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Atrial fibrillation (AF) is a progressive condition characterized by atrial remodeling and dysfunction. This systematic review explores biomarkers that predict new-onset AF, highlighting their potential to improve early diagnosis and risk stratification in high-risk patients, and prevention of stroke and major adverse cardiovascular events. We conducted a literature search of studies published between January 2014-November 2025 in PubMed, Scopus, Web of Science, and Google Scholar, following PRISMA 2020 guidelines. Studies analysing specific populations and patients with prior or postoperative AF were excluded. Quality was assessed using the Newcastle-Ottawa scale. Effect sizes were expressed as HR with 95% CIs. We included 10 cohort studies comprising 472,581patients and 35,271 (7.5%) new-onset AF. Overall, 18 biomarkers were associated with an increased risk of AF, most notably NT-proBNP and sVCAM-1. Conversely, 9 biomarkers were associated with a lower AF incidence, such as ADAMTS13 (HR 0.78, 95%CI 0.70-0.88). A meta-analysis of NT-proBNP demonstrated its association with a higher incidence of AF (HR 1.37, 95%CI 1.19-1.59) with high heterogeneity (I2 = 80%, p<0.01) and Lp(a) was associated with a significant 3% increase in AF incidence per 20 mg/dL increment. Two networks were constructed according to whether biomarkers were associated with a higher or lower incidence of AF, visualising their connection with other biomarkers. Well-known biomarkers, such as NT-proBNP, and others not yet incorporated into clinical practice, such as Lp(a) and sVCAM-1, could play a role in the diagnosis and preventive management of AF. Large-scale prospective studies are needed to validate and optimise their diagnostic utility in predicting new-onset AF. Show less

Lipoprotein(a) [Lp(a)] is recognized as a cardiovascular risk indicator; however, its connection to peripheral arterial disease (PAD) in individuals with type 2 diabetes mellitus (T2DM) is not well established. This research seeks to explore how Lp(a) concentrations relate to the occurrence of PAD in T2DM patients. A retrospective analysis was conducted on 590 patients diagnosed with T2DM who were admitted to Hefei First People's Hospital from January 2022 to August 2024. Participants were grouped into tertiles according to their Lp(a) levels. The diagnosis of PAD was made using the ankle-brachial index (ABI), with an ABI <0.9 considered indicative of PAD. The association between Lp(a) concentrations and PAD was examined using multivariate logistic regression models, subgroup analyses, receiver operating characteristic (ROC) curves, and restricted cubic spline (RCS) plotting. Compared to lower Lp(a) levels, the group with higher Lp(a) levels exhibited a higher prevalence of PAD ( A significant correlation was observed between elevated Lp(a) levels and an increased risk of PAD in patients with T2DM. Show less

To identify latent profiles of proactive health behaviors in patients with hypertension, examine the category-specific influencing factors. Proactive health behavior, as an emerging concept, refers to a self-motivated approach to systematically managing health-related factors in order to actively maintain and promote one's health status. However, existing studies have largely focused on describing the overall level of such behaviors among patients with hypertension, with insufficient exploration of behavioral heterogeneity within this population. Moreover, there has been a lack of systematic integration of established behavioral theories to explain the multifactorial mechanisms underlying different behavioral patterns, which limits the development of precise nursing interventions. A cross-sectional study was performed, involving 352 patients with hypertension from 8 communities in Anhui Province from September to December 2025. The survey tools included self-designed demographic and clinical instrument, the Proactive Health Behavior Scale for Hypertensive Patients, the Self-Efficacy Scale for Hypertensive Patients, the Health Literacy Management Scale (HeLMS). Latent profile analysis (LPA) was used to identify subtypes of proactive health behavior among hypertension patients. Multinomial logistic regression analysis was applied to determine the factors associated with the identified subtypes. A total of 352 questionnaires were distributed, yielding 321 valid responses (a response rate of 91.2%). The total score of proactive health behavior was 89.57 ± 22.99 points. The LPA revealed four profiles of proactive health behavior: the positive proactive health behavior profile (Class 1, The proactive health behavior among hypertension patients was at a moderate level, revealing four distinct behavioral categories with significant differences. Guided by the Health Belief Model, profile-specific influencing factors were analyzed, which informed the development of tailored intervention strategies. Show less

The 24-h movement behavior framework includes all physical activity (PA), sedentary behavior (SB), and sleep as interdependent components of a full day. While evidence highlights the benefits of higher PA, lower SB, and adequate sleep for health, the combined effects of these behaviors on mental and physical health remain unclear. This systematic review will explore the associations between 24-h movement behavior compositions and mental and physical health outcomes, providing insights for developing balanced movement behavior guidelines. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guideline. PubMed, PsycINFO, Embase, Web of Science, and Sport Discus will be searched for studies published between 2015 and 2025. Eligible studies must report 24-h movement behavior metrics-the composition of time allocated to sleep, sedentary behavior, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Included studies must also examine at least one mental (e.g., depression, anxiety) or physical (e.g., BMI, systolic blood pressure, all-cause mortality) health outcome. For each study, we will extract the time allocated to each behavior and effect estimates with 95% CIs (e.g., percent change in BMI, odds ratios for depression, hazard ratios for mortality) to quantify the magnitude and direction of associations. Screening, data extraction, and quality assessment will be conducted independently by two reviewers. The quality of evidence for each outcome will be assessed using the GRADE approach. Due to expected heterogeneity in study designs, a meta-analysis will not be performed. Instead, a structured narrative synthesis will be presented, stratified by age group and health condition, to summarize findings and identify key research gaps. The proposed systematic review will be the first to comprehensively review how combinations of PA, SB, and sleep are associated with mental and physical health using compositional data analysis. By emphasizing the interdependent nature of 24-h movement behaviors, the findings will provide a clearer understanding of how time spent among these behaviors influences health outcomes. The review aims to support evidence-based recommendations for optimizing daily movement behavior patterns to improve health across diverse populations. PROSPERO (CRD42023445730). Show less

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

Given the globalization of the nursing workforce, psychological empowerment represents a critical intrinsic determinant of nurses' mobility intentions, specifically regarding cross-border work. To identify latent profiles of nurses' psychological empowerment, examine associated factors, and explore the relationship between these profiles and cross-border working intention. A cross-sectional multicenter study was conducted from March to September 2023. Using convenience sampling, clinical nurses were recruited through liaisons from nursing societies in nine cities of Guangdong Province. Data were collected through questionnaires covering sociodemographic questionnaire, psychological empowerment, and cross-border working intention, with analyses including chi-square tests, logistic regression, and latent profile analysis (LPA) performed using SPSS 23.0 and Mplus 8.3. A total of 3671 valid questionnaires were collected, and 39.5% of the respondents reported cross-border intentions. LPA identified three psychological empowerment profiles among nurses, ranked from high to low: the core-driven empowerment profile (16.94%), the adaptive empowerment profile (70.42%), and the constrained empowerment profile (12.64%). The nurses with lower salary, intermediate title, and without specialist nurse qualification were more likely to fall into the constrained empowerment profile. Psychological empowerment was positively correlated with nurses' cross-border work intention. The core-driven profile showed the highest cross-border work intention (50.6%), followed by the adaptive (38.2%) and constrained profiles (31.7%). For cross-border work, the constrained profile prioritized salary (87.1%) as the key concern, while the core-driven profile focused more on good promotion opportunities (70.3%). Psychological empowerment exerts a positive impact on clinical nurses' cross-border work intention, with the three identified empowerment profiles exhibiting divergent motivational priorities and decision logics. These findings highlight the need for subgroup-specific strategies to balance nursing workforce mobility and stability. The findings support a differentiated human resource strategy based on nurses' psychological empowerment profiles. For core-driven nurses, institutions should provide international career development channels to strengthen their domestic job embeddedness. For adaptive nurses, tailored skill training and decision-making autonomy should be offered to guide their mobility aspirations. For constrained nurses, competitive compensation and family support services should be prioritized to address their stability needs and rebuild professional confidence. These targeted measures balance talent mobility and domestic workforce stability. Show less

While family resilience is a recognized determinant of adaptation following stroke, the distinct, empirically derived profiles of family resilience among Chinese stroke survivor-caregiver dyads have not been clearly delineated. Identifying these profiles and their determinants is crucial for developing targeted interventions. To identify latent profiles of family resilience and examine the socio-demographic and clinical factors associated with profile membership among stroke patient-caregiver dyads in China. In this cross-sectional study, a convenience sample of 773 stroke survivor-caregiver dyads was recruited from three hospitals in Zhejiang Province, China. Latent profile analysis (LPA) was conducted on the 20-item Family Resilience Questionnaire (FRQ). Multinomial logistic regression was used to determine factors associated with profile membership. LPA supported a four-profile solution: Profile 1 "Low-Functioning Families" (22%), Profile 2 "Moderately Resilient - Low Cohesive Families" (24%), Profile 3 "Highly Resilient - Well-Functioning Families" (31%), and Profile 4 "High-Functioning - Optimistically Resilient Families" (24%). Multinomial logistic regression revealed that lower caregiver competence (higher FCTI scores) was strongly associated with profile membership (standardized aORs ranged from 2.58 to 43.19), whereas higher perceived social support (PSSS) was a significant protective factor (standardized aORs ranged from 0.03 to 0.19). Caregiver relationship and payment source were also significantly associated with profile membership. Family resilience among Chinese stroke families manifests in four distinct profiles, which are differentiated predominantly by caregiver competence and perceived social support. Our findings advocate for a precision family support paradigm, shifting from one-size-fits-all approaches to interventions tailored to distinct resilience profiles. Given the strong association, intervention programs should prioritize enhancing core caregiver competencies as a primary leverage point for building family resilience. Show less

Lipoprotein(a) [Lp(a)] is a potent, independent causal risk factor for coronary artery disease (CAD). This study aimed to assess the association between Lp(a) and the diagnosis, clinical presentation, and angiographic characteristics of obstructive CAD and occurrence of myocardial infarction (MI). We included 446 individuals with very high Lp(a) (>230 nmol/L) who underwent routine lipid profiling, matched 2:1 by age and sex using nearest-neighbor propensity matching to 223 controls with low Lp(a) (≤7 nmol/L). Kaplan-Meier analysis was used to assess CAD- and MI-free survival. Multivariable ORs were calculated for multivessel disease and the SYNergy Between percutaneous coronary intervention with TAXus and Cardiac Surgery-1 score. Median follow-up time, defined by age at last follow-up, was 60 years (Q1-Q3: 50-71). Individuals with very high Lp(a) had significantly lower event-free survival time for the diagnosis of obstructive CAD and occurrence of MI (P = 0.006 and P = 0.012, respectively). In multivariable analysis, Lp(a) was associated with multivessel CAD (adjusted OR: 1.43 [per 100 nmol/L]; 95% CI: 1.04-1.96; P = 0.028), but not with an intermediate or high SYNergy Between percutaneous coronary intervention with TAXus and Cardiac Surgery-1 score (adjusted OR: 1.28 [per 100 nmol/L]; 95% CI: 0.82-1.99, P = 0.279). Individuals with very high Lp(a) levels had a 2.4-fold higher risk of ST-segment elevation MI and a 15.9-fold higher risk of recurrent MI compared to those with low Lp(a). Very high Lp(a) is associated with earlier diagnosis of obstructive CAD and MI, predominantly ST-segment elevation MI. In addition, individuals with very high Lp(a) levels seem at a particular high risk of recurrent MI. Show less

Elevated lipoprotein(a) [Lp(a)] is an independent, causal risk factor for atherosclerotic cardiovascular disease (ASCVD), yet testing remains low. As our health system has expanded its efforts to increase Lp(a) awareness, we evaluated testing rates and their impact on care. Lp(a) testing rates were collected through electronic health record queries between 1/1/2022 to 12/31/2024. Baseline demographics, ASCVD status, Lp(a) testing rates by specialty, lipid lowering therapy (LLT) prescriptions and number of cardiology referrals were collected. 450,412 outpatients had ≥1 lipid panel order and 3.7 % ( While Lp(a) testing was low, it increased substantially over time. High risk Lp(a) levels were found irrespective of ASCVD status and were associated with more aggressive treatment. Systematic strategies to increase Lp(a) awareness and testing are warranted to mitigate cardiovascular risk. Show less

Lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for coronary disease owing to its atherogenic, proinflammatory, and prothrombotic properties. Current guidelines recommend a single measurement in adults to refine cardiovascular (CV) risk assessment. We aimed to characterize Lp(a) levels in patients with acute coronary syndrome (ACS) and explore associations with sex, age, comorbidities, and traditional cardiovascular risk factors. We conducted a cross-sectional study of patients with ACS admitted to our center between January 2022 and December 2023, with Lp(a) measured at admission. Patients were stratified into two groups: Lp(a) >100 nmol/L and ≤100 nmol/L. Demographic and clinical data, including traditional cardiovascular risk factors (dyslipidemia, diabetes mellitus, arterial hypertension, smoking, and obesity), were collected from hospital records. Chi-square and independent t or Mann-Whitney U tests were used to compare categorical and quantitative variables; linear regression analysis assessed associations between continuous Lp(a) values and independent variables. Among 903 patients admitted with ACS during the study period, Lp(a) was measured in 388 (42%). Median Lp(a) level was 62.0 [18.4, 153.8] nmol/L. Of these, 38.7% had Lp(a) >100 nmol/L. Women had higher Lp(a) than men (p-trend=0.014). Lp(a) levels were similar across traditional cardiovascular risk factors categories. Among patients without traditional cardiovascular risk factors, women also had higher Lp(a) than men (p=0.003). Elevated Lp(a) was associated with history of coronary artery disease (p-trend=0.003) and with treatment with high-intensity statins alone (p-trend=0.032) or in combination with ezetimibe (p-trend=0.014). Lp(a) levels showed a heterogeneous distribution and was not associated with traditional cardiovascular risk factors or other lipid parameters. This reinforces Lp(a) as an independent risk factor, supporting active screening in patients with ACS, particularly in women not affected by traditional cardiovascular risk factors. Show less

This study used a group-based multi-trajectory model (GBMTM) to identify distinct muscle health trajectories and examine their associations with physical activity (PA) in middle-aged and older adults. Data were obtained from 2818 middle-aged and older adults (aged ≥40 years) in the China Health and Retirement Longitudinal Study (2011-2015). Muscle health was assessed using muscle mass (appendicular skeletal muscle mass index), muscle strength (handgrip strength), and physical performance (5-time chair stand test). PA was assessed using the International Physical Activity Questionnaire Short Form. A GBMTM was applied to jointly identify longitudinal trajectories of muscle mass, muscle strength, and physical performance, and to evaluate their associations with PA. In this study, four muscle health trajectories were identified: low-function declining, moderate-function declining, moderate-function stable, and high-function stable group. Engaging in ≥150 min/wk of light PA (LPA), moderate PA (MPA), or vigorous PA (VPA) was associated with the moderate-function stable group (LPA: aOR = 3.44, 95% CI: 1.94 - 6.11; MPA: aOR = 2.83, 95% CI: 1.67 - 4.96; VPA: aOR = 2.88, 95% CI: 1.61 - 5.13) and the high-function stable group (LPA: aOR = 5.20, 95% CI: 2.44 - 11.19; MPA: aOR = 4.10, 95% CI: 1.92 - 8.73; VPA: aOR = 3.42, 95% CI: 1.55 - 8.55). In older adults aged ≥70 years, associations persisted for MPA and VPA. Distinct muscle health trajectories highlight individualized muscle aging and inform personalized PA guidance. Regular PA ≥150 min/wk across intensities was associated with more favorable longitudinal muscle health. Show less

Psychological well-being among university students is often examined using variable-centered approaches that assume population homogeneity. Using Ryff's eudaimonic model and a person-centered analytic framework, this study examined latent profiles of psychological well-being among Ghanaian undergraduates, offering insight into how the Western-derived model functions in a non-Western cultural context. A cross-sectional design was employed to sample 574 regular undergraduate students from a public university in Ghana. Students completed the 18-item Ryff's Psychological Well-Being Scale. Latent profile analysis (LPA) followed by Chi-square tests were performed using JAMOVI statistical software. Four distinct profiles emerged: fully flourishing students (38.7%), harmonious life seekers (45.1%), purposeful self-actualizers (7.5%), and aspiring actualizers (8.7%). The profiles differed primarily in levels of autonomy, personal growth, and environmental mastery. Well-being profile membership was not associated with gender but varied significantly by age, although the effect size was small. The study findings suggest meaningful heterogeneity in eudaimonic well-being among Ghanaian undergraduates and highlight the importance of culturally sensitive, profile-based mental health interventions beyond demographic assumptions. Show less

Healthcare professionals are expected and motivated to engage empathetically with patients, their families, yet how different components of empathy, coping traits interact to shape psychological responses remains unclear. This study examined these relationships in medical, nursing students to inform tailored educational interventions METHODS: Participants who completed two surveys 2 years apart (30 medical students and 88 nursing students) were included. Empathy traits were assessed using the Interpersonal Reactivity Index, coping traits using the Brief Coping Orientation to Problems Experienced Inventory, and psychological responses using the Professional Quality of Life Scale. Mixed-effects models for repeated measures analyzed the impact of empathy and coping traits. Latent profile analysis (LPA) classified participants by empathy and coping traits. Personal distress was significantly associated with increased secondary traumatic stress (STS) and burnout, and decreased compassion satisfaction. Empathic concern was associated with increased compassion satisfaction. Active coping and support seeking were associated with increased compassion satisfaction and reduced burnout, whereas indirect coping was associated with increased STS and burnout. LPA identified three distinct profiles of empathy and coping traits, showing significant differences in psychological responses. Differences in empathy and coping traits influence psychological responses in medical and nursing students. Tailored interventions that consider these traits may be more effective. Show less

Lipoprotein(a) [Lp(a)] is an inherited cardiovascular risk factor. However, its association with coronary plaque characteristics beyond traditional risk enhancers remains unclear. We aimed to evaluate the association between Lp(a) levels and coronary plaque characteristics in asymptomatic primary prevention patients, and to compare its predictive value against other risk enhancers, including LDL particle concentration (LDL-P), high-sensitivity C-reactive protein (hsCRP), and coronary artery calcium (CAC) score. We retrospectively analyzed 547 asymptomatic patients undergoing coronary computed tomography angiography (CCTA) between 2018-2024. Plaque characteristics were assessed using artificial intelligence-based quantitative CCTA. Associations between Lp(a), LDL-P, hsCRP, CAC score, and plaque features were evaluated using multivariable regression adjusted for age and sex. Median age was 56 years, 69.8% were male. Higher Lp(a) was associated with greater total plaque volume (β=23.1 mm³, p=0.006), calcified plaque (β=11.1 mm³, p=0.014), non-calcified plaque (β=12.0 mm³, p=0.027), and low-density non-calcified plaque (LDNCP; β=0.4 mm³, p<0.001) volumes, as well as increased area stenosis (β=1.9%, p=0.031) and remodeling index (β=0.02, p=0.017). In multivariable models, CAC score was the strongest predictor of overall plaque burden including calcified and non-calcified plaque (p<0.000) but was not associated with LDNCP. Lp(a) remained independently associated with LDNCP (β=0.45 mm³, p=0.013), while LDL-P and hsCRP showed no significant associations. In asymptomatic primary prevention patients, Lp(a) was independently associated with high-risk coronary plaque features, specifically LDNCP, beyond traditional risk enhancers. These findings highlight the unique role of Lp(a) in identifying coronary plaque vulnerability and suggest complementary roles for Lp(a) and CAC in refining cardiovascular risk stratification. 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 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

Suicidal ideation is prevalent among university students and is associated with a complex interplay of psychological, interpersonal, and behavioral factors. While prior research has examined individual predictors such as sleep disturbances, depressive symptoms, and impulsivity, less is known about how these factors co-occur in clinically distinct profiles. This study aimed to identify latent profiles of suicide risk using a multidimensional model.We conducted a secondary data analysis using the Assessing Nocturnal Sleep/Wake Effects on Risk of Suicide (ANSWERS) dataset, which includes self-reported data from 971 U.S. university students aged 18 to 52 years (M = 20.10, SD = 2.41). Seven continuous variables were included as indicators: sleep quality (PSQI), insomnia severity (ISI), depressive symptoms (CES-D), suicidal ideation severity (C-SSRS), thwarted belongingness and perceived burdensomeness (INQ), and total impulsivity (UPPS-P). Latent Profile Analysis (LPA) was employed to identify subgroups, and model fit was assessed using the AIC, BIC, and entropy.Latent Profile Analysis identified five distinct profiles based on indicators of sleep, affect, interpersonal behavior, and impulsivity. These included a severely distressed profile characterized by elevated depressive symptoms, suicidal ideation, sleep disturbances, and interpersonal burden; an interpersonally burdened profile with mild affective symptoms; a moderately symptomatic profile; a psychologically resilient profile with minimal symptoms across domains; and a high impulsivity profile accompanied by emotional dysregulation.This study identified five clinically distinct profiles of suicide risk in a large sample of university students. These results may inform the development of tailored screening and intervention strategies in campus-based mental health settings. 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 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

Despite substantial progress in the management of cardiovascular disease (CVD), lipoprotein(a) [Lp(a)] persists as a genetically determined risk factor that remains insufficiently explored. Both extremely high and low levels of Lp(a) are linked to adverse outcomes. Current diagnostic assays for Lp(a) lack standardization, and conventional lipid-lowering therapies exert minimal effects on its levels, resulting in limited treatment options specifically targeting Lp(a). To address these gaps, we conducted a comprehensive molecular and clinical review of Lp(a), examining its unique structure, genetic determinants, metabolic pathways, and the factors influencing its plasma concentration. Furthermore, we discuss emerging therapeutic strategies aimed at targeting Lp(a). Show less

Plasma lipoprotein(a) [Lp(a)] levels greater than 50 mg/dL are an independent risk factor for cardiovascular diseases, including heart failure, atherosclerosis, and aortic valve stenosis. Lp(a) exhibits proatherogenic properties by promoting vascular inflammation, thrombosis, and calcification. Several therapeutic agents specifically designed to reduce Lp(a) formation are currently under evaluation in clinical trials or regulatory review. Muvalaplin is notable as the first orally administered drug developed to lower plasma Lp(a) levels. This review evaluates the efficacy, safety, and tolerability of muvalaplin and compares its profile with other Lp(a)- lowering agents. A systematic literature search was conducted using the PubMed database for articles published between 2020 and 2025, with keywords, including muvalaplin, lipoprotein, and cardiovascular. Only original research, clinical trials, and review articles were included. Muvalaplin is an oral small-molecule inhibitor being studied as the first oral Lp(a)-lowering agent. In Phase I trials, daily administration of muvalaplin for 14 days reduced Lp(a) levels by up to 65%. In Phase II trials, 12 weeks of daily muvalaplin resulted in reductions of up to 86% in Lp(a) levels without significant safety or tolerability concerns. These findings suggest that muvalaplin could be a valuable therapeutic option for managing cardiovascular risk associated with elevated Lp(a). Notably, unlike other Lp(a)-lowering agents, muvalaplin did not cause skinrelated adverse events at injection sites. Although the initial clinical data are promising, Phase III trials are required to establish long-term safety and determine whether reductions in plasma Lp(a) translate into meaningful reductions in cardiovascular events. Show less

AI literacy is increasingly important in college students' academic achievement, daily life, and future employability. However, current research predominantly overlooks the heterogeneity in students' AI literacy, especially how individual psychological characteristics and features of AI technology contribute to this variation. This oversight limits the formulation of tailored strategies to meet the students' various demands in an era shaped by rapid AI advancement. This study aims to adopt an individual-centered approach to identify distinct AI literacy profiles among college students. In addition, it investigates, based on affordance theory, how positive emotions, instrumental motivation, perceived ease of use, and psychological anthropomorphism predict assignment to different profiles. A total of 808 Chinese college students participated in this survey. Latent profile analysis (LPA) was employed to classify students into distinct AI literacy profiles. Multinomial logistic regression was conducted to examine how psychological and technological factors predict profile classification. This study identified four distinct AI literacy profiles among college students: preliminary contact type, ethical orientation type, balanced development type, and behavioral conservatism type. These profiles showed significant differences in positive emotions, instrumental motivation, perceived ease of use, and psychological anthropomorphism, highlighting diverse psychological and technological characteristics inherent to each group. This study underscores the heterogeneity of AI literacy within the college student population and detects four distinct AI literacy profiles with unique psychological and technological traits. The findings indicate that students' AI literacy is profoundly affected by emotional tendencies, motivational drives, and technological variables, highlighting the need for tailored educational strategies that address the distinct psychological and technological drivers of each literacy profile. Show less

Lipoprotein(a) (Lp(a)) is a proatherogenic particle that is considered an important cardiovascular risk modifier due to its association with atherosclerotic cardiovascular disease (ASCVD) as well as calcific aortic valve stenosis (CAVS). Data on the clinical burden associated with elevated lipoprotein(a) levels in patients at high and very high cardiovascular risk remain limited. We evaluated the prevalence of ASCVD and LDL-C target achievement in subjects with high and very high elevated Lp(a) levels referred to a lipid unit. In this retrospective study, 1755 subjects were evaluated; 265 with Lp(a) ≥240nmol/L were included. The population was divided into two groups: high Lp(a) (240-429nmol/L, n=216) and very high Lp(a) (≥430nmol/L, n=49). ASCVD prevalence was 58% in the very high group and 48% in the high group (p=0.23). Age and statin intensity were higher in the very high Lp(a) group. LDL-C target achievement was low in both groups: 20.0% and 25.4% of very high-risk patients reached <55mg/dL as well as 18.2% and 17.2% of high-risk patients reached <70mg/dL in very high and high Lp(a) groups, respectively. Subjects with elevated Lp(a) levels showed a high prevalence of ASCVD and low LDL-C target attainment despite high-intensity statin therapy. These findings support the need for Lp(a) screening and additional lipid-lowering strategies in high-risk patients. Show less

Physical inactivity is a health concern for children and adolescents with neurodevelopmental disorders (NDDs) as it directly increases their risk of developing various health problems. Evidence on differences in accelerometer-assessed physical activity between children and adolescents with and without NDDs is inconclusive. And age- and body mass index (BMI)-related effects on physical activity remain unclear. The systematic literature searches were performed in 6 databases up to March 2025. Methodological quality was evaluated by the Newcastle-Ottawa Scales. Data were pooled using a random-effects model. Hedges' g was used to express the effect size index with 95 % confidence interval (CI). Meta-regression on age and BMI was also performed to investigate the potential moderating effects. Out of the 2167 studies initially identified, 28 were included in the analysis, which comprised total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), and light physical activity (LPA) included in the meta-analysis, respectively. These studies involved 1060 children and adolescents with NDDs and 1820 without, aged 6.6-16.9 years. A small-to-moderate effect size exists for the difference in TPA (g=-0.299) and MVPA (g=-0.479) between children and adolescents with and without NDD, particularly indicating a difference in 12.7 min of MVPA daily. The difference in LPA was not significant (g=0.450, p = 0.125). The decline in MVPA with age was more pronounced in those with NDDs, and the difference in MVPA was smaller for those with lower BMI. The variation in MVPA differences by age and BMI highlights the need to develop better physical activity habits and reduce these disparities for children and adolescents with NDDs. Show less

Mothers of children with developmental disabilities (DD) experience chronic and cumulative stress, yet many also report positive psychological changes such as post-traumatic growth (PTG). Few studies have examined how depression and PTG co-occur as distinct mental-health patterns or how psychosocial resources influence these profiles. This study identified latent profiles of depression and PTG among Korean mothers of children with DD and examined whether social support and religious participation predicted profile membership. A total of 488 mothers of children with DD participated in a survey conducted in Seoul and surrounding areas (2017-2018). Measures included the Post-Traumatic Growth Inventory, PHQ-9 depression scale, perceived informal support, formal service use, and religious participation. Latent profile analysis (LPA) was used to identify distinct psychological profiles, followed by multinomial logistic regression to examine predictors of class membership. A three-class solution best represented the data: (1) Low PTG/High Depression (13.4 %), (2) Moderate PTG/Moderate Depression (47.9 %), and (3) High PTG/Low Depression (38.6 %). Higher levels of family support, formal support services for caregivers, and active religious participation significantly increased the likelihood of belonging to the High PTG/Low Depression class. Self-rated health also differentiated class membership. Mothers of children with DD demonstrate heterogeneous combinations of distress and growth, supporting a dual-axis understanding of mental health. Social support-especially family support-and active religious participation emerged as key correlates of more adaptive profiles. Findings highlight the importance of culturally embedded support systems and tailored interventions that address both distress reduction and growth promotion. Show less

Advanced age is a well-recognized risk factor for atherosclerotic cardiovascular disease (ASCVD). Given the ongoing debate regarding the initiation of statin therapy in elderly individuals, identifying those with underlying coronary artery disease (CAD) who may benefit from lipid-lowering treatment is essential. This study aimed to identify predictors of CAD in statin-naïve adults aged ≥ 70 years with elevated low-density lipoprotein cholesterol (LDL-C), with particular emphasis on risk assessment, cumulative LDL-C burden, and lipoprotein(a) [Lp(a)] levels. The analysis included consecutive patients aged ≥ 70 years with LDL-C ≥ 160 mg/dL, available Lp(a) measurements, no prior history of ASCVD or diabetes, who underwent evaluation for CAD by coronary imaging or functional stress testing. Global ASCVD risk was estimated using the Systematic Coronary Risk Estimation 2-Older Persons (SCORE2-OP) and the Spanish Familial Hypercholesterolemia Cohort Study (SAFEHEART) risk scores. A total of 202 patients were included (mean age 76 years; 68.3% female). CAD was diagnosed in 30.7% of participants. In multivariable analysis, male sex (odds ratio [OR]: 2.109), Lp(a) level (OR: 1.012 per mg/dL), and cumulative LDL-C (OR: 1.155 per g/dL) were independently associated with CAD. The highest CAD prevalence was observed among individuals with cumulative LDL-C ≥ 14 g/dL and Lp(a) ≥ 50 mg/dL. While the SCORE2-OP algorithm failed to predict CAD, the SAFEHEART risk score was significantly associated with CAD. In statin-naïve elderly individuals with elevated LDL-C levels, male sex, cumulative LDL-C exposure, and high Lp(a) levels were independently associated with CAD. These findings underscore the potential utility of incorporating cumulative LDL-C and Lp(a) into risk stratification for older adults. Show less

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

Spinal TB (STB) is paucibacillary form of disease caused by Mycobacterium Tuberculosis. Late diagnosis of STB can lead to significant disability and morbidity. There is limited data available on diagnostic yield of CT guided biopsy/ultrasonography guided aspiration by various laboratory tests (phenotypic and molecular) used in evaluation STB. Present study was conducted in Department Orthopaedics and Pathology at tertiary care centre in Delhi. Total 68 clinico-radiologically suspected cases undergoing percutaneous aspiration (CT/USG guided) were included in the study. The aspirated tissue/pus was sent for cytology/histopathology/culture/molecular tests. Diagnostic yield of CT/USG guided aspiration for various phenotypic (histopathology/cytology/AFB smear) and molecular tests (CBNAAT/LPA) was calculated alone and in various combination. pvalue <0.05 was considered significant. AFB smear had the lowest diagnostic yield in both USG and CT guided aspirate (28 % and 17.2 % respectively). Histology/cytology combination with molecular method had 100 % diagnostic yield similar to all tests combined. Diagnosis of STB was ascertained in all cases using the combination of molecular methods and phenotypic tests and no single test is effective in ascertaining the diagnosis. The tissue obtained by percutaneous CT guided biopsy/USG guided aspiration technique is adequate to submit tissue to all tests to ascertain diagnosis. 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 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