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Speed capability is critical for early childhood development, but troubling patterns are emerging in the motor fitness of Chinese preschoolers (3-6 years). This study investigated how compositional 24-h movement behaviours (sleep, sedentary behaviour [SB], light physical activity [LPA] and moderate-to-vigorous physical activity [MVPA]) relate to speed capability. Via compositional data analysis and isotemporal substitution modelling, we assessed relationships between 24-h movement behaviours (sleep, SB, LPA and MVPA) and speed capability in 275 preschoolers (mean age 4.98 ± 0.76 years). Participants completed 20-m sprint tests and 7-day accelerometry. Time-reallocation effects were quantified through pairwise behavioural substitutions (5- to 30-min durations), with all models adjusted for age, sex and BMI z scores (z-BMI). Higher relative MVPA time significantly predicted faster sprint times (β = -1.302, p < 0.001), while higher LPA predicted slower times (β = 1.570, p = 0.003). Reallocating 15 min from sleep, SB or LPA to MVPA reduced sprint times by 0.176, 0.201 and 0.385 s, respectively (all p < 0.05). Conversely, reallocating MVPA to other behaviours worsened performance. The effects exhibited asymmetry: displacing time away from MVPA impaired speed capability to a greater extent than equivalent gains in MVPA time improved it. MVPA is the strongest positive predictor of speed capability in preschoolers. Optimizing 24-h movement patterns by reallocating time from LPA or SB to MVPA is associated with enhanced speed performance, supporting targeted interventions for early childhood development. Show less

Latino persons with chronic spine pain (CSP) face challenges engaging in physical activity (PA) and minimizing sedentary behavior (SB). This study aimed to objectively characterize PA and identify correlates of PA and SB in Latino persons with CSP. Cross-sectional baseline data from Latino participants who were enrolled in a clinical trial for CSP near the U.S.-Mexico border were utilized. Blockwise regression assessed the association between sociodemographic, clinical, interpersonal, and environmental factors with light PA (LPA), moderate-to-vigorous PA (MVPA), and SB. Participants (N = 154, Mage = 47.5 ± 12.1 years) spent 342.8 ± 111.6 min/day in LPA, 56.1 ± 71.1 min/day in MVPA, and 550.3 ± 140.9 min/day in SB. Seventy-five percent of participants met national PA guidelines. Lower income and higher pain interference were associated with lower LPA (R2 = 9%, p < .05). Younger age and lower income were associated with higher MVPA (R2 = 13%, p < .05). Lower income was associated with lower SB (R2 = 5%, p < .05). Younger age (OR 95% confidence interval [CI] [0.87, 0.98]) and higher exercise self-efficacy (OR 95% CI [1.06, 8.09]) increased the odds of meeting PA guidelines. Participants with CSP exhibited greater levels of LPA, MVPA, and SB compared with prior studies of Latino persons without pain. Sociodemographic variables including age and income were most consistently associated with PA and SB outcomes. Future research is needed to identify other relevant intrapersonal, interpersonal, and environmental determinants of PA and SB in this clinical population. (PsycInfo Database Record (c) 2025 APA, all rights reserved). Show less

This study used compositional data techniques that address the interdependence of 24-h movement behaviors (sleep, sedentary behavior [SB], light-intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA]) to examine: (1) how patients undergoing metabolic bariatric surgery (MBS) allocate time among these behaviors before MBS, and (2) whether overall time-use composition and modeled reallocation patterns relate to early weight loss after MBS. Participants wore an accelerometer 24 h/day for 10 days before MBS to measure time in sleep, SB, LPA, and MVPA. Isotemporal substitution models estimated differences in 6-month post-MBS percentage total weight loss (%TWL) associated with reallocations of these pre-surgery movement behaviors. Forty-five participants provided valid data. Pre-MBS time-use composition was associated with %TWL (23.8 ± 5.1%; F = 2.66, p = 0.047). Reallocating 15-60 SB or LPA minutes/day to MVPA was estimated to relate to 0.9-3.5% greater %TWL. Reallocating 15-30 MVPA minutes/day to SB or LPA was estimated to relate to 1.4-5.0% less %TWL (all comparisons p < 0.05). Other reallocations were non-significant. In conclusion, modeled shifts in time from SB or LPA to MVPA and vice versa were associated with estimated increases or decreases in early post-surgical weight loss, respectively. Experimental research is needed to clarify causal relationships and inform interventions to improve MBS outcomes. Show less

Based on epidemiological and genetic studies in recent decades, lipoprotein(a) (Lp(a)) has been accepted as a causal risk factor for atherosclerotic cardiovascular disease and aortic stenosis. Although inter-ethnic differences exist, Lp(a) level ≥50 mg/dL is commonly reported to indicate elevated cardiovascular risk. Blood Lp(a) levels are largely determined based on genetic background, and the kringle IV type 2 repeat variant is a major factor. Lp(a) is structurally similar to low-density lipoprotein (LDL) but also contains apolipoprotein(a) (apo(a)), which includes kringle domains associated with diverse effects depending on particles and individuals. The LDL-like property of Lp(a) and effect of apo(a) on vascular cells can promote atherosclerosis. Apo(a) competes with plasminogen and can inhibit the role of plasmin during fibrinolysis. Furthermore, oxidized phospholipids on apo(a) may induce oxidative stress to enhance atherosclerosis and can affect valve calcification. Trials on new therapeutics targeting Lp(a) RNA, including antisense oligonucleotide (e.g., pelacarsen), siRNAs (e.g., olpasiran, lepodisiran, and zerlasiran), and small molecules (e.g., muvalaplin), are under way. Depending on the study or dose, these agents lowered Lp(a) levels by 80-100% compared with the control; however, results of clinical outcomes have yet to be reported. Show less

The 2025 update of the European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines on dyslipidemia introduce important innovations based on new evidence. The risk assessment is now conducted using the systematic coronary risk evaluation 2 (SCORE2) and SCORE2-OP (older persons), which enable improved stratification, particularly in older individuals. In addition, risk modifiers, such as family history, ethnicity, comorbidities and the biomarkers elevated highly sensitive C‑reactive protein (hs-CRP) or lipoprotein(a) (Lpa), have been introduced. Risk categories have been refined while low-density lipoprotein cholesterol (LDL-C) target values and the principle of stepwise treatment remain unchanged. A major focus is on the acute coronary syndrome: the immediate initiation of high-intensity statin treatment, mostly in combination with ezetimibe is recommended. Increasingly more important are elevated Lp(a) levels and special subgroups: in people with human immunodeficiency virus (HIV), statin treatment is recommended over the age of 40 years regardless of the LDL‑C as well as in high-risk patients undergoing anthracycline treatment. The use of dietary supplements and vitamins for prevention, however, are discouraged. The update reinforces the principle of risk-adapted LDL‑C target values, expands the treatment options and emphasizes the need for early, consistent lipid-lowering with practical recommendations. Show less

The Lipoprotein(a) (LPA) rs3798220 and rs10455872 polymorphisms have been indicated to be involved with the coronary heart disease (CHD) susceptibility. However, there are still differences between the individual studies. To explore the correlation of LPA gene rs3798220 and rs10455872 polymorphisms and CHD, the current meta-analysis was performed. The random or fixed effect genetic models were used to calculate the pooled odds ratios (ORs) and their corresponding 95 % confidence intervals (CI). A significant association was found between LPA rs3798220 polymorphism and CHD under allelic (OR: 1.488), recessive (OR: 1.543), dominant (OR: 1.534), homozygous (OR: 1.544), heterozygous (OR: 1.498) and additive genetic models (OR: 1.531). There was also a significant association between LPA rs10455872 polymorphism and CHD under allelic (OR: 1.607), dominant (OR: 1.751), heterozygous (OR: 1.723) and additive genetic models (OR: 1.686). LPA rs3798220 and rs10455872 polymorphisms were significantly associated with increased CAD risk. The persons carrying C allele of LPA rs3798220 and G allele of LPA rs10455872 polymorphisms might have higher CHD risk than the T allele of rs3798220 or A allele of rs10455872 carriers. Show less

The process model of emotion regulation highlights affect's ebb and flow in daily life in response to external events or internal processes, such as stress. Collectively daily stress and affect can shape daily experiences and influence long-term health. Understanding the dynamics of the stress-affect relationship requires examining intensity (average level), inertia (autoregression), and variability (residual variances), yet few studies simultaneously consider both arousal (high vs low, denoted as H vs L) and valence (positive vs negative, denoted as PA vs NA) dimensions of affect. Participants (N = 424; 72.4 % women, M Show less

Prior evidence indicate that differences in treatment settings between patients with colorectal cancer (CRC) from high-poverty areas (HPA, ≥ 20% residents living under poverty level) and low-poverty areas (LPA) might have contributed to disparities in their health outcomes. We sought to determine whether certain hospitals predominantly provided surgical care for patients with CRC from HPAs and examine associated patient outcomes. We identified patients undergoing surgery for nonmetastatic CRC diagnosed during 1/1/2009-12/31/2019 from SEER-Medicare. We defined poverty-area-serving (PAS) hospitals as hospitals with ≥ 50% patients from HPAs. We compared in-hospital adverse events, 30 day readmission, and long-term mortality between patients from HPAs and LPAs treated at PAS and non-PAS hospitals using logistic and Cox regression. Our cohort included 81,992 patients with CRC (median age = 78 years, 53.8% female, 15.9% in HPAs) treated by 991 hospitals. The 180 (18.2%) PAS hospitals treated 64.2% of patients from HPAs versus 2.6% from LPAs. Compared with patients from LPAs treated at non-PAS hospitals, patients from HPAs treated at PAS hospitals had more frequent in-hospital adverse events (OR[95%CI] = 1.17[1.07-1.29]), 30-day readmission (OR[95%CI] = 1.33[1.20-1.47]), worse all-cause (HR[95%CI] = 1.16[1.10-1.22]), and cancer-specific mortality (HR[95%CI] = 1.23[1.15-1.32]). A group of PAS hospitals treated a significant proportion of patients with CRC from HPAs and few from LPAs and was associated with worse short- and long-term patient outcomes. These findings highlight the presence and negative impact of healthcare segregation by area-level poverty and systemic inequities faced by individuals from HPAs. Multilevel resources are needed to address quality of care and other healthcare-associated needs for individuals from disadvantaged areas. Show less

Diabetic kidney disease (DKD) is one of the most serious microvascular complications of diabetes mellitus and a leading cause of end-stage renal disease worldwide. Although hyperglycemia and hypertension are well-established drivers of DKD, accumulating evidence suggests that additional factors, such as lipoprotein(a) [Lp(a)], may contribute to its pathogenesis. Lp(a) is a genetically determined lipoprotein with pro-atherogenic, pro-inflammatory, and pro-thrombotic properties, and elevated circulating levels have been associated with increased cardiovascular and renal risk in diabetic individuals. In this review, we summarize the current understanding of the relationship between Lp(a) and DKD, with a focus on the proposed molecular mechanisms. These include activation of TGF-β/Smad signaling leading to fibrosis, induction of oxidative stress, chronic inflammation, endothelial dysfunction, impaired fibrinolysis, and direct injury to podocytes resulting in proteinuria. While several clinical and experimental studies support the involvement of Lp(a) in these pathways, the precise molecular mediators remain largely undefined. Understanding these mechanisms may offer novel insights into the pathophysiology of DKD and identify new therapeutic targets. This article aims to provide a comprehensive overview of the potential role of Lp(a) in DKD and to highlight areas requiring further investigation. Show less

Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for myocardial infarction and stroke. Elevated Lp(a) >50 mg/dL (>125 nmol/L) is common and present in about 1 in 5 individuals. Although Lp(a) may be a cause of young ischemic stroke (age ≤60), limited data on national testing trends in this population are available, testing in the general population remains low overall, and different organizations have varying guidelines for testing. By determining the degree to which this population is tested, information on national testing trends of Lp(a) in young ischemic stroke patients may influence future guideline recommendations to increase Lp(a) testing. This study aims to use a large, real-world dataset to assess trends of Lp(a) testing in young ischemic stroke patients in the United States from 2015-2024. We performed a retrospective analysis of Lp(a) testing in young ischemic stroke patients across the United States from January 1, 2015 to December 31, 2024 using Epic Cosmos, a nationwide, de-identified electronic health record (EHR) dataset comprising over 300 million patient records from over 1,715 hospitals and 41,000 clinics, including from all 50 states, Washington D.C., Lebanon, and Saudi Arabia. The current count values for patients, hospitals, and clinics are available on the Epic Cosmos website. Although the Epic Cosmos data dictionary includes Lebanon and Saudi Arabia as standardized site locations, no patients from these countries were present in our analytic cohort; thus, all analyses were restricted to individuals within the United States. We evaluated the number of young ischemic stroke patients, defined as age ≤60 with history of an ischemic cerebrovascular accident (CVA), who had ever undergone Lp(a) testing, the testing rate per annual young ischemic stroke patients, geographical variation, and percentages of patients tested stratified by age, sex, ethnicity, race, and diagnosis of coronary artery disease (CAD). Testing rates were calculated as the number of distinct patients tested per year and as the testing rate per annual patient population. For each stratum we calculated the proportion tested with Wilson 95 % confidence intervals and assessed between-group differences using chi square or Fisher exact tests as appropriate. Annual trends in the testing proportion were modeled using a binomial generalized linear model with a logit link, treating the annual number tested as the numerator and the annual young ischemic stroke population as the denominator, and we report the odds ratio per calendar year with robust standard errors. Geographical variation was visualized using a heat map of testing by state. All analyses were descriptive and intended to characterize population-level patterns of ischemic stroke within the Cosmos network rather than infer causal associations. Given the exploratory design, no additional model-based adjustment for confounding was performed. All data are de-identified in compliance with HIPAA standards and governed under Epic's "Rules of the Road" for institutional data use. From 2015 to 2024, out of a total of 188,305 distinct young ischemic stroke patients, 9,226 (4.9 %) underwent Lp(a) testing. Additionally, the annual number of tested patients increased significantly from 179 in 2015 to 1,992 in 2024 (p<0.001), and the annual percentage of patients undergoing Lp(a) testing increased from 4.3 % in 2015 to 9.3 % in 2024. The states with the largest number of tested patients were Ohio (10.4 %), Texas (7.4 %), and Pennsylvania (5.5 %). The rates of testing were significantly different between sexes, with a larger percentage of young women with ischemic strokes tested compared to young men. Analyzing patients with reported racial data, patients who identified as Black or African American underwent testing for Lp(a) at the highest rate, compared with patients who identified as Asian, "None of the above", White, or Other Race. Among patients undergoing testing with reported ethnic identity, a higher percentage of patients who identified as Hispanic or Latino were tested compared to those who identified as non-Hispanic. Stratifying the total tested patients by age, adults between the ages of 50-60 years made up the largest percentage of patients (4,460; 48.3 %); however, the highest rate of testing occurred in patients aged 5-18. In addition, a higher rate of the young ischemic stroke patients who had ever had a diagnosis of CAD underwent testing compared to patients without CAD. Lp(a) testing among young ischemic stroke patients has increased significantly over the past decade, likely reflecting growing clinical recognition of its causal role in atherosclerotic disease. The rise parallels key updates in lipid management and stroke prevention guidelines, including the 2019 European Society of Cardiology and 2024 National Lipid Association recommendations advocating at least once-in-a-lifetime Lp(a) measurement. Increasing assay availability and heightened awareness of the causal relationship of Lp(a) with atherosclerotic disease may also have contributed to the observed upward trend. Despite this, only about one in twenty young ischemic stroke patients had ever been tested, underscoring a substantial implementation gap between evidence and clinical practice. Show less

Suicidal ideation (SI) and behavior are complex phenotypes, with multiple contributing risk-factors. This study used longitudinal data from the Million Veteran Program Mental Health Survey to identify SI profiles among Veterans based on trajectories of ideation and depression severity and compared them to a non-suicidal (no-SI) control group. Latent profile analysis (LPA) was performed to identify SI profiles using data from Veterans (n = 34,322) endorsing SI in their electronic health record. LPA identified four highly reproducible SI profiles: mild ideators with and without depression, variable ideators, and persistent ideators. Veterans across the SI profiles were significantly more likely to have diagnoses of suicidal ideation or behavior, mental disorders, and TBI compared to Veterans with no-SI. The variable ideators showed higher rates of comorbid conditions. The mild ideators without depression and persistent ideators had a significantly higher proportion of deaths by suicide than the no-SI Veterans. European and African American GWAS and pan-ancestry meta-analyses of SI profiles compared to no-SI controls were also performed, which identified genome-wide significant loci across all SI profiles proximal to genes implicated in auditory and vestibular functioning, Alzheimer's, diabetes, and asthma. In summary, SI profiles identified were associated with novel genetic variants not identified by previous suicide GWAS studies. Additionally, Veterans within the mild SI profile that did not present with high-risk comorbidities had the highest rate of suicide deaths, indicating the need for upstream suicide risk prevention interventions across the SI risk continuum. Show less

Frontotemporal dementia (FTD) is driven by progranulin haploinsufficiency, in which age-dependent microglial activation promotes neurodegeneration through TDP-43 proteinopathy. Cyclic phosphatidic acid (cPA) is a natural phospholipid mediator characterized by a unique cyclic phosphate ring at the sn-2 and sn-3 positions of its glycerol backbone. A pharmacologically active derivative of cPA has been shown to suppress microglial activation. Based on this, we aimed to investigate the potential of cPA derivatives to prevent the onset of FTD. Specifically, we administered metabolically stabilized cPA derivatives, 2-carba-cPA (2ccPA) and its degradation product, 2-carba-LPA (2cLPA), to presymptomatic progranulin-deficient (Grn Show less

Elevated plasma lipoprotein(a) (Lp(a)) (> 125 nmol/L) is highly prevalent and a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) that may contribute significantly to plasma levels of low-density lipoprotein-cholesterol (LDL-C). This study aimed to describe clinical characteristics across Lp(a) levels and to estimate the proportion of individuals with normal, moderately elevated, or elevated LDL-C earlier in life according to levels of Lp(a), to assess whether LDL-C levels are a reliable marker for an underlying elevated Lp(a) level. In this retrospective study, detailed information on clinical characteristics was collected through medical records, while biochemical data was retrieved from the North Denmark Region Clinical Laboratory System (LABKA) I and II between January 2021 and August 2024. A total of 1346 individuals were included of whom 28.5% had elevated Lp(a) levels ≥ 125 nmol/L. A history of ASCVD was found in 57.7% of patients with Lp(a) levels ≥ 400 nmol/L compared to 21.1% of patients with Lp(a) levels < 100 nmol/L and the median age of onset of ASCVD was 51 years and 56 years, respectively. Furthermore, in individuals with Lp(a) levels ≥ 300 nmol/L, we found that 7.6% had LDL-C < 3.0 mmol/L and 9.1% had LDL-C between 3.0 and 3.5 mmol/L when measured for the first time, respectively. This study highlights distinct clinical characteristics across Lp(a) levels. With increasing Lp(a) levels, the prevalence of ASCVD increased, while the age at onset of ASCVD decreased. Furthermore, we found that LDL-C within the normal range cannot be used to rule out highly elevated Lp(a) levels. Show less

Previous research has suggested that high levels of internet use are associated with lower levels of physical activity. However, recent studies have yielded mixed findings. First, we aim to explore the prevalence of internet addiction and sedentary behavior among college students. Second, we examine the relationship between sedentary behavior and body composition. Additionally, we employ latent profile analysis (LPA) to identify subgroups of internet addiction profiles and to explore the associations between these latent profiles and sedentary behavior. This cross-sectional study examined the relationship between sedentary behavior, internet addiction, and body composition among 369 Chinese college students. Sedentary behavior was assessed via self-reported sitting time, internet addiction was measured using a standardized questionnaire, and body composition was evaluated with the InBody 120 device. LPA, an individual-centered method, was used to identify homogeneous subgroups of internet addiction. 42.3 % of students exhibited internet addiction and 72.6 % reported ≥6 h of daily sitting. LPA revealed two distinct profiles of internet addiction-"Regular" (57.2 %) and "Internet addiction" (42.8 %)-highlighting its heterogeneous nature. The findings suggest that age (p = 0.296), gender (p = 0.304), and sedentary time (p = 0.954) may not be the primary factors contributing to these profiles. Policymakers and campus health programs should tailor interventions to distinct internet addiction subgroups. Further research is needed to examine psychological, behavioral, and social contributors, as well as long-term effects. Show less

Older adults' social participation is associated with frailty, but the transition patterns and their relationship with frailty remain unclear. This longitudinal study aims to explore the latent classes and transition patterns of social participation in older adults with chronic non-communicable diseases and to assess their relationship with subsequent frailty. The data set from the China Health and Retirement Longitudinal Study (CHARLS) in 2018 (T1) and 2020 (T2) was analyzed, including 4793 older adults. Latent profile analyses (LPA) and latent transition analyses (LTA) were employed to identify latent classes and the transition probabilities of social participation at T1 and T2. The ANCOVA was employed to examine the frailty index at T2 was compared across transition patterns. The LPA results supported a 4-class model labeled as inactive group, voluntary group, social interaction group, and omni-engaged group. The probability of transition from the other groups to the inactive group was significant (33.3 %, 53.8 %, 54.4 %). Age, residence, marital status, and other demographic characteristics can significantly impact transition patterns. However, after controlling for baseline frailty and other covariates, transition patterns were not significantly associated with T2 frailty levels. The short-term (two-year) effect of qualitative shifts in social participation on frailty may be limited when pre-existing health status is accounted for. Future interventions should prioritize sustained engagement and investigate the longer-term effects of both qualitative and quantitative changes in social participation. Show less

A health-promoting lifestyle involves increasing health awareness and actively adopting healthier habits. For women with osteopenia, becoming more aware of osteoporosis prevention and taking positive preventive actions can effectively improve health outcomes. This study employed latent profile analysis (LPA) to assess the potential categories of healthy lifestyle promotion for women at high risk of primary osteoporosis. It aimed to identify high-risk subgroups, analyze differences and influencing factors among these groups, and offer evidence-based guidance for clinical nursing practice. From December 2024 to July 2025, women were recruited using convenience sampling from endocrine outpatient departments and physical examination centers at two Grade A tertiary hospitals in Guiyang City. Data collection followed the planned time frame, and only eligible samples were included. Latent profile analysis was performed with Mplus 8.3, and univariate and multiple logistic regression analyses were conducted using SPSS 27.0. A total of 340 valid questionnaires were analyzed. Participants were categorized into three latent profiles: the low self-management-ineffective health behaviors group (28.8 %), the moderate self-management-average health behaviors group (45.3 %), and the high self-management-favorable health behaviors group (25.9 %). These findings highlight disparities in the adoption of healthy lifestyles among women at high risk of primary osteoporosis. In clinical practice, nurses help patients with low health management recognize and overcome cognitive biases, use healthcare resources appropriately, and understand the importance of bone health. For patients with moderate health management, the can suggest exercise in addition to calcium supplementation. For those with high self-management, nurses can support their social networks to help maintain healthy behaviors over time. Show less

Social isolation has emerged as an increasingly critical public health issue among adolescents with depression. This study aimed to identify latent subgroups of social isolation based on its manifestations among adolescent patients with depression and to explore the associated influencing factors. A cross-sectional study was conducted from August 2024 to March 2025 at a specialized psychiatric hospital in Nanjing, China. Data were collected using paper-based questionnaires, which included demographic characteristics, the General Social Alienation Scale (GSAS), the Patient Health Questionnaire for Adolescents (PHQ-A), and the Resilience Scale for Chinese Adolescents (RSCA). Latent profile analysis (LPA) was used to classify patterns of social isolation. Chi-square tests, analysis of variance (ANOVA), lasso regression, and multinomial logistic regression were used to analyze profile characteristics and their influencing factors. A total of 412 adolescent patients with depression were included. This study identified three distinct profiles of social isolation: "Low isolation - Fluctuating group" (24.7 %, n = 102), "Moderate isolation - Skeptical group" (39.6 %, n = 163), and "High isolation - Avoidant group" (35.7 %, n = 147). Patients were significantly more likely to be classified into the "High isolation - Avoidant group" if they had siblings, a longer duration of mental illness, more severe depressive symptoms, or lower psychological resilience (all p < 0.05). This study revealed the heterogeneity of social isolation among adolescents with depression through LPA and identified key influencing factors. These findings provide a theoretical foundation for the development of tailored intervention strategies. Show less

Health-related fitness (HRF) is essential for wellbeing and daily functioning. While objective fitness assessments are preferred, self-report measures are practical for large-scale or geographically diverse studies. Existing self-report HRF measures may lack sensitivity for younger or healthy adults. Additionally, many include items with no or poorly defined reference populations, potentially limiting their validity and comparability. This study examined the reliability and validity of single-item self-reported HRF measures of aerobic fitness, muscular strength and endurance, flexibility, coordination, agility, and body composition. Between April and July 2023, University of Calgary students and staff (N.=129; mean age 28±9 years) completed the first questionnaire, with subsets completing a second questionnaire and validated fitness assessment. Nine items captured participants' self-rated HRF relative to those of the same age and gender. The nine self-reported HRF items were aggregated to obtain an estimate of overall HRF (Multidimensional Health-Related Fitness Scale, MHFS). We used intraclass correlations (ICC) to estimate test-retest reliability of the individual self-reported HRF items and MHFS. We assessed convergent validity with self-reported leisure physical activity (LPA) and concurrent validity with objective fitness measures using age- and sex-adjusted partial correlations. The single-item self-reported HRF measures (ICC=0.60-0.85) and MHFS (ICC=0.87) had acceptable test-retest reliability. The MHFS also had high internal consistency (Cronbach's α=0.87). Evidence of validity was observed with partial correlations ≥0.30 between self-reported HRF and LPA, and objective fitness measures. The MHFS provides a reliable and valid HRF indicator among younger adult populations. Show less

Digital technology is frequently regarded as a tool to alleviate loneliness and enhance mental health among older adults, yet its effectiveness remains contested. This study explores whether digital exclusion moderates the association between loneliness and depressive, and examines symptom structure and depressive subtypes. Drawing on data form the 2018 and 2020 waves of the CHARLS (N = 13,719), we employed fixed-effect and mixed-effect models to assess the effect of loneliness on depressive and the moderating role of digital exclusion. Latent profile analysis (LPA) was used to identify symptoms subtypes, while symptom network analysis assessed centrality and network stability. Loneliness significantly predicted depressive symptoms across multiple models, demonstrating robust effects. Digital exclusion was positively associated with depressive symptoms but did not exhibit a statistically significant moderating effect on the loneliness-depression relationship (p > 0.05, Δβ ≈ 0.011). LPA identified six psychologically meaningful subtypes of depression. Symptom network analysis revealed that emotional and motivational symptoms occupied central positions within the network structure, whereas loneliness, despite its strong connections, exhibited relatively low centrality. The overall network structure remained stable over two years, with the digital access group exhibiting stronger network connectivity. This study emphasizes that digital access alone is not a universal remedy for alleviating loneliness. The psychological benefits of digital technology depend on the alignment between individual motivations, usage patterns, and broader social contexts. Future research should focus on digital usage quality and contextual adaptability of interventions, promoting a shift from customization in digital mental health intervention strategies. Show less

This study aims to identify distinct subgroups of digital resilience among nursing students and examine the factors associated with these subgroups. Digital resilience, the ability to adapt to technological changes and overcome challenges in higher education, is crucial for protecting students' psychological health and improving academic performance. In the context of Artificial Intelligence (AI) and digital transformation in nursing education, this resilience is essential for students to navigate virtual learning and integrate advanced technologies into their practice. A cross-sectional study. This study was conducted in eight universities in China guided by ecological systems theory and nursing students were recruited through convenience sampling. Latent profile analysis (LPA) identified subgroups and logistic regression examined related factors. A total of 331 (81.73 %) participants were included in the final analysis. The average age of participants was 20.41SD0.67 years, with 283 female (85.55 %). Latent profile analysis revealed two subgroups: the "High Digital Resilience Group" (n = 278, 83.99 %) and the "Low Digital Resilience Group" (n = 53, 16.01 %). Participants who were male (OR = 3.47, p = 0.02), had low household income (OR = 0.23, p = 0.01, low professional identity (OR = 0.86, p < 0.001) and low friend support (OR = 0.82, p < 0.001) were more likely to belong to the low digital resilience group. Educators should focus on enhancing students' professional identity and providing social support, especially for those with low digital resilience. The findings provide practical guidance for integrating AI into nursing education to enhance digital resilience. Show less

Tumor-related metabolites in the tumor microenvironment may induce immune dysfunction, leading to malignant progression and metastasis of tumors. Here, it is demonstrated that tumoral PLA2G16, a phospholipase catalyzes phospholipids to generate free fatty acid (FFA) or lysophosphatidic acid (LPA), is an important contributor to triple-negative breast cancer (TNBC) lung metastasis in an immune-dependent pattern by improving tetracosatetraenoic acid (C24:4 (n-6)) accumulation in the early metastatic niche of lung and impairing immune function of pulmonary CD8 Show less

Anxiety is a major symptom associated with alcohol withdrawal and a major factor increasing the risk of relapse. Although fluoxetine, a selective serotonin reuptake inhibitor, is used to alleviate these symptoms, its effects on brain lipid signaling pathways involved in withdrawal-related anxiety remain unclear. This study evaluated, in a preclinical model, the behavioral and molecular effects of chronic alcohol exposure and fluoxetine treatment during early abstinence. Male Wistar rats received oral alcohol (3 g/kg) or saline for 14 days, followed by 7 days without alcohol, during which fluoxetine (10 mg/kg) was administered to designated groups. Anxiety-like behavior was assessed using the elevated plus maze. Circulating plasma levels of corticosterone, 2-arachidonoylglycerol (2-AG), lysophosphatidic acid (LPA), and interleukin-10 (IL-10) were quantified, and gene expression analyses were performed in the amygdala and medial prefrontal cortex (mPFC). Chronic alcohol administration increased anxiety-like behavior and plasma 2-AG, while reducing LPA and IL-10 levels. Fluoxetine induced an anxiolytic effect in controls but was ineffective in alcohol-exposed rats, only normalizing the alcohol-induced increase of plasma 2-AG. At the molecular level, fluoxetine modulated gene expression region-specifically, altering 2-AG-related genes in the amygdala and enhancing LPA signaling in the mPFC. Hierarchical clustering revealed coordinated downregulation of 2-AG pathway genes in the alcohol-fluoxetine group and partial restoration of anti-inflammatory markers. These findings indicate fluoxetine modulates lipid signaling and immune-related genes during alcohol withdrawal, but its anxiolytic efficacy may be limited after alcohol exposure. These findings may contribute to the development of targeted therapeutic strategies for alcohol-related anxiety and relapse prevention. Show less

Complex PTSD (CPTSD) is often associated with prolonged or repeated trauma exposure and the experience of intimate partner and childhood abuse. CPTSD includes the criteria for PTSD (re-experiencing, avoidance, and sense of threat) in addition to three criteria for self-organization disturbances (affective dysregulation, negative self-concept, and relational disturbance). This study aimed to assess profiles of CPTSD symptoms and their association with psychiatric distress among people with co-occurring Serious Mental Illness (SMI; schizophrenia/schizoaffective, bipolar, and treatment-refractory major depression). Treatment-seeking participants ( A model with three classes best fit the data with the most parsimonious interpretation: 26.7% ( The results demonstrate the heterogeneity in symptom presentation across the PTSD classes and that, despite similar diagnoses, individuals may present with varying symptom patterns. This emphasizes the importance of studying CPTSD in subpopulations of persons with SMI. Show less

Anger is prevalent in chronic pain (CP), often co-occurring with heightened distress and disability. The complexity of the anger construct manifests in heterogeneity of how anger is experienced, expressed, and regulated. Nevertheless, most work does not consider the inter-relationships between multiple dimensions of anger, limiting understanding of how anger might differentially contribute to pain outcomes. Here, various anger metrics and latent profile analysis (LPA) were utilized to identify disparate anger profiles in people with CP. Whether these profiles associated cross-sectionally and longitudinally with pain outcomes was subsequently examined. Data was collected from 735 treatment-seeking adult patients with CP of varied etiologies, of which 242 also completed follow-up assessments about 5 months after baseline. Anger measures included state and trait anger, anger expression (anger-in, anger-out), anger control (control-in, control-out), and perceived injustice. Pain outcomes included pain- intensity, distribution, interference, and behavior, and physical function. LPA identified four distinct anger profiles characterized by the combination of varying levels (low, medium, high) of anger and of perceived injustice. These profiles significantly associated with pain outcomes at both baseline and follow-up, above and beyond anxiety and depression. Profiles with medium-to-high levels of both anger (state, trait, and expression) and perceived injustice predicted the worst pain outcomes, suggesting that injustice-based profiling should be prioritized for anger-related stratification of risk in CP. The mechanistic and prognostic value of these anger profiles suggests that early assessment could enhance long-term treatment planning and advance personalized pain care, further emphasizing the need for tailored, anger-focused, patient-specific interventions. PERSPECTIVES: This study demonstrates that multidimensional anger profiles, particularly those marked by higher perceived injustice, are linked to more severe and persistent high impact chronic pain. Identifying these profiles may facilitate early clinical screening for at-risk patients, personalized emotion-focused interventions, and potentially prevent progression to high-impact chronic pain and long-term disability. Show less

Hypoxia plays a crucial role in driving tumor progression by altering cellular signaling pathways. Lysophosphatidic acid (LPA) receptor signaling regulates malignant properties in cancer cells, including motility and chemoresistance. This study aimed to compare the cellular functions of gastric cancer AGS cells under cobalt chloride (CoCl Show less

In this work, we conducted a study on the analysis of monosodium glutamate (MSG) in broths by the induced fluorescence derivatization (IFD) method. The method was based on the derivatization of naturally non-fluorescent MSG to form a fluorescent structure when reacting with orthophthalaldehyde (OPA). The chemical reaction parameters were optimized in an aqueous medium. The calibration curve was subsequently established under optimal conditions, and its linearity was assessed using variance analysis, which indicated a significant regression. The low LOD (0.006 ng mL Show less

To date, despite the new lipid-lowering drugs, some subjects do not reach LDL-cholesterol and/or lipoprotein(a) [Lp(a)] goals and lipoprotein apheresis (LA) plays a role in atherosclerosis prevention. The aim of this study is to paint a portrait of the current LA activity in Italy, collecting data via an electronic survey. Forty-seven centers were contacted, data from 142 patients (male 67%) were obtained from 15 sites. Two sites had discontinued LA treatment. In the active sites, a median of 17 [14-26] LA treatment/patient per year was performed; 7/13 sites used more than one LA system, with venous vascular access used in 87% of cases. High Lp(a) plasma concentrations (> 60 mg/dL or ≥ 145 nmol/L) were recorded in 73/142 patients; 14/36 homozygous familial hypercholesterolemia patients were on lomitapide or evinacumab therapy. The PORTRAIT survey would like to promote a network to better manage the patients on chronic LA. Show less

Enhancing students' subjective well-being (SWB) is an inevitable requirement for achieving comprehensive human development. This study utilized data from 11,990 students in Beijing, Shanghai, Jiangsu, and Zhejiang from the PISA 2018 survey to identify distinct SWB profiles and examine the mechanisms linking parental emotional support to these profiles. Using latent profile analysis (LPA), we identified three distinct SWB profiles: 'Low Affect-Low Cognition' (30.6 %), 'Moderate Affect-High Cognition' (45.9 %), and 'High Affect-High Cognition' (23.5 %). Path analyses, controlling for gender, age, and socioeconomic status, revealed that: (1) Parental emotional support exerted significant direct effects on membership in all three profiles. (2) Parental support influenced the 'Low Affect-Low Cognition' through the mediating role of psychological resilience alone and the serial mediation of growth mindset and psychological resilience. Parental support influenced the 'Moderate Affect-High Cognition' through the mediating role of growth mindset alone and the serial mediation of growth mindset and psychological resilience. (3) For the 'High Affect-High Cognition' profile, parental support operated through three pathways: the specific indirect effects of growth mindset and psychological resilience independently, plus their serial mediation. The findings suggest that interventions for students with low SWB should prioritize building psychological resilience, while for other groups, fostering both a growth mindset and resilience is beneficial. The research results are primarily applicable to adolescents in China's high-development level regions and caution should be exercised in generalizing them to other contexts. Show less