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Physical activity can improve health-related quality of life (HRQoL); however, it is not clear whether this association is direct or indirect. The aims of this study were to examine the associations of daily movement behaviours with physical and mental HRQoL in older adults, and the mediating role of muscle strength and body composition on it. Three hundred thirty-four community-dwelling older adults wore the Intelligent Device for Energy Expenditure and Activity for two consecutive days to quantify time spent in sedentary behaviour (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). HRQoL was assessed using the 12-Item Short-Form Health Survey, yielding physical (PCS) and mental (MCS) component scores. For muscle strength, a handgrip dynamometer and the Sit-to-Stand test were used. Body mass index (BMI), waist circumference, and estimates of skeletal muscle mass and fat mass by bioelectrical impedance were included as body composition variables. Association analyses were examined using linear regression models, and for mediation analysis, structural equation modelling was used. MVPA was positively associated with PCS [β (95%CI): 0.39 (0.19, 0.59)], whereas no significant associations were observed between MVPA, LPA, or SB and MCS. The association between MVPA and PCS was partially mediated by lower-limb muscle strength and fat mass percentage [8.5% (z = 1.753, p = 0.080) and 28.9% (z = 1.912, p = 0.056), respectively], and fully mediated by skeletal muscle mass normalized by BMI [28.2% (z = 2.016, p = 0.044)].Regular engagement in MVPA is positively associated with the physical component of HRQoL in older adults, both directly and indirectly through muscle strength and skeletal muscle mass. Show less

The SEMpsych project offered the "Blaufeuer" counselling service for people with psychological impairments and work-related stress. Firstly, this study investigated whether the recognisably high variability in the work-related problem areas can be explained by statistically and quantitatively determinable profile types. Secondly, it was investigated whether typical patterns of individual problem constellations in the course of life and habitual imprints (latent basic convictions) of Blaufeuer counselling participants, which are associated with psychological stress, can be reconstructed in their interaction.A convergent-parallel mixed methods approach was used. A latent profile analysis (LPA) was carried out statistically and quantitatively with 457 participants in the Blaufeuer programme. Qualitatively, 16 guided individual interviews were analysed using a combination of grounded theory and narrative analysis.The LPA revealed seven profiles of characteristic work and occupational problems. The qualitative analysis identified six latent basic beliefs and individual problem constellations that can contribute to the description of vulnerability risks.Both typifications provide guidance for the high variability of work-related stressors. Specifically, the qualitative findings show the necessity to consider latent basic beliefs as well as individual life events and everyday stresses in addition to the types of work-related stressors for counselling. 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 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

Moral inclusiveness-the scope of one's moral circle-has traditionally been studied as a single, global trait. This study instead applied latent profile analysis (LPA) to uncover nuanced moral inclusiveness profiles spanning nested layers of relational proximity (family, community, global citizen, and nonhuman living beings). The study looked across four validated scales-Kindness, Compassion, Global-Mindedness, and Speciesism-and further examined how these profiles relate to trauma, mental health, and spirituality. A cross-sectional sample of 763 U.S. participants completed measures assessing moral inclusiveness, mental health, lifetime and recent traumatic events, and three spiritual dimensions: general spirituality, spiritual decline, and awakened awareness. LPA revealed five distinct profiles: Ingroup Concern, Outgroup Concern, Average Overall Concern, Universal Empathy, and Lovers. The Ingroup Concern class exhibited the highest levels of psychopathology, the most recent traumatic events, and elevated spiritual decline. The Universal Empathy and Lovers classes reported low current distress, minimal spiritual decline, and significantly higher awakened awareness, suggesting they experienced adversity yet still maintained meaning and/or guidance. Lifetime trauma exposure alone did not preclude a broad moral scope of inclusion: the Ingroup Concern and Universal Empathy classes both reported substantial trauma histories but diverged in moral inclusiveness, possibly due to differences in spiritual injury and ongoing stress. These findings reveal that a more parochial or limited moral scope is associated with lifetime and recent adversity, current mental health challenges, and spiritual injury. More expansive concern for human and fellow living beings is associated with positive spiritual engagement and fewer immediate negative life events. Show less

The 2025 ESC/EAS Dyslipidaemia Focused Update provides a targeted revision of the 2019 guidelines, integrating newly available evidence with the potential to influence clinical decision-making before the next full update. While LDL-C treatment targets remain unchanged, the document reshapes how they should be achieved, emphasizing faster therapeutic intensification, broader use of combination therapy and improved risk stratification with SCORE2/SCORE2-OP, lipoprotein(a) [Lp(a)] and coronary artery calcium (CAC) scoring. New evidence supporting bempedoic acid, inclisiran and evinacumab expands the therapeutic armamentarium, particularly for patients at high, very high and extreme cardiovascular risk or those with statin intolerance. In the acute coronary syndrome (ACS) setting, the update reinforces a more proactive, early-intensification approach. Overall, the Focused Update refines the operational framework of LDL-C management, promoting earlier, more personalized and more sustained lipid lowering to reduce cumulative atherosclerotic exposure. Show less

This study investigated the latent profiles of reproductive concerns among women of childbearing age with systemic lupus erythematosus (SLE) and analyzed the differences in the characteristics across these profiles. A questionnaire was administered to 332 female patients of childbearing age with SLE at four tertiary-grade general hospitals in Mianyang City, China. We used a general information questionnaire, the Reproductive Concerns After Cancer Scale (RCAC), the Medical Coping Modes Questionnaire (MCMQ), and the Social Support Rating Scale (SSRS). A latent profile analysis (LPA) and multiple logistic regression models were employed to investigate the characteristics of the latent profiles and the factors that influence reproductive concerns. The total score for the reproductive concerns among women with SLE of childbearing age was moderate (58.45 ± 13.51). Four latent profiles were identified: low reproductive concern–high infertility acceptance (12.66%), moderate reproductive concern–concern about personal health (18.95%), moderate reproductive concern–concern about the child’s health (45.64%), and high reproductive concern–balance (22.75%). The model fit indices that support the four latent profiles included high entropy (0.92) and a significant result of the Lo–Mendell–Rubin (LMR) adjusted likelihood ratio test ( The reproductive concerns observed among women of childbearing age with SLE exhibited significant heterogeneity. In the field of clinical nursing, personalized intervention measures should be developed based on distinct categorical characteristics and influencing factors to reduce reproductive concerns among members of this patient population. Show less

Capacities for giving compassion to others, being open to others' compassion, and self-compassion are not always balanced for everyone. Identifying unique compassion profiles provides a holistic understanding of how the balance or imbalance among different facets of compassion relates to psychopathology and well-being. Using latent profile analysis (LPA) with U.S. college students ( Show less

The benefits of physical activity are well-documented, and healthy habits established in childhood often continue into adulthood. Recent research has shown that schoolyards provide a valuable platform for children to be physically active, with greener spaces in particular enhancing both physical and mental well-being. The City of Stockholm has formally decided to reconstruct 20 schoolyards, incorporating more play areas and greenery. This study will evaluate the impact of these reconstructions, aiming to increase physical activity levels among schoolchildren across all socioeconomic groups, while also contributing to climate change mitigation in urban environments. This study will utilize a stepped-wedge design, where each school undergoing schoolyard reconstruction will serve as both a control and intervention site. Over four years, from 2024 to 2027, five schools will have their schoolyards reconstructed each summer. Control data will be collected in the spring prior to the reconstruction, with follow-up data collected in the spring after the reconstruction. We aim to recruit 3 600 children aged 6 to 12 years. The primary outcome will be changes in physical activity, measured via accelerometers. Secondary outcomes will include changes in musculoskeletal fitness, perceptions of the schoolyard, and environmental impact. Given the 24-hour constraint of daily time, movement behaviors (e.g., MVPA, LPA, SB, and sleep) will be treated as compositional data. Log-ratio transformation will be applied and introduced as outcomes in general linear mixed models, with schools treated as random effects. This large-scale study has the potential to set new guidelines for physical health policies in schools across the City of Stockholm, potentially influencing the well-being of an even greater number of children. Additionally, the study could provide valuable insights into strategies for mitigating climate change through urban design, offering a model for sustainable school environments that promote both health and environmental resilience. The trial has been registered on ClinicalTrials.gov the 19th of May 2023, with the reference number NCT05865782. The online version contains supplementary material available at 10.1186/s12889-026-26609-9. Show less

Lipoprotein(a) (Lp(a)) has the reputation of being the most misunderstood metric in laboratory medicine. The unique apolipoprotein(a) (apo(a)) in Lp(a) is very heterogenous, the kringle IV domain of apo(a) being formed by 12-50 kringles due to 3 to ∼40 KIV Show less

Osteoporosis frequently affects older women and is strongly linked to their daily routines, which include both sedentary behavior (SEB) and physical activities (PA) of different intensities. This study investigates the dose-response relationship of different SEB and PA patterns among community-dwelling older women and assesses the potential impact of time reallocation on osteoporosis risk through an isotemporal substitution analysis. In this study, 1,106 older women aged between 60 and 70 years in Tianjin participated. Their moderate to vigorous physical activity (MVPA), light physical activity (LPA), and SEB were objectively assessed using an accelerometer. The connection between MVPA, LPA, SEB, and osteoporosis was assessed using binary logistic regression models and isotemporal substitution models. The osteoporosis group and non-osteoporosis group comprised 461 and 645 subjects respectively, accounting for 41.68 and 58.32% of the total cohort. The osteoporosis group had significantly higher daily SEB compared to the non-osteoporosis group ( PA and SEB in older women exhibit a significant dose-response relationship with osteoporosis. Avoiding prolonged sitting and increasing PA duration both offer protective effects against osteoporosis in older women, with achieving a certain level of MVPA being the most effective protective measure. Show less

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

Elevated lipoprotein(a) [Lp(a)] levels have been strongly related to cardiovascular (CV) risk. However, its association with Hypertension Mediated Organ Damage (HMOD) and CV events in the primary prevention setting remains unclear. To evaluate in these patients, the correlation between Lp(a) levels and: (i) heart, vessels and kidney HMOD and; (ii) CV events and all-cause mortality in a primary prevention setting. 747 low CV risk subjects were recruited between 2009 and 2014. HMOD was assessed through Pulse Wave Velocity, carotid Intima-Media Thickness (IMT), presence of carotid plaques, Left Ventricular Hypertrophy (LVH) and Ejection Fraction and glomerular filtration rate. All-cause mortality and CV events up to 2021 were retrieved by electronic health records, for a median follow-up time of 10 years (I-III quartiles 9.6-11.1). Mean age was 50.8 ± 13.0 years and 63.5% of the subjects were men. The prevalence of hypertension was 37.9%, dyslipidemia 67.2%, smoking 17.8%, and diabetes mellitus 8.7%. Median Lp(a) value was 17 mg/dL (5.9-56.0), and 26.5% of patients had values above 50 mg/dL. Regarding HMOD, 10.3% subjects had arterial stiffness, 7.2% increased IMT, 19.8% carotid plaques while only 0.7% had LVH. No significant correlation was found between Lp(a) levels and indices of subclinical HMOD. Furthermore, no relationship was found between CV events and all-cause mortality and Lp(a) levels. In this primary prevention cohort, elevated Lp(a) levels were not associated with significant structural damage to the heart, carotid arteries, or increased aortic stiffness and were not associated with CV events and all-cause mortality. 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 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

An original dataset based on a national quota sample in the Czech Republic (n = 490, M = 46.09 y/o, 45.7% women) was used to assess susceptibility to medical (COVID-19) and political (Russian invasion of Ukraine) disinformation. Susceptibility to disinformation was assessed using 30 items addressing contemporary topics. To identify the latent structure underlying these items, an exploratory factor analysis (principal-axis factoring with direct oblimin rotation) was conducted. EFA yielded four correlated factors: one specific to COVID-19 hoaxes/misinformation (F1) and three others pertaining to the political (F2), economic (F3), and moral/ethical (F4) dimensions of the Russian war. In order to identify response patterns, all 30 items from 490 participants were subjected to Latent Profile Analysis (LPA) in which the EFA factors served to interpret the five resulting types: a neutral No Strong Opinion type (48%); two disinformation-resilient types-Rational Pro-Ukrainians (22%) and Anti-Russians (7%); and two disinformation-susceptible types-Pro-Russians (15%) and the Generally Disinformed (9%). The discussion addresses the sizable No Strong Opinion type and the correlation between COVID-19 hoaxes and propaganda disinformation (r = 0.47), which supports the 'monological belief system' concept. The identified types can be further followed prospectively and retrospectively within an ongoing panel study. Show less

Elevated lipoprotein(a) [Lp(a)] is an independent and causal risk factor for atherosclerotic cardiovascular disease. Increasingly, prevention societies recommend testing Lp(a) at least once for all adults. A quality improvement (QI) initiative aimed to increase the rates of Lp(a) ordering for patients was piloted in the general cardiology fellows' clinic at an urban academic medical center. QI project interventions focused on provider education and inclusion of electronic health record-based tools. Over a period of 10 months, the proportion of patients with an Lp(a) order increased from 10.1% to 20.9%, and the proportion of patients with an Lp(a) result increased from 7.0% to 11.2%. Ahead of results from ongoing clinical trials testing Lp(a)-targeted therapies, health systems can use QI methods to assess current Lp(a) ordering practices, identify patients who may benefit from future Lp(a)-targeted therapy, and plan for rapid expansion of Lp(a) testing. Show less

This study aimed to identify latent profiles of spiritual orientation (SO) and psychological well-being (PWB) among female healthcare workers and to examine how demographic factors predict profile membership. A total of 104 female healthcare professionals from two hospitals in eastern Türkiye were recruited using purposive criterion sampling. Participants completed validated self-report measures assessing SO and PWB. Latent Profile Analysis (LPA) with varying means, equal variances, and covariances fixed to zero (Model 1) was conducted to uncover distinct profiles based on standardized mean scores. Four profiles were identified: “Low Spirituality-Low Well-Being” (5.8%), “Moderate Spirituality-Low Well-Being” (13.5%), “High Spirituality–High Well-Being” (61.5%), and “Low Spirituality-High Well-Being” (19.2%). The four-class solution demonstrated superior fit indices (BIC = 1737.0, entropy = 0.956) compared to alternative models. Multinomial logistic regression analysis revealed that education level, tenure, and marital status standing significantly predicted membership in the more adaptive profiles, particularly the “High Spirituality–High Well-Being” group. Notably, a moderate positive correlation ( Show less

Lipoprotein(a) [Lp(a)] is an independent cardiovascular risk factor, with a growing recognized role in stroke. To investigate the association between Lp(a) levels, large artery atherosclerosis (LAA) TOAST (Trial of ORG 10172 in Acute Stroke Treatment) category, and stroke-related atherosclerosis distribution (extracranial/intracranial) in a single-center retrospective cohort of patients with ischemic stroke. We included all patients with ischemic stroke admitted between March and December 2021 with Lp(a) levels and computed tomography angiography. Multivariable regression assessed the relationship between Lp(a) and LAA, extracranial carotid stenosis, or intracranial atherosclerotic stenosis (ICAS). Predicted probabilities of atherosclerosis location per Lp(a) increment were estimated from a multinomial logistic regression model. We screened 523 patients and included 397 with complete data. The median age was 78 years, and 47% were female. Median Lp(a) was significantly higher in patients with stroke-related atherosclerosis, particularly those with intracranial involvement. Statin use (adjusted β = 15.01, 95% CI: 3.32-26.70, P = .012) and low-density lipoprotein levels (adjusted β = 0.236, 95% CI: 0.09-0.38, P = .002) were independently associated with Lp(a). Lp(a) was significantly associated with LAA (per 10 mg/dL increment: adjusted odds ratio [OR]: 1.08, 95% CI: 1.03-1.14, P = .003; for Lp(a) ≥50 mg/dL vs <50 mg/dL, LAA prevalence was 27% vs 15%, P = .007; adjusted OR: 2.71, 95% CI: 1.47-5.91, P = .001). Lp(a) ≥50 mg/dL was significantly associated with ICAS (adjusted OR: 4.49, 95% CI: 2.41-8.38, P < .001), but not with extracranial carotid stenosis (P = .065). With increasing Lp(a) levels, ICAS showed the steepest increase in predicted probability. Higher Lp(a) values are associated with LAA stroke, particularly ICAS. Lp(a) levels should be included in the stroke workup. Show less

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

Autistic youth experience high rates of emotion dysregulation, which can significantly impact functioning and quality of life. Despite its clinical significance, emotion dysregulation remains understudied and misunderstood, with few validated measures for use in autistic youth. This study aimed to further validate the Emotion Dysregulation Inventory (EDI) and explore its utility in understanding emotion dysregulation, its relationship with autism symptoms, and its associations with treatment-relevant factors. Caregivers of autistic youth aged 6-11, recruited through the SPARK initiative, completed questionnaires on child behaviors, emotions, and experiences. A total of 320 families were included, with oversampling of minoritized racial and ethnic backgrounds. Structural equation modeling was used to confirm the EDI's two-factor structure and measurement invariance across diverse groups. Latent profile analysis (LPA) and the R3STEP procedure were used to identify subgroups based on emotion dysregulation and autism symptom severity and examine associations with child and family factors. The EDI demonstrated robust psychometric properties, with measurement invariance supporting its use across diverse racial and ethnic groups, as well as for youth with or without a history of language disorder. LPA identified three phenotypic subgroups, each showing meaningful associations with child and family characteristics, including behavioral problems, parental stress, and sleep disturbances. This study contributes to our understanding of emotion dysregulation in autism by supporting the EDI's validity in diverse samples and highlighting associations with autism symptoms, comorbidities, and other challenges. Integrating emotion dysregulation into clinical conceptualizations can improve the quality of care for autistic youth. Show less

Major depressive disorder (MDD) in adolescents is a critical public health concern, yet objective diagnostic biomarkers remain lacking. We conducted an integrative lipidomics study across human cohorts and a chronic unpredictable mild stress (CUMS) rat model. Targeted UPLC-MS/MS profiling was applied to a training cohort (95 MDD, 40 controls), and untargeted UPLC-HRMS profiling to an independent cohort (56 MDD, 37 controls). Candidate biomarkers were identified using univariate tests, partial least squares discriminant analysis, and three feature-selection methods (Boruta, LASSO, RFE), with predictive performance evaluated by cross-validation and external replication. Translational relevance was examined in CUMS rats through behavioral assays and lipidomic profiling of serum and brain tissues. Pathway enrichment and regression models explored metabolic context and clinical associations. In the training cohort, we found that 244 lipids were significantly altered, highlighting altered glycerophospholipid, glycerolipid, and sphingolipid metabolism. A 29-lipid panel achieved 90.4% cross-validation accuracy, while a reduced 7-lipid subset reached 94.8%. In the validation cohort, an 8-lipid panel achieved 71.2% accuracy, and a minimal 2-lipid set-LPA(18:2) and SPH(d16:1)-reached 72.1%. Cross-species analysis confirmed consistent downregulation of SPH(d16:1) in serum of both humans and rats, and of LPC(0:0/16:0) specifically in the rat prefrontal cortex. Regression analyses linked sex, age, and anxiety severity to lipid alterations. This cross-platform, cross-species study identifies reproducible lipid signatures of adolescent MDD, highlights SPH(d16:1) and LPC(0:0/16:0) as translational biomarkers, and implicates glycerophospholipid metabolism in MDD pathophysiology, providing a foundation for biomarker-guided diagnostics and therapeutics. Show less

To identify distinct latent frailty profiles using latent profile analysis (LPA) in patients undergoing radiotherapy for head and neck cancer (HNC) and to examine the factors associated with profile membership. A cross-sectional study. This research used data acquired from a major tertiary referral hospital in China. This study recruited 391 HNC patients receiving radiotherapy. Validated instruments included a demographic questionnaire, Charlson Comorbidity Index (CCI), Pittsburgh Sleep Quality Index, FRAIL Scale, Hospital Anxiety and Depression Scale and Perceived Social Support Scale. Profile membership associations were assessed using χ The frailty status of patients can be divided into three different categories: (1) robust group (23.0%), (2) prefrail group (49.6%) and (3) frail group (27.4%). Frailty demonstrated independent associations with nine clinical parameters in adjusted regression models: radiotherapy session frequency, social support, age, CCI score, educational attainment, metastasis, nutritional risk, radiation-induced injuries and serum albumin levels (p<0.05). The distinct frailty profiles identified by LPA can inform the future development of targeted care protocols for specific subgroups (eg, the frail group), with a focus on key predictors such as age and nutritional risk. Show less

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

COVID-19 is associated with cardiometabolic complications, including lipid abnormalities, but its effect on lipoprotein(a) [Lp(a)] remains unclear. This pilot cohort study was conducted at an academic tertiary hospital and a primary healthcare facility (6 July-31 August 2021). It included a cross-sectional baseline comparison of patients hospitalised with COVID-19, diabetic controls, and healthy controls, with COVID-19 patients additionally followed for three months post-discharge. The study evaluated the relationship between lipid profiles, Lp(a), disease severity, and recovery. Among 169 participants, patients with COVID-19 ( The online version contains supplementary material available at 10.1038/s41598-026-37439-5. Show less

Lipoprotein(a) [Lp(a)] is a significant, genetically determined contributor to the risk of atherosclerotic cardiovascular disease (ASCVD), which remains the leading cause of mortality worldwide despite successes in the management of LDL cholesterol. Lipoprotein(a) possesses increased atherogenicity, contributing to residual cardiovascular risk. Elevated Lp(a) levels affect a substantial proportion of the population, rendering this a potentially high-impact therapeutic target, but currently available lipid-lowering agents and lifestyle interventions have minimal impact on lowering Lp(a), and lipoprotein apheresis is the sole effective-but impractical-method to significantly reduce Lp(a). Recent advances in Lp(a)-targeted therapies, notably nucleic acid-based approaches (e.g. antisense oligonucleotides and small interfering RNAs) and a small molecule inhibitor of Lp(a) synthesis, demonstrated substantial and often durable Lp(a)-lowering effects in Phase II trials. Phase III trials of these agents are now underway to examine the impact of lowering Lp(a) levels on atherosclerotic cardiovascular disease outcomes, and their results may transform the landscape of cardiovascular risk reduction and management for patients with elevated Lp(a). This review summarizes existing lipid-lowering therapies' limited effects on Lp(a), provides an update on the array of emerging therapeutics and their safety and efficacy, and discusses ongoing Phase III trials as well as other potential benefits of Lp(a)-lowering, such as slowing progression of calcific aortic valve stenosis. Show less

Dysregulated extracellular matrix (ECM) deposition and epithelial-mesenchymal transition (EMT) in the trabecular meshwork (TM) contribute to glaucoma-associated fibrotic remodeling, and lysophosphatidic acid (LPA) potently induces these profibrotic responses in human trabecular meshwork (HTM) cells. We investigated whether an ethanolic extract of Show less

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

Lipoprotein(a) [Lp(a)] is a genetically determined independent risk factor for atherosclerotic cardiovascular disease (ASCVD) that drives a significant residual risk through proatherogenic, proinflammatory, and prothrombotic pathways. However, current mainstay lipid-lowering therapies such as statins have limited efficacy in reducing Lp(a) levels, highlighting a critical therapeutic gap. This review aims to synthesize evidence on the role of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) inhibitors in targeting Lp(a). We systematically searched PubMed and Embase for clinical trials and mechanistic studies (2010-2025), using the PRISMA and AMSTAR-2 frameworks to ensure methodological rigor and demonstrated that PCSK9 inhibitors (eg, alirocumab, evolocumab, and tafolecimab) not only reduced low-density lipoprotein (LDL-C) by 55%-60% but also lowered Lp(a) by 20%-30%. The efficacy of these agents varies ethnically, with tafolecimab showing superior performance in East Asian populations, which is partly attributable to the higher prevalence of the PCSK9 R46L loss-of-function allele. Mechanistically, PCSK9 inhibitors lowered Lp(a) levels through 2 pathways: suppression of hepatic synthesis and enhanced plasma clearance. This evidence supports the 2023 ESC guidelines, which issued a Class IIa recommendation for PCSK9 inhibitor use in patients with ASCVD and elevated Lp(a) levels. Given the evolving landscape, further research is warranted to confirm the role of these therapies in precision medicine paradigms for managing Lp(a)-associated risks. Show less