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This study analyzes the global patterns and trends of breast cancer attributable to low physical activity (LPA) among women of reproductive age (1990-2021) using Global Burden of Disease (GBD) data, providing quantitative evidence for prioritizing physical-activity interventions to reduce LPA-attributable breast-cancer burden, specifically among women of reproductive age. This study used data from the GBD Study 2021. We analyzed the changes in the burden of LPA-related breast cancer in women of reproductive age at the global, regional, and national levels from 1990 to 2021. The Bayesian age-period-cohort (BAPC) model was used to predict future trends. Decomposition analysis using Das Gupta's framework explored the factors driving changes in LPA-attributable breast-cancer burden among reproductive-age women. From 1990 to 2021, in high sociodemographic index (SDI) regions, deaths and disability-adjusted life years (DALYs) of breast cancer in women of reproductive age attributable to LPA showed a decreasing trend, with corresponding estimated annual percentage change (EAPC) values of -1.20 (95% CI: -1.29, -1.10) and -1.05 (95% CI: -1.14, -0.96), respectively. Globally, deaths increased by 68% and DALYs by 69% between 1990 and 2021, while low-SDI countries showed the steepest relative rise in age-standardized mortality (EAPC=1.04, 95 % CI: 0.83-1.25) and DALY rates (EAPC=1.08, 95 % CI: 0.87-1.29). Decomposition analysis indicated that population growth was the main driver of the increasing global breast cancer burden. The BAPC model predicted that from 2022 to 2035, the global burden of breast cancer in women of reproductive age attributable to LPA would continue to rise, with age-standardized mortality rates (ASMRs) projected to increase by 7.1 % (to 0.15 per 100,000) and age-standardized DALY rates (ASDRs) by 4.2 % (to 7.3 per 100,000 ) by 2035. Globally, the burden of breast cancer in women of reproductive age attributable to LPA has shown an increasing trend, with significant regional disparities. Our findings underscore the importance of physical activity in controlling the burden of breast cancer among reproductive-age women. Show less

To develop and evaluate a predictive model for myocardial injury in patients with advanced gastric cancer treated with fluorouracil plus platinum-based chemotherapy, incorporating baseline characteristics and inflammatory, nutritional, and atherosclerotic factors. A total of 268 patients with advanced gastric cancer who received this treatment between April 2020 and September 2024 were selected and divided into a training set ( In the training set, 56 patients (29.79%) developed myocardial injury, while 23 patients (28.75%) in the validation set developed myocardial injury, with no statistically significant difference in the incidence or clinical characteristics between the two sets ( This predictive model aids in the early identification of myocardial injury, guiding clinical decision-making and improving prognosis. Show less

Psychological problems are a common concern among children and adolescents. Identifying distinct profiles of internalizing and externalizing problems offers a comprehensive understanding of the psychological challenges faced by this population. This study aimed to explore mental health profiles in a sample of 5652 Spanish children and adolescents aged 8-16 years, examining differences between these profiles and reference groups. Using the Child and Adolescent Assessment System (SENA) and latent profile analysis (LPA), six profiles were identified among children and seven among adolescents, based on internalizing, externalizing and contextual problems. Among children, the most frequent profiles were 'moderate problems, low conflict' and 'low problems', while adolescents most commonly exhibited 'moderate internalizing, low externalizing' and 'low problems' profiles. Significant differences across profiles were linked to emotional regulation, self-esteem and social competence. These findings provide a nuanced perspective on the mental health landscape of Spanish youth, emphasizing the critical role of early detection of emotional difficulties in educational settings. Furthermore, the study offers valuable insights for developing tailored interventions to meet the specific emotional needs of children and adolescents. Show less

Lipoprotein(a) [Lp(a)] is associated with atherosclerotic cardiovascular disease. An Lp(a) threshold of ≥125 nmol/L is commonly used to identify individuals at higher risk for events, but there is a paucity of data on individuals of Hispanic/Latino descent. The purpose of this study was to provide a comprehensive evaluation of Lp(a) and its association with 10-year cardiovascular disease risk and mortality among Hispanic/Latino adults in the United States. We evaluated the association between Lp(a) and myocardial infarction (MI), ischemic stroke, and all-cause mortality among 16,117 Hispanic Community Health Study/Study of Latinos individuals. Event rates were compared across Lp(a) quintiles. Multivariable Cox proportional hazards models assessed the relationship between events and Lp(a) across increasing quintiles, log-transformed Lp(a), and ≥125 nmol/L vs <125 nmol/L. Sampling weights and survey methods were used to account for the stratified probability sampling of the cohort. Among the Hispanic Community Health Study/Study of Latinos target population (median age 41.1 years, 52.4% women), the median Lp(a) was 19.7 nmol/L (Q1-Q3: 7.3-60.6 nmol/L), with 11.4% having Lp(a) ≥125 nmol/L, and the highest Lp(a) quintile defined as >77 nmol/L. Over a median follow-up of 9.8 years, 883 events (135 MI, 99 stroke, 649 all-cause mortality) occurred. The age-adjusted incidence rate of the composite events (MI, stroke, and all-cause mortality) was 505.2 per 100,000 person-years. After multivariable adjustment, each 1-SD increase in log-transformed Lp(a) was associated with a higher risk of MI (HR: 1.47; 95% CI: 1.14-1.89). Compared with Lp(a) <125 nmol/L, elevated Lp(a) ≥125 nmol/L conferred an increased risk of MI (HR: 2.29; 95% CI: 1.45-3.63), all-cause mortality (HR: 1.43; 95% CI: 1.05-1.93), and composite events (HR: 1.56; 95% CI: 1.22-2.01), but not stroke. Findings were consistent when comparing the highest Lp(a) quintile to the lower 4 quintiles, but the elevated risk was observed only for MI and composite events. Hispanic/Latino individuals with elevated Lp(a) are at an increased risk of MI and all-cause mortality. Although Lp(a) ≥125 nmol/L is a valid risk threshold, Hispanics/Latinos show a continuous relationship between increasing Lp(a) levels and MI risk. Show less

This study aimed to analyze latent profiles and characteristics of nurses' knowledge, attitudes, and practices (KAP) regarding pressure injury (PI) prevention, as well as influencing factors across distinct profiles. A convenience sampling method was employed to recruit nurses from hospitals at various tiers in Guangxi Zhuang Autonomous Region between July and August 2024. Data were collected using a General Information Questionnaire and a Nurse PI-KAP Questionnaire. Latent profile analysis (LPA) identified distinct PI-KAP profiles, while univariate analysis and multinomial logistic regression determined profile-specific influencing factors. Among 17,253 enrolled nurses, the total PI-KAP score was 63.44 ± 7.69. Three latent profiles emerged: low-level PI-KAP (12.82%), moderate-level PI-KAP (52.23%), and high-level PI-KAP (34.95%). Multinomial logistic regression revealed that hospital tier, years of experience, education level, professional title, gender, and attitudes toward PI training significantly influenced PI-KAP profiles (p < .05). Heterogeneity exists in nurses' PI-KAP profiles, with a substantial proportion demonstrating suboptimal competency. Nursing administrators should establish hierarchical training systems tailored to PI-KAP characteristics. Capacity-building strategies include prioritizing training for core nurses, optimizing resource allocation, and establishing tiered hospital assistance mechanisms to enhance team-based PI prevention capabilities. Not applicable. Show less

This study aimed to identify profiles of autistic youths' sibling relations and examined if social-ecological variables (i.e., youth characteristics, family and caregiver functioning, peer relations, academic performance) were associated with these profiles. Caregivers (N = 2,142; 88.1% mothers) of autistic youths aged 6-17 years (M = 11.07 years; SD = 3.17; 80.1% male) completed electronic measures assessing social-ecological variables and youths' sibling relations. We used a latent profile analysis (LPA) to define sibling relation profiles based on the qualities (emotional support, companionship, conflict, and criticism) of relations between autistic youths and their closest-in-age siblings. We performed ANOVAs to compare sibling profiles on social-ecological variables. The LPA yielded a 3-profile solution: a positive group (18.2%), a negative group (17.2%), and a low engagement group (64.5%). ANOVAs and χ Most sibling relations among autistic youth fit a low engagement profile based on caregiver report. Positive sibling relations were linked with positive functioning in other social-ecological domains. The nature of these linkages warrants further investigation, particularly using longitudinal, multi-informant, and mixed-method designs. Show less

Various adverse mental health outcomes (e.g., burnout) have been reported and shown to impact the longevity of veterinarians' careers, especially during the early career. Both compassion fatigue (CF) and compassion satisfaction (CS) are significant predictors of burnout. Increasing attention is being paid to positive psychology, including psychological wellbeing (PWB) and resilience, as they have the potential to enhance wellbeing in the profession. The objectives of this research were to measure various psychological outcomes of newly graduated veterinarians in Canada and identify underlying profiles based on empirical data. An online questionnaire with validated psychometric scales was distributed to graduates of all five Canadian veterinary schools in 2022 and 2023. Latent profile analysis (LPA) (n = 189) revealed two profiles, interpreted as follows: thriving (n = 116; high PWB, CS and resilience, and low burnout and CF) and surviving (n = 73; low PWB, CS and resilience, and high burnout and CF). The sample size was smaller than typically recommended for LPA. Our findings revealed that 61% (116/191) of newly graduated veterinarians were considered to have good mental wellbeing or were 'thriving'. Our study amplifies the need for more research on positive wellbeing outcomes and interventions to strengthen veterinary students' and veterinarians' wellbeing. Show less

Familial hypercholesterolemia (FH) is characterized by lifelong elevated LDL-C levels and increased cardiovascular risk. PCSK9 inhibitors (PCSK9i) reduce LDL-C and Lp(a), however, the effect of dual lipid reduction on mechanical vascular function remains unclear. The aim of this study was to evaluate the efficacy of PCSK9i in reducing LDL-C and Lp(a) and to assess the relationship between the dual lipid reduction and the mechanical vascular profile improvement in FH subjects. This prospective observational study included 301 genetically confirmed FH subjects treated with PCSK9i added to high-intensity statins and ezetimibe. Biochemical and PWV measurements were performed at baseline and after six months. Subjects were stratified into four groups based on median values of ΔLDL-C and ΔLp(a). After six months of add-on PCSK9i, 44.9% of FH subjects achieved their LDL-C targets. Reductions were observed in LDL-C (− 49.8%, Dual lipid reduction with PCSK9i was associated with a pronounced mechanical vascular profile improvement in FH subjects; however, an intensive Lp(a) reduction may be needed to achieve a greater mechanical vascular benefit. Show less

Limited evidence exists on the role of lipoprotein(a) [Lp(a)] in the progression of atherosclerotic coronary plaques as assessed by intravascular imaging modality, particularly under low-density lipoprotein cholesterol (LDL-C) lowering therapy. In this study, we aimed to evaluate the clinical significance of Lp(a) as a residual risk factor for coronary plaque progression, using serial intravascular ultrasound (IVUS) in statin-treated patients with coronary artery disease (CAD). This observational cohort study included statin-treated patients from two clinical prospective trials (the ENTERPRISE trial and Extended-ESTABLISH trial) in which coronary plaques were assessed using serial grayscale IVUS at baseline and at 6-12 months follow-up. The primary endpoints were defined as absolute changes in normalized total atheroma volume (TAV Show less

Genetically modified soybean is largely used in animal feed and its massive cultivation affects the environmental sustainability of livestock and the dependency for the import in the European market. The aim of this study was to evaluate the partial substitution of soybean meal with an innovative common bean genotype (Phaseolus vulgaris lec-lpa) with reduced content of anti-nutritional factors on zootechnical performance, gut microbiota modulation and faecal minerals in post-weaning piglets. Fourteen piglets were divided into a control group fed with a basal diet and a treatment group fed with a commercial diet in which 7.3% of soybean meal and 0.8% of soybean oil were replaced with 10% of P. vulgaris lec- lpa for 28 days. BW, ADG, ADFI and FCR were evaluated, and diarrhoea incidence was recorded. Evaluation of pH, nitrogen content, protein digestibility and mineral content was performed on faecal samples. Microbiota was analysed by rectal swabs samples. Blood serum metabolic profile was evaluated. The treatment group showed lower BW and ADG during the trial (p < 0.05), but the health status of the animals was preserved. The treatment group released lower levels of minerals in faeces when compared with the control group after 28 days (p < 0.05) suggesting a lower dispersion of faecal minerals in the environment. Significant Beta diversity index was observed at 14 and 28 days (p < 0.05). Roseburia and Butyricicoccus increased in treatment group at day 28 (p < 0.05). These genera are associated with SCFA production, contributing to the maintenance of intestinal integrity, promoting positive bacterial populations and limiting inflammatory phenomena. In conclusion, P. vulgaris lec- lpa could be a viable and sustainable alternative protein source to reduce the European protein gap, playing a potential role in microbiota modulation and faecal minerals release. Show less

Lipoprotein(a) (Lp[a]) was discovered more than six decades ago. Since then, it has evolved from a subject of curious experiments performed by a few scientists to an extensively explored therapeutic target for prevention and management of cardiovascular disease (CVD). This has prompted an intense search for therapies and agents with potent Lp(a)-specific lowering effects on the horizon. Some of these agents are already in clinical trials to clarify whether lowering high Lp(a) levels would result in reductions in CVD events. The road to this point has been filled with many challenges, where landmark genetic discoveries opened new avenues and set the stage for interventions. Although there is no doubt that genetics play a key role in determining Lp(a) level, accumulating evidence also supports a role for some clinical conditions in influencing Lp(a) levels. CKD is a prevalent condition associated with elevated Lp(a) levels. Most available data show that elevated Lp(a) levels predict CVD risk in patients with CKD. Given the growing evidence for a relationship between Lp(a), CVD, and CKD as well as ongoing cardiovascular outcomes trials of Lp(a)-specific agents, we provide an overview of recent evidence on this topic. We focus on recent studies in patients with CKD on treatment modalities affecting Lp(a) level as well as on existing gaps in knowledge and future research directions related to clinical care and CVD risk reduction in patients with CKD. Show less

Lipoprotein (a) (Lp[a]) is an independent risk factor for cardiovascular disease (CVD). Structurally like low-density lipoprotein, Lp(a) is distinguished by the covalent attachment of apolipoprotein(a) to apolipoprotein B-100. Although its physiological role remains incompletely understood, evidence suggests that Lp(a) may facilitate wound healing and inhibit cancer growth and metastasis. In contrast, Lp(a) exhibits proatherogenic properties; it transports proinflammatory oxidized phospholipids, induces the secretion of proinflammatory cytokines, increases endothelial permeability, promotes smooth muscle cell migration and proliferation, and upregulates adhesion molecules that facilitate monocyte recruitment and retention. In addition, Lp(a) exerts prothrombotic activity by enhancing platelet aggregation, suppressing plasminogen activation, and inhibiting fibrinolysis. Although its clinical relevance in CVD is well established, the role of Lp(a) in peripheral arterial disease (PAD) remains unclear. This narrative review aimed to synthesize and critically examine the current evidence on the biological role of Lp(a) in PAD pathogenesis and identify knowledge gaps in PAD-specific outcomes. This review summarizes the epidemiology, pathophysiology, and management of elevated Lp(a) levels in patients with PAD and examines their association with post-treatment clinical outcomes. Elevated Lp(a) levels are associated with an increased PAD incidence and a higher risk of restenosis post-revascularization. Understanding the mechanisms by which Lp(a) contributes to PAD pathogenesis is essential for developing effective targeted therapeutic approaches and improving the identification and management of high-risk patients. Show less

In solid tumors, cancer cells adapt to hypoxic and nutrient deprived environments to support malignant progression. This study examined whether hypoxic and low glucose conditions enhance malignant behaviors more strongly in highly migratory MG63-R10 cells, which are derived from osteosarcoma MG-63 cells, compared to parental MG-63 cells, and further investigated whether lysophosphatidic acid (LPA) receptor signaling regulates this adaptation. MG63-R10 and MG-63 cells were cultured under hypoxic (1% O Under 1% O These results suggest that, compared to parental MG-63 cells, highly migratory osteosarcoma MG63-R10 cells adapt their malignant cellular functions to hypoxic and low-glucose conditions through LPA receptor signaling, highlighting this pathway as a potential therapeutic target in aggressive osteosarcomas. The online version contains supplementary material available at 10.1007/s12195-025-00873-y. Show less

There is increasing interest in the importance of patterns of accumulation and overall daily time-use composition of physical activity (PA) and sedentary time (SED) for children's cardiometabolic health. This study examined cross-sectional associations between the time-use composition of PA and SED patterns with cardiometabolic risk factors in 4-year-olds. Data were drawn from the Barwon Infant Study 4-year review (n = 467). Accelerometer data were classified into short (≤ 1-minute) and long (> 1-min) SED, light-, moderate-, and vigorous-intensity PA (LPA, MPA, VPA) bouts. A waking time-use composition of eight distinct components (total volumes plus short and long bouts of SED, LPA MPA, VPA) was constructed using compositional data analysis. Linear mixed models examined associations between composition patterns and body mass index (BMI), percent body fat, triceps and subscapular skinfold thickness, blood pressure, heart rate, carotid-femoral pulse wave velocity, and aortic and carotid intima-media thickness. Adjusted models indicated a higher ratio of long versus short LPA bouts was associated with higher z-BMI (β = 1.69, SE = 0.83, p = 0.04), percent body fat (β = 10.72, SE = 3.71, p = 0.004), and z-triceps (β = 1.90, SE = 0.93, p = 0.04). A higher ratio of long versus short MPA bouts was associated with lower z-BMI (β = - 0.99, SE = 0.46, p = 0.03) and percent body fat (β = - 4.63, SE = 1.93, p = 0.02). A higher total volume of MPA versus VPA was associated with higher percent body fat (β = 4.07, SE = 1.63, p = 0.01) and z-triceps (β = 1.05, SE = 0.43, p = 0.01). Other outcomes showed no associations (p ≥   0.05). In preschoolers, accumulating LPA in shorter bursts, MPA in longer bursts, and maintaining a higher proportion of VPA may support healthier adiposity profiles. These findings underscore the importance of minimizing prolonged sedentary time and encouraging sustained, high-intensity PA from early childhood. Show less

Amyloid deposition of human islet amyloid polypeptide (hIAPP) is closely linked to the pathogenesis and progression of type 2 diabetes mellitus (T2DM). Developing effective inhibitors to suppress hIAPP aggregation holds significant therapeutic potential for the prevention and treatment of T2DM. Recent researches indicate that both heme and lithospermic acid (LPA) can inhibit hIAPP aggregation. However, heme is prone to induce protein damage under oxidative stress, while LPA exhibits limited inhibitory efficacy despite its antioxidant properties. To overcome these limitations, we aimed to develop a dual-component inhibitor comprising heme and LPA. thioflavin T (ThT) fluorescence, transmission electron microscopy (TEM), circular dichroism (CD) and gel electrophoresis were combined to observe the inhibitory efficacy of heme-LPA co-formulation on hIAPP aggregation. The results demonstrate that LPA and heme can synergistically inhibit hIAPP aggregation. The inhibitory effect of heme-LPA co-formulation on hIAPP aggregation is significantly stronger than that of either component alone. The heme-LPA not only prevents the complete conversion of hIAPP into β-sheet fibrillar structures but also maintains its active monomeric conformation for extended periods. Furthermore, peroxidase activity assays revealed that the presence of LPA significantly reduces the peroxidase activity of heme in a concentration-dependent manner and attenuates peptide nitration damage under H₂O₂-NO₂ Show less

Refugees and asylum seekers encounter numerous post-migration living difficulties (PMLDs) that can substantially affect their mental health. However, the role of PMLDs remains insufficiently explored, particularly in clinical refugee populations. This study aimed to identify subgroups based on patterns of PMLD by examining their relationship with depressive symptoms and determining which stressors function as key bridges. This study reports a secondary analysis of baseline data from the ReTreat trial. Data were collected from 141 refugees and asylum seekers enrolled in a multicentre randomized controlled trial of a culturally adapted CBT program in Germany. Participants completed measures of depressive symptoms (PHQ-9) and post-migration stressors (27-item checklist). Latent Profile Analysis (LPA) was used to identify distinct burden profiles. Exploratory Factor Analysis (EFA) examined the dimensionality of PMLDs. Network analysis was conducted to investigate symptom-stressor connectivity. Three latent profiles emerged: Class 1 showed elevated distress across all domains; Class 2 was characterized by family separation and homesickness; and Class 3 exhibited minimal post-migration stress. EFA of PMLDS supported a four-factor solution: institutional/legal stressors, structural hardship, health/service access, and emotional/family-related strain. Depressive symptoms differed significantly across profiles, with highest scores in the high burden group (Class 1). Network analysis identified institutional/legal and emotional/family-related stressors as central bridge nodes linking PMLDs to depressive symptoms. PMLDs are multidimensional and heterogeneously distributed among forcibly displaced individuals. Legal insecurity and emotional strain are particularly influential in connecting environmental hardship to depressive symptoms. This study uses baseline data from a registered randomized controlled trial (DRKS00021536). Show less

With less than two years remaining from 2027-the year which the government has targeted to achieve zero Indigenous cases, we map the malaria indicators across the 700 + districts for five years between 2019 and 2023 using spatiotemporal maps and also assess the potential drivers of malaria transmission in different regions. We used the annual district-wise malaria data from the National Center for Vector Borne Disease Control Programme (NCVBDC) and the cross-sectional socio-economic data from the National Family Health Survey. We also collated the meteorological and land-use land-cover data from the MERRA-2 and Sentinel-LPA satellites, respectively. We then developed region-specific ensembles of spatiotemporal models that allowed us to identify the associated covariates while the regions were identified using the Getis-Ord Gi* statistics. With 0.33 million malaria cases in 2019, the COVID-19 pandemic led to a significant reduction in reported cases. The P. falciparum affected regions are widespread in North-eastern and Central India. However, after the pandemic, an emerging geographical expansion into the north-eastern parts is observed for the P. vivax, which is evident from the clusters and the spatiotemporal ensemble models. Population belonging to scheduled castes and scheduled tribes and those economically marginalised are among the most vulnerable, but lifestyle habits such as drinking water practices, maternal education, and healthcare accessibility are associated with malaria transmission. We also developed a digital dashboard that allows the general public and the stakeholders to track the malaria indicators for each district and the corresponding year. Show less

This study employed a person-centered Latent Profile Analysis (LPA) to explore adolescents' perceived teacher-student and friendship relationships in the school environment and to examine their association with interest in physical education. A survey was conducted among 3,613 adolescents using the Teacher-Student Relationship Scale, the Friendship Quality Scale, and the Interest in Physical Education Scale. LPA was applied to identify relationship quality profiles, and multinomial logistic regression was used to examine gender differences and associations with interest in physical education. Three profiles emerged from the LPA: the Low Relationship Quality profile (23%, Adolescents exhibit heterogeneous experiences of teacher-student and friendship relationship quality, which were significantly associated with differences in interest in physical education. By applying a person-centered approach, the study extends prior research by showing that teacher-student and friendship contexts are linked to adolescents' interest in physical education, underscoring the importance of considering interest as a distinct outcome in relational research. Show less

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Lipoprotein (a) [Lp(a)] has emerged as an independent risk factor for CAD, but its role in predicting coronary severity in Vietnamese populations remains unclear. To evaluate the value of Lp(a) in predicting the severity of coronary artery stenosis in chronic CAD. This cross-sectional study was conducted at Tam Anh General Hospital from June 2024 to June 2025, including 138 patients diagnosed with chronic CAD. Demographic, clinical, laboratory, and coronary angiographic data were collected. CAD severity was assessed using the Gensini score. Logistic regression and ROC analysis were employed to evaluate the predicting value of Lp(a). Severe CAD (Gensini score >40) was present in 31.9% of the cohort. Patients with Lp(a) ≥30 mg/dL exhibited a significantly higher prevalence of severe CAD (72.5% vs. 8.0%). Lp(a) levels correlated strongly with the Gensini score. The optimal cut-off for predicting severe CAD was 30.6 mg/dL (AUC = 0.869). Multivariate analysis confirmed Lp(a) as an independent predictor. Lp(a) ≥30 mg/dL is strongly associated with severe coronary artery stenosis. Lp(a) is a valuable independent predictor of CAD severity and may serve as an essential tool for risk stratification in clinical practice. Show less

This study aimed to investigate the effect of lipoprotein(a) (Lp(a)) on major adverse cardiovascular events (MACEs) among individuals with chronic coronary syndrome (CCS) according to ABO blood groups. Two independent cohorts of patients with CCS were included consecutively. Blood groups and Lp(a) levels were measured. Patients with the AB group were excluded due to the small sample size. In the exploratory cohort ( Show less

Workplace violence (WPV) is a significant occupational hazard that threatens nurses' psychological well-being and professional stability. Although prior studies have addressed the impact of WPV on nurses, the latent heterogeneity of their violence exposure patterns has not been systematically explored. Moreover, empirical evidence regarding the role of individual psychological traits in shaping different WPV experiences remains limited. This study aimed to identify latent profiles of WPV exposure among nurses and examine the associations between profile membership and demographic as well as psychological factors, in order to uncover key predictors of distinct WPV patterns. A cross-sectional survey was conducted between March and May 2025 among 549 registered nurses from eight tertiary hospitals in Sichuan Province, China. Participants completed a battery of standardized instruments, including General Demographic Data Scale, Workplace violence Scale, Maslach Burnout Inventory, Connor-Davidson Resilience Scale, Emotional Labor Scale, and Perceived Organizational Support Scale. Latent Profile Analysis (LPA) was performed using Mplus 8.3 to identify WPV exposure subgroups, and multivariate logistic regression was used to determine associated factors. LPA revealed two distinct WPV profiles: a high-frequency, multi-type violence group (n = 152, 27.7%) and a low-frequency, mild violence group (n = 397, 72.3%). Nurses in the high-frequency group reported significantly higher scores across all WPV dimensions, including verbal abuse, sexual harassment, threats, and physical assault ( Nurses' WPV experiences exhibit distinct latent profiles. Educational level, salary satisfaction, and psychological resilience are key differentiating variables. These findings highlight the need for stratified risk identification and targeted interventions, particularly for nurses with higher education levels, low salary satisfaction, and reduced psychological resilience, in order to mitigate the adverse effects of WPV and enhance occupational adaptation. Show less

The optimal plasma lipoprotein(a) [Lp(a)] cutoff level for predicting atherosclerotic cardiovascular disease (ASCVD) in Southeast Asian populations remains limited. Therefore, our study aimed to identify the optimal plasma Lp(a) cutoff for predicting ASCVD in Thai patients. We conducted a retrospective analysis of patients who underwent Lp(a) measurement at Siriraj Hospital between January 2019 and August 2024. Inclusion criteria included Thai ethnicity and age ≥15 years. Baseline characteristics, comorbidities, laboratory data, and Lp(a) levels were extracted from medical records. Lp(a) levels were compared between ASCVD and non-ASCVD groups. Odds ratios (OR) for ASCVD and coronary artery disease (CAD) were calculated using Lp(a)<25 nmol/L as the reference. A total of 2341 patients (age 54.4±17.7 years, 42.0% male) were included. Among them, 413 (17.6%) had ASCVD, 254 (10.9%) had CAD, 186 (7.9%) had ischemic stroke, 21 (0.9%) had peripheral arterial disease (PAD), and 14 (0.6%) had abdominal aortic aneurysm. Median Lp(a) levels (nmol/L) were significantly higher in patients with ASCVD [37.2 vs 24.4, p<0.001], CAD [43.8 vs 24.5, p<0.001], and AS [51.6 vs 25.3, p=0.002] compared to those without diseases. After adjusting for other risk factors, Lp(a)≥40 nmol/L was associated with increased risks of ASCVD [OR 1.538 (1.203-1.958)] and CAD [OR 1.877 (1.407-2.505)]. A multivariate model incorporating Lp(a)≥40 nmol/L with other risk factors demonstrated 70-80% sensitivity and specificity for predicting ASCVD and CAD. Elevated plasma Lp(a) levels are significantly associated with ASCVD and CAD. An Lp(a) cutoff of≥40 nmol/L predicted ASCVD and CAD risk in Thai. Show less

The phase angle (PhA), assessed using bioelectrical impedance analysis (BIA), is becoming increasingly popular as an index of muscle quality associated with various health-related outcomes. This study aimed to clarify the relationship between PhA and sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), which were objectively measured using accelerometers in older adults with disabilities requiring care. We recruited 90 older adults (39 men and 51 women, mean age of 78.7 ± 6.7 years) with disabilities under the long-term care insurance system. Skeletal muscle mass index (SMI) and PhA of the lower limbs were measured using a multifrequency BIA instrument. Daily durations of SB, LPA, and MVPA per day were measured using a triaxial accelerometer. Nutritional status was assessed using the long form of the Mini Nutritional Assessment (MNA). The MVPA duration was significantly associated with lower limb PhA after adjusting for age, sex, SB and LPA durations, MNA score, and medical history (p = 0.037), whereas SB and LPA durations were not associated with lower limb PhA. The duration of SB, LPA, and MVPA were not significantly associated with lower limb SMI, whereas the MNA score was. Lower limb PhA, but not lower limb SMI, was associated with MVPA duration, independent of nutritional status and medical history. Enhancing the duration of MVPA is needed to maintain the PhA and prevent further decline in physical function in older adults who require long-term care due to disabilities. Show less

Undergraduate nursing students face significant academic and practical challenges, with their responses reflecting their academic resilience. However, most studies have overlooked the differences in their levels of academic resilience and the factors contributing to these differences. To identify the latent profiles of undergraduate nursing students' academic resilience and to analyze their influencing factors. A cross-sectional study was carried out among 1795 undergraduate nursing students from November 2022 to October 2023 by employing the general information questionnaire, the academic resilience questionnaire for college students, and the brief 2-way social support scale. Latent profile analysis (LPA) was used to analyze the latent profiles of academic resilience, and multiple logistic regression was utilized to explore the factors associated with the identified profiles. Four potential profiles were identified: low academic resilience group, moderate academic resilience group, high academic resilience but low focus and dissociation group, and high academic resilience group. Residence, attitude towards the nursing profession, self-directed study duration, academic performance rank, received and provided instrumental support were found to be associated with the different profiles. These findings highlight the heterogeneity in academic resilience and support tailored educational interventions based on students' specific academic resilience profiles. Show less

This study aimed to analyse the latent profiles of moral sensitivity of nursing students and to explore the different types of influencing factors. A cross-sectional study. Convenience sampling method was used to select nursing students from five hospitals in Zunyi City, Guizhou Province, from July to September 2024. The demographic characteristics questionnaire and the Chinese version of the Nursing Student Moral Sensitivity Scale (MSQ-ST) were used as survey tools. Latent profile analysis (LPA) was performed on the moral sensitivity of nursing students. Logistic regression was used to analyse the influencing factors of different profiles. A total of 805 nursing students completed the questionnaire, of which 787 were valid, with a validity rate of 97.76%. The results of latent profile analysis showed that the moral sensitivity of nursing students was divided into two latent profiles: "low moral sensitivity group" (18.68%) and "high moral sensitivity group" (81.32%), and the results of logistic regression analysis showed that the level of hospital, the length of internship and the frequency of training on moral education were the factors influencing the moral sensitivity of nursing students (p < 0.05). In this study, we have demonstrated that there are two categories of moral sensitivity in nursing students, and that demographic traits have an impact on moral sensitivity in nursing students. These findings may provide a valuable theoretical foundation for nursing educators in developing the moral awareness of nursing students. No patient or public contribution. Show less

Lipoprotein(a) [Lp(a)] is a genetically determined and independent cardiovascular risk factor. Despite its clinical relevance, data on Lp(a) prevalence and impact in Latin America are limited. We aimed to assess the prevalence of elevated Lp(a) and its association with cardiovascular outcomes in a large, multicenter Argentine registry. The GAELp(a) registry included 3000 adults from six Argentine regions. Lp(a) levels were measured using standardized assays; elevated Lp(a) was defined as >50 mg/dL or >125 nmol/L. Clinical, biochemical, and imaging data were collected retrospectively and prospectively. Associations between Lp(a) and major adverse cardiovascular events (MACE) were evaluated with logistic regression in the overall population and stratified by statin use. Elevated Lp(a) was present in 31.4 % of participants, with no sex difference. It was associated with family history of cardiovascular disease, subclinical atherosclerosis, and familial hypercholesterolemia. Patients with elevated Lp(a) had a higher prevalence of coronary artery disease (18.4 % vs. 12.5 %, p < 0.001), peripheral artery disease (4.8 % vs. 2.5 %, p = 0.001), and MACE (21.3 % vs. 14.8 %, p < 0.001). Elevated Lp(a) independently predicted MACE (OR 1.53, 95 % CI: 1.24-1.90, p < 0.001), with stronger associations in statin-naïve individuals (OR 2.18, 95 % CI: 1.17-4.07). ROC analysis showed modest discrimination (AUC 0.57 in nmol/L, 0.59 in mg/dL). Elevated Lp(a) is frequent in Argentina and strongly linked to cardiovascular disease and events. Its predictive value appears greater in statin-naïve patients, highlighting its role as a marker of residual risk. These findings support routine Lp(a) measurement in cardiovascular risk assessment, particularly in regions with high ASCVD burden. Show less

Children with diabetes mellitus (DM) have an increased risk for cardiovascular disease (CVD), a risk potentially exacerbated by elevated lipoprotein(a) (Lp(a)). While other cholesterol parameters are screened in this population, Lp(a) is often overlooked despite being an independent CVD risk factor. Lp(a) levels are historically believed to not change over an individual's life and are genetically determined, but newer literature suggests variation. This study investigated Lp(a) levels and their relationship with glycated hemoglobin A Children and adolescents aged 5 to 18 years with incident DM had baseline Lp(a) and lipid profiles. Repeat Lp(a) and HbA Seventy-six children were included for evaluation: 76% with type 1% and 23% type 2 DM. Baseline median (Q1-Q3) Lp(a) was 43.3 nmol/L (13-73.7 nmol/L), 17 of which were elevated (≥75 nmol/L). Of the 22 participants with follow-up, 8 were abnormal: A total of 4 whose baseline Lp(a) were abnormal remained so and 4 with normal levels became abnormal. A positive correlation was found between 3-month Lp(a) values and HbA Children with DM have abnormal Lp(a) levels at a prevalence of approximately 20%, so this should be considered in CVD risk stratification. Further, observed Lp(a) fluctuations suggest value in serial Lp(a) assessments due to nongenetic influences. Without Lp(a) quantification, CVD risk characterization in children with DM may be inaccurate and should be considered for a comprehensive assessment. Show less

Given the lack of evidence, we cannot definitively determine the relationship between attachment networks and problematic mobile phone use, hindering effective intervention strategies. Therefore, a three-wave longitudinal study was designed to explore the heterogeneity of parent-child attachment networks using latent profile analysis (LPA) and random intercept latent transition analysis (RI-LTA). Participants included 2116 adolescents (ages 14-21; 53.8% girls). Results identified five stable parent-child attachment network profiles, each showing moderate but decreasing stability. Notably, adolescents who were grouped into an attachment network characterized by secure maternal attachment but insecure paternal attachment, similar to those in attachment networks with both insecure maternal and paternal attachment, scored higher levels of problematic mobile phone use than those who were grouped into attachment networks with both secure maternal and paternal attachment. Our findings fill empirical gaps and provide strong evidence supporting attachment-based interventions to reduce problematic mobile phone use. Show less

ObjectiveTo describe characteristic CLEFT-Q response profiles and patterns in patients with cleft palate and/or lip (CP ± L).DesignRetrospective analysis using latent profile analysis (LPA) to categorize patient-reported outcome responses into distinct profiles.SettingTertiary care pediatric hospital with multidisciplinary cleft team.Patients, ParticipantsPatients aged 8-29 years with CP ± L completing CLEFT-Q questionnaires from September 2021 to June 2025 ( Show less