, and multinomial logistic regression were utilized to explore the factors influencing different kinesiophobia profiles in these patients. A total of 293 survey subjects were included, the age of the 293 patients was 62.31 ± 11.49 years, Males represent 77% of the total population. The results of potential profile analysis revealed that kinesiophobia in the out-of-hospital early rehabilitation phase of CHD in PCI-treated patients could be divided into three potential categories: the low kinesiophobia-exercise avoidance group (52.1%), the medium kinesiophobia-danger perception group (41.6%), and the high kinesiophobia-dysfunction group (6.3%). The logistic regression analysis results revealed that age, mode of residence, chronic comorbidities, polypharmacy, and debilitation were influential factors for different categories of kinesiophobia in the out-of-hospital early rehabilitation phase of CHD patients undergoing PCI. There is obvious group heterogeneity in kinesiophobia in the out-of-hospital early rehabilitation phaseof CHD patients undergoing PCI, and healthcare professionals should carry out individualized intervention Strategies to reduce the degree of kinesiophobia in patients on the basis of the characteristics and influencing factors of different categories. Show less
24-h activity encompasses four categories: light-intensity physical activity (LPA), moderate-to-vigorous-intensity physical activity (MVPA), sedentary behavior (SB), and sleep (SP). This study aims to Show more
24-h activity encompasses four categories: light-intensity physical activity (LPA), moderate-to-vigorous-intensity physical activity (MVPA), sedentary behavior (SB), and sleep (SP). This study aims to investigate the effects of different physical activity components on executive function in older adults with chronic diseases and to examine substitution effects among activity components. The findings provide scientific evidence to inform physical activity interventions for improving executive function in older adults with chronic diseases. A total of 105 older adults (72.64 ± 6.82 years) were recruited. Following questionnaire screening, 75 older adults with chronic diseases were ultimately included. Accelerometers objectively measured participants' daily SP, SB, LPA, and MVPA. Executive function was objectively assessed using the Stroop task, N-back task, and More-odd-shifting task. Component linear regression equation assessed the relationship between different activities and executive function in older adults with chronic diseases. The dose-response effects of "one-for-one" substitutions between different activity behaviors were explored. Component linear regression results showed that SB positively correlated with inhibitory control ( SP and MVPA significantly improve inhibitory control in older adults with chronic diseases, while LPA significantly enhances their working memory. It is recommended that older adults with chronic diseases adjust their daily time structure by increasing diverse physical activities, ensuring adequate sleep duration, and reducing sedentary behavior to improve executive function. Show less
Cancer patients face a markedly elevated risk of thromboembolism (TE), including both venous thromboembolism (VTE) and arterial thromboembolism (ATE), which contribute substantially to morbidity and m Show more
Cancer patients face a markedly elevated risk of thromboembolism (TE), including both venous thromboembolism (VTE) and arterial thromboembolism (ATE), which contribute substantially to morbidity and mortality in this population. This study examined sex disparities in associations between sleep, sedentary behavior (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and TE risk, in cancer patients using data from the UK Biobank. A longitudinal cohort analysis of 6,765 cancer patients (2,774 men and 3,991 women) from the accelerometry subsample was conducted using Cox proportional hazards and isotemporal substitution models stratified by sex. The incidence of VTE was 3.0% in men versus 2.2% in women, while ATE incidence was 5.0% versus 2.2%, respectively. Compared with high LPA, medium and low durations were associated with 2.75- and 2.88-fold higher VTE risk only in men. Reallocating 1 h per day from sleep or SB to LPA reduced VTE risk by 24% and 19% in men. Low MVPA was associated with 3.35- and 1.59-fold higher ATE risk in women and men, respectively. Reallocating 1 h per day from sleep, SB, or LPA to MVPA reduced ATE risk by 71%, 70%, and 66%, respectively, only in women. LPA was associated with a lower risk of VTE only in male cancer patients, whereas MVPA was linked to a lower risk of ATE in female patients, indicating sex-specific associations between movement behaviors and TE risk. Show less
Tongtong Hao, Dong Wu · 2026 · Frontiers in public health · Frontiers · added 2026-04-24
The study explores the interconnection between the latent categories of mobile phone dependency and self-control in the sub-healthy urban older adults practicing Tai Chi. The findings aim to provide a Show more
The study explores the interconnection between the latent categories of mobile phone dependency and self-control in the sub-healthy urban older adults practicing Tai Chi. The findings aim to provide a reference for preventing mobile phone dependence, enhancing self-control and improving sub-health status in this population. A multi-stage cluster sampling method was employed to screen 560 sub-healthy urban older adults from 2,946 valid survey responses in Xuzhou City, Jiangsu Province. Sub-health status was verified using the SHMS V1.0 scale. Data were collected between September and October 2025. Latent profile analysis (LPA) was used to categorize mobile phone dependency and self-control. Pearson correlation analysis measured the relationship between these two variables. Additionally, chi-square test examined demographic differences across the identified latent profiles. Finally, multivariate logistic regression analyzed the associations between mobile phone dependency, self-control, and Tai Chi exercise. LPA identified four distinct profiles: Low dependency-Medium control (109 individuals, 19.5%), High dependency-No control (207 individuals, 37.0%), No dependency-High control (191 individuals, 34.1%), and Moderate dependency-Low control (53 individuals, 9.5%). These categories had statistically significant differences ( Tai Chi exercise exerts differential effects on urban sub-healthy older adults across distinct latent profiles of mobile phone dependency and self-control. Societal stakeholders should strengthen Tai Chi programs for these diverse categories to promote their physical and mental wellbeing. 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
Lp(a) (lipoprotein[a]) is a known cardiovascular risk factor; however, its role in cardiac remodeling and functional changes over time across diverse racial and ethnic groups remains underexplored. ME Show more
Lp(a) (lipoprotein[a]) is a known cardiovascular risk factor; however, its role in cardiac remodeling and functional changes over time across diverse racial and ethnic groups remains underexplored. MESA is a prospective multi-ethnic cohort study of individuals without a history of cardiovascular disease on enrollment (2000-2002), conducted across 6 sites in the United States. Participants with baseline Lp(a) measurements and cardiac magnetic resonance imaging at both baseline and 10-year follow-up exam were included. Lp(a) was treated as both a log-transformed continuous variable (per SD log) and a categorical variable based on data-driven Lp(a) terciles. Multivariable regression models adjusted for sociodemographic, and cardiovascular risk factors, including coronary artery calcium and interim myocardial infarction, were used to assess associations between Lp(a) and longitudinal changes in left ventricular and atrial structure and function over a decade across different racial/ethnic groups. A total of 2366 participants were included. The average age at baseline was 60±9 with 53% women, 43% White, 24% Black, 21% Hispanic, and 12% Chinese. Each 1-SD increase in log-transformed Lp(a) was associated with an increase in left ventricular end-systolic volume index (β, 0.60 [95% CI, 0.02-1.18]), and left atrial minimum volume index (β, 0.81 [95% CI, 0.09-1.52]), and a decline in left ventricular ejection fraction (β, -0.75 [95% CI, -1.34 to -0.17]), and total left atrial emptying fraction (β, -1.17 [95% CI, -2.09 to -0.24]) in Hispanic subjects over a decade. No significant associations were seen in White, Black, or Chinese participants. The observed findings persisted after adjusting for coronary artery calcium, interim myocardial infarction, and atrioventricular decoupling, and when Lp(a) was treated as a categorical variable with race-specific terciles. Elevated Lp(a) levels were independently associated with maladaptive left ventricular and left atrial remodeling in Hispanic adults over a decade, while no statistically significant relationships were observed in White, Black, and Chinese participants. This suggests a unique susceptibility of Hispanic individuals to Lp(a)-mediated cardiovascular remodeling, independent of ischemic pathways. Show less
Using latent profile analysis (LPA) based on Self-Determination Theory (SDT), this study aimed to explore the profiles of health behavior motivation among Chinese patients with prediabetes and examine Show more
Using latent profile analysis (LPA) based on Self-Determination Theory (SDT), this study aimed to explore the profiles of health behavior motivation among Chinese patients with prediabetes and examine the relationship between these profiles and self-management ability. A cross-sectional study was conducted involving 335 patients with prediabetes. The questionnaires were used to assess health behavior motivation, self-management ability, satisfaction of basic psychological needs and disease knowledge level. Latent profile analysis was performed based on five subscale scores of the health behavior motivation measure. Three distinct latent profiles were identified: a "Self-Determined" profile (C1,29.55%, n=99), a "Non Self-Determined" profile (C2, 55.82%, n=187), and a "Conflicted" profile (C3, 14.63%, n=49). Patients in the C1 profile demonstrated higher levels of autonomy and competence. Patients in the C2 profile were characterized by better disease knowledge and lower relatedness. Compared to patients in the C3 profile, patients in both the C1 and C2 profiles exhibited significantly lower self-management ability. The heterogeneity in health behavior motivation profiles must be considered in the design and clinical practice of personalized interventions for prediabetes. Profile-specific strategies serve as the foundation for enhancing patients' self-management ability and sustaining healthy behaviors. Show less
From a positive psychology perspective, this study aimed to identify the latent profiles of spiritual well-being and analyze the serial mediation mechanism of family care and spiritual coping in the r Show more
From a positive psychology perspective, this study aimed to identify the latent profiles of spiritual well-being and analyze the serial mediation mechanism of family care and spiritual coping in the relationship between spiritual well-being and health-related quality of life (HRQoL). The findings are intended to inform strategies for improving the spiritual well-being of maintenance hemodialysis (MHD) patients. A cross-sectional design was employed with 220 MHD patients recruited from two tertiary hospitals in Guangdong, China (August 2023-January 2024). Assessments were conducted using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-SP-12), Family Care Index, Spiritual Coping Questionnaire (SCQ), and Short Form-12 Health Survey (SF-12). Latent profile analysis (LPA) was employed to identify heterogeneous subgroups based on spiritual well-being. A chain mediation model was then used to examine the mediating effects of family care and spiritual coping. HRQoL scores averaged 56.50 ± 22.29. Significant correlations emerged: spiritual well-being ( Spiritual well-being indirectly influences the quality of life in MHD patients through the serial mediation of family care and spiritual coping. Clinicians should recognize the heterogeneity in spiritual well-being and integrate routine spiritual screening into nursing assessments to identify patients with low spiritual well-being. It is recommended to develop family-based education and support programs, along with interventions that combine family care and spiritual coping strategies, so as to improve patients' long-term health outcomes. Show less
Influenza vaccination coverage among older adults in China is low. We sought to identify latent vaccine-hesitancy profiles and their correlates. This community-based cross-sectional survey from May to Show more
Influenza vaccination coverage among older adults in China is low. We sought to identify latent vaccine-hesitancy profiles and their correlates. This community-based cross-sectional survey from May to July 2025 involved 1773 older adults from various areas in Jiangsu province. Data were collected via Wenjuanxing and included demographics, the Influenza Vaccine Hesitancy Scale, and the vaccine literacy scale. Group differences were examined using chi-square tests and one-way ANOVA; latent profile analysis (LPA) identified vaccine hesitancy subgroups, and multinomial logistic regression estimated correlates of profile membership. Three profiles emerged: Low Hesitancy (23.0%), Moderate Hesitancy (35.0%), and High Hesitancy (42.0%). Rural residence predicted Moderate (OR = 2.030) and High (OR = 2.993) hesitancy. Lower household income and chronic disease were associated with the Moderate Hesitancy profile, whereas male sex was associated with the High Hesitancy profile. Higher interactive (OR = 0.686) and critical (OR = 0.599) vaccine literacy were inversely associated with High hesitancy.Concerns about vaccine quality predicted both Moderate (OR = 1.433) and High (OR = 1.376) groups; knowledge gaps and fear of adverse reactions concentrated in the High group. Older adults show heterogeneous vaccine hesitancy phenotypes. Uptake efforts should move beyond one-size-fits-all messaging toward segmented strategies. These strategies should integrate cost-related measures with literacy-sensitive, trust-oriented communication, prioritizing rural residents, older men, and those with chronic conditions. The reported proportions of hesitancy profiles reflect our sample only and should not be viewed as nationally representative. Show less
Lipoprotein(a) [Lp(a)] has been recognized as a genetically determined and independent contributor to atherosclerotic cardiovascular disease. However, its role in lower extremity arterial disease (LEA Show more
Lipoprotein(a) [Lp(a)] has been recognized as a genetically determined and independent contributor to atherosclerotic cardiovascular disease. However, its role in lower extremity arterial disease (LEAD) among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remains insufficiently studied. Given the overlapping metabolic disturbances in both conditions, such as insulin resistance and lipid abnormalities, a potential relationship between Lp(a) and peripheral vascular injury in MASLD is biologically plausible. This study aimed to investigate the cross-sectional association between circulating Lp(a) concentrations and the presence of LEAD in a well-characterized MASLD population. A total of 468 MASLD patients undergoing routine health check-ups were included. Lp(a) levels were stratified into three categories: <10 mg/dL, 10–30 mg/dL, and ≥ 30 mg/dL. LEAD was diagnosed using duplex ultrasonography. Multivariable logistic regression models were used to assess the relationship between Lp(a) levels and the presence of LEAD, with adjustments for demographic variables, metabolic conditions, and lipid-related parameters. Subgroup analyses were conducted to assess potential effect modification. LEAD was diagnosed in 61.5% ( Elevated Lp(a) levels were associated with a higher prevalence of LEAD in patients with MASLD. Although the magnitude of association per unit increase was modest, higher Lp(a) concentrations were associated with greater LEAD prevalence. These findings should be interpreted cautiously and viewed as hypothesis-generating, particularly with respect to subgroup analyses. Prospective studies are needed to clarify causality and clinical relevance. The online version contains supplementary material available at 10.1186/s12872-026-05600-7. Show less
Ningying Zhou, Feng Zhang, Min Liu+4 more · 2026 · Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · Taylor & Francis · added 2026-04-24
Inadequate childbirth readiness can adversely affect the birthing experience of pregnant women and may even influence their willingness to have further children. This study aimed to explore the determ Show more
Inadequate childbirth readiness can adversely affect the birthing experience of pregnant women and may even influence their willingness to have further children. This study aimed to explore the determinants of childbirth readiness and the network relationships among these factors, thereby providing evidence to improve childbirth readiness. This cross-sectional study surveyed 350 pregnant women attending Wuxi Maternity and Child Health Care Hospital. Latent profile analysis (LPA) was first performed using the four domains of the Childbirth Readiness Scale to identify subgroups of childbirth readiness, and potential associated factors were then screened using univariate analysis and multinomial logistic regression. A Bayesian network model was employed to construct the structural relationships of factors influencing childbirth readiness. Childbirth readiness was categorised into three levels: poor (26%), good (30.9%), and complete (43.1%). Univariate analysis revealed significant differences across the three categories in relation to age, parity, pregnancy complications, antenatal exercise, planned pregnancy, self-efficacy, eHealth literacy, fear of childbirth, and family support ( Previous studies on childbirth readiness have mainly relied on regression models, which are unable to elucidate the intrinsic interconnections among influencing factors. By constructing a Bayesian model, this study demonstrated that women with high self-efficacy, no fear of childbirth, high eHealth literacy, and multiparity had the highest probability of achieving complete childbirth readiness (83.3%). Show less
To identify latent family resilience profiles among families of patients with first-episode stroke in the intensive care unit (ICU) and examine factors associated with resilience heterogeneity, with t Show more
To identify latent family resilience profiles among families of patients with first-episode stroke in the intensive care unit (ICU) and examine factors associated with resilience heterogeneity, with the aim of informing targeted family-support interventions. A cross-sectional study was conducted among 335 ICU patients with first-episode stroke and their primary caregivers. Family resilience was assessed using the Chinese version of the Family Resilience Assessment Scale (FRAS-C). Latent profile analysis (LPA) was used to identify subgroups of family resilience, while LASSO regression and multiple binary logistic regression were applied to determine influencing factors. Two distinct resilience profiles were identified: Developing Families, characterized by lower levels of communication, resource utilization, and positive outlook; and Optimized Families, characterized by higher resilience across all dimensions. ICU admission count (OR = 2.299, 95% CI: 1.066-4.960), frequency of care and support from relatives or friends (OR = 1.851, 95% CI: 1.068-3.206), and number of additional organ system dysfunctions (OR = 0.233, 95% CI: 0.122-0.445) were significantly associated with family resilience profiles (all Family resilience among ICU first-episode stroke patients shows notable heterogeneity, with two typical resilience patterns. Early identification of high-risk families-particularly those with limited social support or higher disease complexity-can guide clinicians in delivering targeted communication support, psychological counseling, and resource linkage interventions. Tailored resilience-enhancing strategies may contribute to better patient recovery and improved family adaptation during critical care. Show less
Keyun Xu, Liyang Wu, Lei Zhu · 2026 · Journal of affective disorders · Elsevier · added 2026-04-24
Late-life depression shows heterogeneous developmental trajectories. Prior studies in older Chinese populations have identified distinct depressive trajectories, yet the influence of family emotional Show more
Late-life depression shows heterogeneous developmental trajectories. Prior studies in older Chinese populations have identified distinct depressive trajectories, yet the influence of family emotional support across the life course remains underexplored. We conceptualized intergenerational emotional interaction patterns as the combined configuration of early-life parental affection and later-life emotional support from adult children. This study identified late-life depressive trajectories and tested whether these patterns predict depressive trajectory among Chinese older adults. Using China Health and Retirement Longitudinal Study (CHARLS) data (2011-2020; n = 9888), this study identified depressive trajectories using Latent Class Growth Modeling (LCGM) and Latent Profile Analysis (LPA) was used to categorize participants into subgroups based on maternal/paternal affection and emotional support from adult children. Multinomial logistic regression and Chi-square tests assessed associations between profiles and trajectories. Four depressive trajectories emerged: "no depression" (56.3%), "deterioration" (22.4%), "alleviation" (12.3%), and "chronic depression" (9.1%). Three distinct intergenerational emotional interaction patterns were found: "emotional inheritance" (40.7%), "emotional compensatory" (17.4%), and "emotional mismatch" (41.9%). The "emotion inheritance" group was overrepresented in the "no depression" trajectory, whereas the "emotional compensatory" group faced elevated risks for being classified into "deterioration" and "chronic depression" trajectories. Intergenerational emotional interaction patterns are independently and jointly associated with depressive symptoms trajectories in later life. The strongest protective effects were observed for individuals with both high childhood parental affection and ongoing emotional support from children. Conversely, low parental affection-even when compensated by later-life support-was linked to worse mental health outcomes. Show less
Corneal transparency maintenance relies on the water-pumping function of the corneal endothelium. Currently, corneal transplantation remains the only available treatment for corneal endothelial dysfun Show more
Corneal transparency maintenance relies on the water-pumping function of the corneal endothelium. Currently, corneal transplantation remains the only available treatment for corneal endothelial dysfunction, therefore, the development of alternative therapies is critical due to the global shortage of donor corneas. In our previous study, we confirmed that corneal stromal cells (CSCs) secretion can promote corneal endothelial cells (CEnCs) proliferation. This effect can be enhanced by treatment with lysophosphatidic acid (LPA), a bioactive phospholipid. Nevertheless, the components involved in CSC secretion remain to be elucidated. In this study, we investigated the therapeutic potential of CSC-derived exosomes and exosomal microRNAs (miRNAs) for enhancing CEnCs proliferation and corneal endothelial healing. CSC exosomes were characterized via nanoparticle tracking (NTA), transmission electron microscopy (TEM), and immunoassays. The miRNA expression profiles of CSC exosomes were identified via RNA sequencing, revealing a total of 767 distinct miRNAs. The proliferative effects of CSC exosomes and exosomal miR-221-3p were increased by LPA. Ectopic expression of miR-221-3p further increased CEnC proliferation and suppressed the expression of the CDK inhibitor p27 Show less
Background Although substantial evidence has demonstrated the impact of obesity on brain structure and cognition, the heterogeneity of adiposity-particularly in terms of fat distribution patterns-and Show more
Background Although substantial evidence has demonstrated the impact of obesity on brain structure and cognition, the heterogeneity of adiposity-particularly in terms of fat distribution patterns-and its differential neurologic effects remain poorly understood. Purpose To identify body fat distribution patterns with MRI and latent profile analysis (LPA) and their associations with brain structure measurements, cognition, and neurologic diseases. Materials and Methods This secondary analysis used prospective data from the UK Biobank, including health records and MRI scans of the brain, heart, and abdomen. Fat distribution profiles were classified using LPA based on eight body mass index (BMI)-adjusted MRI-derived fat quantification metrics. Differences in brain volume, white matter properties, cognition, and the risk of neurologic disorders were analyzed across profiles and relative to a benchmark lean profile; analyses were stratified by sex. Group differences were examined using analysis of covariance (ANCOVA) or rank-based ANCOVA. Results Among 25 997 participants (mean age, 55 years ± 7.4 [SD]; 13 536 female participants), LPA identified six profiles of body fat distribution in both sexes. Four high-adiposity patterns were identified, including the pancreatic-predominant profile (profile 1), with elevated proton density fat fraction (mean BMI-adjusted Show less
The associations between 24-h movement behaviours (24 h MBs) and emotional and behavioural problems (EBPs) in early years are not well understood. This study examined these associations in a nationall Show more
The associations between 24-h movement behaviours (24 h MBs) and emotional and behavioural problems (EBPs) in early years are not well understood. This study examined these associations in a nationally representative sample of Chinese preschoolers. As part of the Chinese cohort of the SUNRISE International Study of Movement Behaviors in the Early Years main study, this research recruited 1316 children aged 3-4 years through multistage stratified cluster sampling in urban and rural areas across seven major administrative regions in China. Moderate- to vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA) and sedentary behaviour (SED) were measured using 24-h accelerometry over five consecutive days. Sleep duration was parent-reported. EBPs were evaluated using the parent-rated Strengths and Difficulties Questionnaire (SDQ), which assesses total difficulties, internalising problems, externalising problems and prosocial behaviour. Compositional multiple linear regression was employed to analyse the relationships between 24 h MBs and EBPs. Compositional isotemporal substitution was also utilised to predict changes in EBPs due to reallocating time among 24 h MBs. Isotemporal substitution analyses revealed that replacing as little as 1 min of MVPA, LPA or SED with sleep was associated with significant reductions in total difficulties (β Increasing LPA by reducing MVPA or SED was significantly associated with improvements in internalising and conduct problems, whereas increasing sleep to decrease MVPA or SED-even by small amounts-was consistently associated with improvements in EBPs across all SDQ subscales. However, increasing LPA at the expense of sleep exacerbates total difficulties and externalising problems. Promoting diverse LPA opportunities alongside sufficient sleep, while maintaining a balance between them, is essential for supporting preschoolers' emotional and behavioural development. Show less
The cornerstone of treating lower extremity deep venous thrombosis (LEDVT) lies in anticoagulation therapy to prevent thrombus progression and recurrence. However, patient adherence to medication is a Show more
The cornerstone of treating lower extremity deep venous thrombosis (LEDVT) lies in anticoagulation therapy to prevent thrombus progression and recurrence. However, patient adherence to medication is a critical factor influencing treatment efficacy. Traditional research often simplifies adherence into binary categories of "adherent" and "non-adherent," which fails to comprehensively reflect the complex behavioral patterns. Based on latent profile analysis (LPA), medication adherence in LEDVT patients can be categorized into distinct classes, enabling more precise identification of their characteristics. Therefore, exploring these latent classes and their influencing factors holds significant importance for optimizing intervention strategies and improving prognosis. A cross-sectional survey was used to study LEDVT. From March 14, 2024 to September 20, 2024, a random sampling method was used to recruit 469 patients with LEDVT from four grade-A tertiary hospitals in Urumqi, China. Participants completed questionnaires on general demographic information, the Medication Adherence Scale, the Perceived Health Competence Scale, the Herth Hope Index, the Patient Activation Measure, the Beliefs about Medicines Questionnaire-Specific. LPA was conducted to analyze the medication adherence characteristics of patients with LEDVT. Univariate analysis and multivariate logistic regression were used to identify the influencing factors of their latent profiles. Data analysis was performed using Mplus 8.3 and SPSS 25.0 software. LPA was employed to investigate medication adherence in LEDVT patients, revealing three distinct latent classes: the poorest adherence group (44.99%), the moderate adherence group (19.83%), and the good adherence group (35.18%). The logistic regression results demonstrated that, perceived health competence, hope, activation, beliefs about medication necessity, and concerns about medication were influential factors affecting the potential profile of medication adherence (all p < 0.05). LEDVT patients exhibit significant individual differences in medication adherence. Personalized intervention strategies can be designed based on different adherence classes to enhance medication adherence. Additionally, targeted interventions addressing perceived health competence, hope, positive affect, and medication beliefs can effectively improve adherence. Show less
Parenting behaviors, including autonomy support and psychological control, have been shown to significantly influence adolescent non-suicidal self-injury (NSSI). However, the underlying mechanisms lin Show more
Parenting behaviors, including autonomy support and psychological control, have been shown to significantly influence adolescent non-suicidal self-injury (NSSI). However, the underlying mechanisms linking heterogeneous parenting behavior profiles to adolescent NSSI remain unclear. This two-wave longitudinal study (with a one-year interval) of 742 Chinese adolescents (52.7% girls; Mage at Time 1 = 13.40 years) identified four distinct parenting profiles using latent profile analysis (LPA): Supportive (43.6% of the sample), Controlling (17.4%), Moderate Mixed Parenting (33.1%) and High Mixed Parenting (5.9%). Multicategorical serial mediation analysis revealed that adolescent emotion regulation difficulties and depressive symptoms serially mediated the relationship between parenting profiles and NSSI for adolescents in the Controlling, Moderate Mixed Parenting and High Mixed Parenting Profiles. Notably, these mediating effects were significant only for girls. These findings underscore the importance of adopting person-centered and sex-sensitive intervention strategies to mitigate the adverse effects of detrimental parenting behaviors on adolescent NSSI. Show less
Myocardial ischemia/reperfusion (I/R) injury commonly occurs in patients undergoing cardiac or noncardiac surgeries, increasing perioperative mortality risk. Although numerous endogenous mediators rel Show more
Myocardial ischemia/reperfusion (I/R) injury commonly occurs in patients undergoing cardiac or noncardiac surgeries, increasing perioperative mortality risk. Although numerous endogenous mediators released during I/R contribute to myocardial damage, their mechanisms require further elucidation. We investigated whether lysophosphatidic acid (LPA), a bioactive phospholipid, mediates myocardial I/R injury by interacting with cardiac transient receptor potential vanilloid 1 (TRPV1). A TRPV1K710N knock-in mouse model was generated by CRISPR/Cas9, introducing a point mutation at K710, the known LPA-binding site on TRPV1. Langendorff perfused isolated hearts from TRPV1K710N and wild-type (WT) mice underwent global I/R injury with or without exogenous LPA (10 μM). Myocardial infarct size, coronary effluent LDH levels, and mitochondrial ultrastructure/function were assessed. Additionally, H9c2 cardiomyocytes were transfected with a pCMV6-entry plasmid carrying TRPV1-K710N or TRPV1-WT for mitochondrial calcium influx and cell viability assays. The V1-Cal peptide (1μM), targeting the K710 region, was applied ex vivo and in vitro to block LPA-TRPV1 interaction. TRPV1K710N hearts exhibited resistance to global I/R injury versus WT hearts, with reduced infarct size (28.3 ± 2.4% vs 39.9 ±2.3%, respectively, P= 0006), lower LDH levels, and attenuated mitochondrial damage. Exogenous LPA exacerbated I/R injury in WT hearts, increasing infarct size (63.7 ± 1.2% vs vehicle: 38.4 ± 2.4%; P <.0001), LDH release, and mitochondrial damage. TRPV1K710N hearts were resistant to LPA-induced injury, with no significant increase in infarct size after LPA treatment. Exogenous LPA induced pronounced swelling in mitochondria isolated from WT hearts, while mitochondria from TRPV1K710N hearts showed resistance to LPA challenge. In H9c2 cells, LPA significantly decreased viability in rTRPV1-WT cells and elevated mitochondrial calcium influx relative to rTRPV1-K710N cells. V1-Cal peptide attenuated LPA-mediated myocardial injury in WT hearts and reduced mitochondrial calcium overload in H9c2 cells. Blockade of the TRPV1 K710 site by K710N mutation or V1-Cal peptide mitigates LPA-mediated myocardial injury and mitochondrial damage/dysfunction in isolated mouse hearts. Targeting the cardiac LPA-TRPV1 interaction represents a promising therapeutic strategy against perioperative myocardial injury. Show less
Anxiety and depression are highly comorbid mental health disorders with heterogeneous symptom patterns and poorly understood transdiagnostic mechanisms. This study aims to characterize latent subgroup Show more
Anxiety and depression are highly comorbid mental health disorders with heterogeneous symptom patterns and poorly understood transdiagnostic mechanisms. This study aims to characterize latent subgroups, risk factors, and symptom-level interactions underlying depression-anxiety comorbidity across adolescents and adults in multi-ethnic Southwest China. The study included a total of 41,394 adolescents (aged 9-19) and 17,345 adults (aged 18-80). Adolescents were recruited using multistage stratified cluster sampling, whereas adults were recruited by convenience sampling. All participants completed a self-designed sociodemographic questionnaire, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Latent profile analysis identified subgroups, logistic regression analyzed risk/protective factors, and network analysis mapped symptom interactions and bridge nodes. This study found that three adolescent profiles emerged: high (11.66 %), moderate (31.95 %), and low/no depression-anxiety (56.39 %). Adults were classified into low/no comorbidity (90.63 %) and comorbid depression-anxiety (9.37 %). Risk factors for adolescents included female gender (OR = 2.77, 95 %CI: 2.55-3.00; OR = 1.59, 95 %CI: 1.52-1.67), higher grade levels (OR = 3.45, 95 %CI: 3.10-3.84; OR = 3.56, 95 %CI: 3.33-3.80), smoking (OR = 1.72, 95 %CI: 1.51-1.96; OR = 1.28, 95 %CI: 1.17-1.41),drinking (OR = 2.45, 95 %CI: 2.23-2.70; OR = 1.66, 95 %CI: 1.55-1.77), family instability (OR = 1.16, 95 %CI: 1.02-1.31; OR = 1.33, 95 %CI: 1.14-1.56) and "other" ethnic minority (OR = 1.15, 95 %CI: 1.04-1.26). For adults, female gender(OR = 1.68; 95 %CI: 1.44-1.97), living alone(OR = 1.37; 95 %CI: 1.14-1.65), poor self-rated health (OR = 0.13, 95 %CI: 0.11-0.15), and Dai ethnicity (OR = 0.70, 95 %CI: 0.49-0.96) predicted comorbidity. Network analysis revealed distinct bridge symptoms: adolescents in the high depression-anxiety group had five symptoms: depressed or sad mood (phq2), psychomotor agitation/retardation (phq8), nervousness or anxiety (gad1), restlessness (gad5), and irritable (gad6); however, adults with comorbidity had one symptom: afraid something will happen (gad7). This study identified three patterns of depression-anxiety comorbidity in adolescents and two in adults. Efforts should prioritize adolescents from "other" ethnic minorities, strengthening family and peer support, as well as smoking and drinking interventions for adolescents, and addressing social isolation, physical health, and catastrophizing cognition in adults may mitigate the comorbidity burden. Show less
To investigate the dose-response relationship between e-health literacy and light physical activity (LPA) in older adults is to provide evidence for targeted interventions that enhance e-health litera Show more
To investigate the dose-response relationship between e-health literacy and light physical activity (LPA) in older adults is to provide evidence for targeted interventions that enhance e-health literacy and promote LPA, thereby advancing healthy aging. This study used a convenience sampling method to select two residential neighborhoods. Subsequently, a random cluster sampling approach was employed, resulting in a total final sample of 105 community-dwelling older adults (aged 60 and above) from these neighborhoods. A three-axis accelerometer (ActiGraph wGT3X-BT) recorded the older adults' LPA, and the Electronic Health Literacy Scale assessed their e-health literacy. Multiple linear regression was used to explore the dose-response relationship between LPA and e-health literacy and sub-dimension scores. Multiple linear regression revealed that both the overall e-health literacy score and its components were positively associated with daily LPA (Tables 2 and 3). However, the empirical impact varied substantially across components. For each 1-point increase, LPA increased by 2.8 min for the overall score, 11 min for judgment ability, and 19.4 min for decision-making ability, whereas the effect of application ability was statistically significant but minimal. Notably, the effect sizes of all e-health literacy components were substantially smaller than that of educational attainment (β = 0.638-0.947), which was the strongest predictor in all models. This study provides empirical evidence that higher e-health literacy and its specific sub-dimensions are positively associated with light physical activity (LPA) among community-dwelling older adults, with educational attainment emerging as a key independent predictor. These findings suggest that public health interventions aimed at promoting LPA could be enhanced by incorporating strategies to improve e-health literacy, particularly targeting older adults with lower educational backgrounds. The development of tailored, theory-informed programs based on these insights holds promise for fostering healthy aging at the community level. Show less
Families with children diagnosed with autism spectrum disorder (ASD) often encounter significant challenges, manifesting in elevated stress levels and compromised physical and mental well-being. This Show more
Families with children diagnosed with autism spectrum disorder (ASD) often encounter significant challenges, manifesting in elevated stress levels and compromised physical and mental well-being. This study employed Latent Profile Analysis (LPA) to comprehensively examine family resilience attributes among 328 Chinese parents of children with ASD. Drawing on Walsh's family resilience framework and the Double ABCX stress-adaptation model, the research examined how protective factors (social support, posttraumatic growth) and risk factors (family stressors) distinctively characterize resilience profiles and predict profile membership, alongside sociodemographic correlates. Through rigorous statistical analysis, the following three distinct family resilience profiles emerged: adversity (32.31%; characterized by low resilience), ordinary (46.65%; demonstrating moderate resilience) and growth (21.03%; exhibiting high resilience). Critically, the findings revealed that higher family income, perceived social support and posttraumatic growth were associated with higher family resilience, while family stressors were associated with lower family resilience. These insights underscore the importance of developing targeted, personalized intervention strategies that can effectively enhance familial coping mechanisms and psychological adaptation for families navigating the complex challenges of ASD. Show less