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Self-determination theory characterizes drinking motives according to level of autonomy and locus of control and aligns with harm reduction approaches to alcohol use. This study used latent profile analysis (LPA) to identify motivational profiles of self-determined behavioral regulations for drinking and to test their associations with sociodemographic variables and alcohol consumption and outcomes. Adults aged 18-57 (N = 630, M A four-profile model fit best. The "Aimless Drinkers" profile (n = 75, 11.9%) had low intrinsic regulation (e.g., enjoyment of drinking) and was disproportionately male (ORs = 2.35-2.65). The "Pleasure Drinker" profile (n = 114, 18.1%) had average intrinsic and low other regulations and was significantly older (OR = 1.07) than the "Externally Controlled Drinker" profile (n = 177, 28.1%), which had high external regulation (e.g., drinking due to social pressure). Externally controlled drinkers reported greater drinking intensity (M Older individuals were more likely to drink due to intrinsic enjoyment, which may reflect a shift toward greater autonomy over alcohol consumption with increasing age. Drinking primarily for enjoyment also facilitated more positive drinking outcomes. Future research should investigate whether motivational profiles of behavioral regulations for drinking predict long-term trajectories of alcohol consumption and alcohol-related risks. Show less

Previous studies suggest that total screen time does not comprehensively predict health behavior. The effects on health behaviors vary by app type. This study examines the association of different app categories (social, entertainment, game, education) related to physical activity (PA) and sedentary behavior (SB) patterns among university students. This study followed 345 university students aged 18–22 for 7 days. Physical activity (PA), and sedentary behavior (SB) were objectively measured using the ActiGraph GT3X-BT accelerometer. Smartphone app usage was tracked via objective daily survey logs. After the 7-day tracking period, semi-structured interviews were conducted to gather detailed information on app usage and physical activity. Data analysis was performed using SPSS 26.0 and R software. In 248 participants (139 males, 109 females), Males had higher daily energy expenditure and more sedentary time (ST) compared to females, who spent more time in light-intensity physical activity (LPA) but less in vigorous-intensity physical activity (VPA). Males showed a positive correlation between entertainment app usage and ST ( Different smartphone app categories show distinct associations with physical activity and sedentary behavior, with social apps linked to more light activity and entertainment/gaming apps to more sedentary patterns, especially in males. Show less

Falls are a significant concern for elderly Maintenance Hemodialysis (MHD) patients, with a rising fall-related mortality rate observed over the past decade. However, the heterogeneity of fall awareness within this population has not been sufficiently explored. Understanding these differences is crucial for developing targeted interventions to address fall risk. This cross-sectional study included 313 elderly MHD patients from a tertiary hospital in China (January-March 2025). Latent Profile Analysis (LPA) was utilized to identify distinct profiles of fall self-awareness based on the Self-Awareness of Falls in Elderly Scale (SAFE), which assesses four dimensions of fall awareness. Multivariate logistic regression analysis was performed to examine factors influencing these profiles, adjusting for demographic and clinical variables. Three latent profiles emerged: the Vulnerable Type (17.6%, low awareness across all dimensions, particularly in cognitive-behavioral aspects), the Balanced Type (48.9%, moderate awareness), and the Active Type (33.6%, high awareness in medication and environmental safety). Younger age, moderate or lower Charlson Comorbidity Index (CCI) scores, and a history of falls were significant predictors for membership in the Vulnerable/Balanced profiles. The findings highlight significant variability in fall awareness among elderly MHD patients, with over 65% demonstrating suboptimal awareness. These descriptive findings emphasize the meaningful variability in fall self-awareness among older MHD patients and may inform class-specific education and screening strategies. Prospective and interventional studies are needed to determine causal effects and evaluate their impact on fall events. Show less

In the last decades, the biological properties of Lp(a) have attracted increasing attention for their possible involvement in a wide range of clinical conditions other than atherosclerotic cardiovascular disease. To date, whether a pathogenic interplay may exist between Lp(a) and cancer remains unclear. Indeed, experimental studies mainly show a protective effect of Lp(a) toward cancer, while results of clinical studies are highly contradictory. Nonetheless, the confirmation of any link between Lp(a) metabolism and cancer may be highly impactful for its translational implications in the current era of a renewed scientific interest in this lipoprotein. Indeed, the increasing availability of laboratory assays for the routine assessment of plasma Lp(a) levels could be proposed as an additional tool for cancer diagnosis and prognostic stratification. In addition, the tumultuous development of anti-Lp(a) therapeutics, if a pro-cancerogenic Lp(a) activity will be confirmed, could have an impact on the natural history of cancer and on its pharmacological management. This review resumes current knowledge on the relationship between Lp(a) and cancer as well as on its possible impact on the oncological field. Show less

We reviewed our institutional database to examine the effect of right ventricular outflow tract (RVOT) stenting on branch pulmonary artery (PA) sizes and their outcomes. RVOT stenting was performed following standard technique. Since 2021, a conscious effort was made to spare the pulmonary valve (PV) whenever feasible. PA annulus and branch PA sizes were serially monitored by echocardiography. Sixty patients, (4.5 [1.75-24] months, weight 6.4 [3.5-9 kg]), were included (Time period:2012-2025). Commonest indications included cyanotic spell (65%) and hypoplastic branch PAs (30%). Pulmonary valve annulus measured 5.1 mm (4.0-7.7); Z score - 3.8 (- 5.1 to - 2.6), and MPA 4.35 mm (3.34-5.7); Z score - 4.9 (- 7.0 to [- 3.1]). At follow-up of 8(25-102) months, branch PAs grew in all, albeit at different paces. RPA z-scores improved from a baseline of - 2.48 (- 5.05 to [- 0.85]) to - 1.55 (- 3.07 to 0.46) and LPA z-scores from - 2.5 (- 4.38 to [- 0.78]) to - 1.08 (- 2.41 to 0.63) in hypoplastic PA group over 1-year period (p value < 0.001). Pulmonary valve was spared in 57% of patients in the cyanotic spell group and 22% of hypoplastic PA group. 29 (48%) patients underwent corrective surgery at 9 (6-14) months from RVOTS. Requirement of transannular patch (TAP) was 38% (11/29) and conduit was 34% (10/29). Valve sparing ICR was feasible in 67% (8/12) when the stent was placed below the valve. In addition to effective palliation, RVOT stenting promotes growth of branch pulmonary arteries even in those with inherently hypoplastic branch PAs. It is possible to effectively palliate selected patients without stenting across the pulmonary valve thereby potentially enabling valve-sparing TOF correction in those with suitable anatomy. Show less

Metabolic health refers to the proper functioning and balance of metabolic processes in our bodies. The metabolism of carbohydrates, lipids, and proteins has a direct impact on the cardiovascular system. Recent advances in pharmacotherapy have introduced several drugs into clinical practice that can improve cardiometabolic health. Between September 2023 and March 2024, we systematically collected cardiometabolic data from 800 kidney transplant patients (KTPs) during their routine outpatient visits. These included clinical data - office blood pressure, body weight and height, body mass index (BMI), and waist circumference (WC) - and laboratory data such as high-sensitivity C-reactive protein (hs-CRP), lipid profile, lipoprotein(a) (Lp(a)), glycated hemoglobin (HbA1c), serum urate, serum albumin, and proteinuria from spot urine samples. Patients who required treatment adjustment were selected. Deviations from the desired values of individual components of the metabolic syndrome (blood pressure, WC, triglycerides, high-density lipoprotein cholesterol, and fasting glucose) were observed in 23 - 61.5% of patients. Elevated hs-CRP levels (5 - 10 mg/L), a known cardiovascular risk factor, were observed in 13.5% of patients. Lp(a) levels exceeded the upper normal limit (> 500 mg/L) in 17% of patients. Only a small proportion of patients with moderate to advanced kidney disease - 13% and 23.6%, respectively - had low-density lipoprotein cholesterol levels within the reference range. Between 23% and 61.5% of patients failed to meet target values for individual components of metabolic health. The largest deviation (61.5%) was observed in WC among women. WC and waist-to-height ratio are two simple and reliable parameters for assessing metabolic status. Show less

This study aimed to identify distinct employee and organizational profiles influencing workplace safety behaviors (compliance and participation) using latent profile analysis (LPA), focusing on psychological need satisfaction, work performance, and organizational safety culture. A cross-sectional survey of 1293 Polish employees across diverse sectors (industry, transportation, construction, agriculture) assessed individual factors (personal safety culture, basic psychological needs, task/contextual performance, counterproductive behaviors) and organizational factors (safety values, leadership commitment, training quality, psychosocial climate). Validated scales, including the Five latent profiles emerged for both employees and organizations. Employees with high basic need satisfaction, strong personal safety values, and high performance exhibited the highest safety compliance and participation. Conversely, those with unmet needs despite strong safety values showed the lowest level of safety behaviors. Organizations with holistic safety cultures (leadership commitment, tailored training, psychosocial support) achieved superior safety outcomes, while those neglecting systemic safety investments performed the poorest. Workplace safety behaviors are shaped by interactions between various individual and organizational variables. The study highlighted the importance of both organizational factors, such as safety climate, and individual factors, including need satisfaction, performance, and counterproductive behaviors. Med Pr Work Health Saf. 2025;76(6):435-447. Show less

Lipoprotein(a) [Lp(a)] is a well recognised contributor in the development of cardiovascular disease. Unlike other lipoproteins, Lp(a) levels are primarily genetically determined, and in most individuals remain largely stable throughout life. Elevated Lp(a) is common in the general population, and various international guidelines now recommend at least one lifetime measurement of Lp(a) and its inclusion into an individual's cardiovascular risk assessment. Despite this, Lp(a) is still rarely measured, even in patients with known cardiovascular risk factors. Critically, the therapeutic landscape for Lp(a)-lowering medications is rapidly evolving with multiple drugs showing considerable promise in late-stage clinical trials. The strength and consistency of the evidence now cement Lp(a) as an essential biomarker of cardiovascular health. Failure to incorporate measurement of Lp(a) into clinical practice will continue to underestimate an individual's risk of CVD. Now is the time for Lp(a) to move from a neglected biomarker to a widely known and measured essential component of cardiovascular risk assessment. Show less

In the field of second language acquisition, there is a growing recognition of the importance of emotional factors, particularly emotional intelligence (EI), in influencing learners' willingness to communicate (WTC) in a second language (L2). However, previous studies have predominantly adopted a variable-centered approach, often overlooking individual heterogeneity and the mediating role of foreign language enjoyment (FLE) in the relationship between EI and WTC. To address these gaps, this study integrated variable-centered and person-centered approaches to examine 1111 students from Chinese private colleges, representing a distinct educational ecology. Questionnaires were used to measure EI, FLE, and L2 WTC, followed by mediation analysis and latent profile analysis (LPA). Results indicated that EI positively predicted WTC ( Show less

The relationship between plasma lipoprotein(a) [Lp(a)] levels and metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. The aim of this study was to examine the combined effects of Lp(a) levels on liver and vascular damage. The study was conducted using the Liver-Bible cohort of individuals with metabolic dysfunction (n = 859, 808 with genomic information) and the Milan Biobank (n = 6963). Genome-wide association studies (GWAS) and polygenic risk scores (PRS) were used to evaluate the inherited factors influencing plasma Lp(a) levels. In the Liver-Bible cohort, genetic variation in the LPA gene was the strongest determinant of Lp(a), followed by liver stiffness measurement (LSM). Additionally, circulating Lp(a) levels, but not genetic predisposition, were inversely related to LSM, suggesting that MASLD severity may affect Lp(a) secretion. Among participants with more severe insulin resistance (n = 250), Lp(a) levels (odds ratio 6.7, 95% CI 1.0-53.0, p = 0.046) and LSM (odds ratio 13.7, 95% CI 1.4-172.2, p = 0.023) were associated with greater prevalence of carotid atherosclerotic plaques, regardless of traditional cardiovascular risk factors. In the Milan Biobank, genetically predicted higher Lp(a) levels tended to increase the risk of liver-related outcomes, whereas genetically predicted MASLD was associated with lower circulating Lp(a) levels. The results of this study suggest that liver damage is more likely the cause of reduced plasma Lp(a) levels rather than a consequence. Assessing plasma Lp(a) levels and the extent of liver damage could improve the prediction of vascular damage. Show less

We investigated the association between lipoprotein(a) [Lp(a)] levels and stroke recurrence in type 2 diabetes mellitus (T2DM) patients with recent acute ischemic stroke or transient ischemic attack (TIA). This study included 3,311 T2DM patients with recent acute ischemic stroke or TIA and complete Lp(a) data from the Third China National Stroke Registry. The patients were categorized into three groups based on the 40th and 70th percentiles of the Lp(a): ≤13.1, 13.1 to 29.2 and ≥ 29.2 mg/dL. The primary outcome was stroke recurrence within one year, with incident cases further classified as either ischemic or hemorrhagic. Cox proportional hazards regression and restricted cubic splines were used to evaluate these associations. A total of 3311 patients (2142 men, 64.69%, median age 63) were analyzed. Restricted cubic spline analysis revealed a U-shaped relationship between Lp(a) levels and the risk of stroke recurrence. After adjusting for cardiovascular risk factors, patients with Lp(a) levels ≤ 13.1 mg/dL or ≥ 29.2 mg/dL had hazard ratios of 1.34 (95% confidence interval (CI), 1.02-1.76) and 1.35 (95% CI, 1.01-1.79), respectively, for total stroke compared to those with Lp(a) levels between 13.1 and 29.2 mg/dL. The corresponding hazard ratios were 1.36 (95% CI, 1.02-1.81) and 1.36 (95% CI, 1.01-1.83) for ischemic stroke and 0.88 (95% CI, 0.37-2.09) and 0.77 (95% CI, 0.31-1.94) for hemorrhagic stroke, respectively. Both low and high levels of Lp(a) are associated with an increased risk of stroke recurrence in T2DM patients with a recent history of acute ischemic stroke or TIA, demonstrating a U-shaped relationship. Show less

The transition from elementary to junior high school presents developmental challenges, particularly for students with neurodevelopmental traits. This study examined how autism, attention-deficit/hyperactivity disorder (ADHD) traits and effortful control (EC) were related to changes in mental health during this transition in a large Japanese community sample (N = 2,564). This longitudinal study used data from a community-based cohort of Japanese students and their parents/guardians (N = 2,692). Autism traits were measured using the Autism Spectrum Screening Questionnaire (ASSQ). ADHD traits were assessed with the Attention Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS). Effortful control (EC) was evaluated using the "Effortful Control" subscale of the Early Adolescent Temperament Questionnaire-Revised (EATQ-R). Mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) before and after the transition. Generalized estimating equations (GEE) and latent profile analysis (LPA) were conducted to examine associations among autism and ADHD traits, EC, and mental health across the transition. GEE revealed that higher autism and ADHD traits and lower EC predicted more severe mental health problems. The LPA identified three distinct subgroups characterized by high, moderate, and low SDQ scores across the transition. The high-SDQ group showed elevated autism and ADHD traits and low EC, whereas the low-SDQ group showed low auism and ADHD traits and high EC. The moderate group exhibited intermediate levels for all measures. These findings suggest that pre-existing mental health problems tend to persist during the transition period. Importantly, students with higher autism and ADHD traits and lower EC exhibited diverse adaptation patterns-some improved while others worsened-highlighting that high autism traits are not necessarily associated with post-transition mental health deterioration. This underscores the need for support tailored to neurodevelopmental and self-regulatory profiles. Show less

Dyslexia, a heterogeneous neurodevelopmental disorder, is characterized by persistent reading and spelling difficulties despite average intellectual potential. Although intellectual functioning in dyslexia is often described as average, emerging evidence suggests meaningful within-group variability. This study examined whether children and adolescents with dyslexia exhibited distinct intellectual profiles based on the Stanford-Binet Intelligence Scales, Fifth Edition (SB5). Data were obtained from a large, diagnostically verified sample of 3458 individuals aged 10-19 years assessed in psychological-pedagogical counseling centers across Poland. We used latent profile analysis (LPA) of all 10 SB5 subtests and compared models that specified 2-6 latent classes. The optimal solution identified two profiles: (a) a small subgroup (5%) with globally reduced intellectual functioning and a profound deficit in verbal working memory (>3 standard deviations below the norm) and (b) the predominant subgroup (95%) with broadly average intellectual functioning and relatively preserved reasoning abilities. Profile membership was associated with socioeconomic status; the low-functioning subgroup was associated with lower parental education and age, as younger participants were more likely to belong to this group. These findings highlight the dimensional nature of intellectual heterogeneity in dyslexia and underscore the diagnostic value of profile-based approaches over global intelligence quotient (IQ) scores. Show less

Objective To investigate the effect and mechanism of baicalin on blood lipid metabolism and immune function in rats with gestational diabetes mellitus (GDM). Methods Female rats fed with high-fat and high-sugar diet and male rats fed with ordinary diet were caged together to prepare pregnant rats, and the GDM rat model was established by intraperitoneal injection of streptozotocin (35 mg/kg). GDM rats were randomly divided into a model group, a fasudil (FA) (RhoA/RocK inhibitor) group (10 mg/kg), low-dose (100 mg/kg) and high-dose (200 mg/kg) baicalin groups, and a high-dose baicalin combined with LPA (RhoA/RocK activator) group (200 mg/kg baicalin+1 mg/kg LPA ), with 12 rats in each group. Another 12 pregnant rats fed with high-fat and high-sugar diet were selected as the control group. After 2 weeks of corresponding drug intervention in each group, the level of fasting blood glucose (FBG) was detected by blood glucose meter. The level of fasting insulin (FINS) in serum was detected by ELISA, and the insulin resistance index (HOMA-IR) was calculated. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) in serum, and the levels of immunomodulator tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and IL-10 in peripheral blood were detected by the kit. The histopathological changes of liver were observed by HE staining. The proportion of T lymphocyte subsets in peripheral blood was detected by flow cytometry. The mRNA and protein expressions of Ras homolog gene family member A (RhoA), Rho associated coiled-coil forming protein kinase 1 (ROCK1), and ROCK2 in liver tissue were detected by real-time quantitative PCR and Western blot. Results Compared with the control group, the levels of FBG, FINS, HOMA-IR, ALT, AST, TG, TC, and LDL-C in serum, the levels of TNF-α, IL-6, the percentage of CD8 Show less

Community structures are common features of many real-world networks, and community detection is necessary to understand how these networks are organized. Various approaches have been devised for community detection, with each providing varying degrees of both accuracy and structural understanding. One of them, the Label Propagation Algorithm, is so common because it is simple and computationally cheap. Nevertheless, it does not usually reach great modularity and yields inaccurate community counts and structures in real-world networks. This is mostly due to its naive criteria of selecting the neighbor nodes when it comes to label propagation. To tackle the issue, we developed an adjusted algorithm, which we call Embedding-based Label Propagation (ELP), a hybrid between LPA and node embedding that allows us to combine both local connectivity and global structural data. ELP update step takes into consideration not only the local neighborhood, as in conventional LPA, but also embedding-based similarities to inform more productive neighbor selection. We tested ELP on popular benchmark datasets such as Karate Club, Dolphins, Football, Polbooks, and LFR synthetic networks and compared its results with LPA and other well-established algorithms. The empirical findings show that ELP can always perform better in modularity, NMI and NF1 scores, but it is also scalable to large and complex networks. These results can be used to identify ELP as an effective and powerful method of community-finding in real and artificial-world scenarios. Show less

Non-suicidal self-injury (NSSI) is a common concern among adolescents. While psychological flexibility (PF) has been established as a key protective factor that prevents NSSI in adolescents, its potential heterogeneity and the mechanisms by which PF influences NSSI remain unclear. The purpose of this study was to explore the heterogeneity of PF among Chinese adolescents and examine whether negative emotions and school interpersonal relationships mediate the associations between PF profiles and NSSI behavior. A convenience sampling method was employed. Participants included 1,562 Chinese adolescents (mean age 13.13 years, SD = 0.99; 54.42% males) from Anhui Province. Latent profile analysis (LPA) was performed to identify the heterogeneity in adolescent PF, and structural equation modeling (SEM) was performed to examine the multiple mediating roles of negative emotions and school interpersonal relationships in the associations between PF profiles and NSSI behavior. The following five distinct PF profiles were identified: the weakly open-highly engaged subgroup (4.42%), the low-PF subgroup (15.43%), the medium-PF subgroup (33.80%), the high-PF subgroup (33.35%), and the extremely high-PF subgroup (13.00%). Both negative emotions and school interpersonal relationships significantly mediated the associations between PF profiles and NSSI behavior. Compared with adolescents in the extremely high PF subgroup, adolescents in the weakly open-highly engaged subgroup, low-PF subgroup, and medium-PF subgroup presented higher levels of negative emotions, poorer school interpersonal relationships, and greater degrees of NSSI behavior. In particular, among the five profile groups, adolescents in the weakly open-highly engaged subgroup exhibited the greatest degree of NSSI behavior. PF profile affected NSSI behavior among adolescents indirectly through negative emotions and school interpersonal relationships, and stronger multiple mediating effects were observed among adolescents with lower levels of PF and openness. Our study highlights the importance of focusing on the heterogeneity of PF among adolescents, the critical role of openness, and the need for tailored interventions to improve PF as well as emotional, interpersonal, and behavioral issues. Show less

This cross-sectional study aims to describe the characteristics of physical activity, sedentary time, sleep quality, and resting EEG among college students with mild depressive symptoms, and further explore pairwise correlations between behavioral patterns, resting EEG, and mild depressive symptoms. This study included 75 college students with mild depressive symptoms (MDS) and 75 college students without depressive symptoms (ND) as research subjects. Physical activity (vigorous physical activity (VPA), moderate physical activity (MPA), and low physical activity (LPA)) and sedentary time（ST） were measured using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Resting EEG power values were collected from subjects in a quiet, eyes-closed state using an electroencephalography (EEG) device. (1) Characteristic analysis revealed that compared with the ND group, the MDS group exhibited reduced MPA and VPA scores, elevated ST scores, and increased total PSQI scores along with elevated scores across its subdimensions. Their behavioral patterns (Moderate-to-Vigorous Physical Activity (MVPA), Sedentary Behavior (SB), Poor Sleep Quality (PSQ) may have changed, including a decrease in the proportion of MVPA, an increase in the proportion of SB, and an increase in the proportion of PSQ. Analysis of resting EEG revealed increased Alpha2 (α2) band power in the temporal regions (T3 and T5) and increased Beta1 (β1) band power in the frontal region (Fp1) in the MDS group (all p College students with mild depressive symptoms may exhibit altered behavioral patterns and abnormal neural activity in the frontal and temporal regions. Their changed behavioral patterns may correlate with mild depressive symptoms, and recognition models based on certain resting EEG indicators demonstrate preliminary application potential. The association between specific sleep issues and localized EEG activity in this population may provide evidence for further elucidating the mechanistic pathways linking their behavior and brain activity. Future longitudinal studies are recommended to explore causal relationships among these variables. Show less

To explore the stratification and identification of adrenal lipid-poor adenomas (LPAs), adrenal cysts (ACs), and adrenal ganglioneuromas (AGNs) from each other using contrast-enhanced computed tomography (CT). Pathologically confirmed, 348 patients were categorized into Model 1 (260 LPAs, 34 ACs), Model 2 (260 LPAs, 54 AGNs), and Model 3 (34 ACs, 54 AGNs). Statistical analyses were performed on the differences in the degree of enhancement in the arterial/venous phase (DEap/DEvp) (in HU) and the corresponding graded variables for the arterial/venous phase (GVap/GVvp). Models were evaluated via receiver operating characteristic (ROC) curves, calibration curves, and the Hosmer‒Lemeshow (HL) test. The values of the area under the curve (AUC) for DEap, DEvp, GVap, and GVvp in Models 1-3 were 0.996, 1.000, 0.993, and 0.999; 0.980, 0.978, 0.961, and 0.975; and 0.734, 0.892, 0.725, and 0.883, respectively. The p values of the HL test were 0.984, 1.000, and 0.113, respectively. The DEvp interval values (in HU) for the LPAs, ACs, and AGNs were [4.9, 190.2] HU, [-3.7, 4.2] HU, and [-4.8, 41.8] HU, respectively. The GVap and GVvp ranges for the LPAs, ACs, and AGNs were [1, 6], [0, 2], and [0, 2] and [1, 6], [0, 1], and [0, 5], respectively. DEvp enhanced discrimination in Models 1 and 3, whereas DEap performed better in Model 2. Lesions with DEvp < 4.5 HU are likely represent non-enhancing pathology (e.g., cysts). When both GVap and GVvp are 0, when both GVap and GVvp are [2, 6], and when GVap is [3, 6] and GVvp is 6, LPA, AC, and AGN are excluded. Not applicable. Show less

A low respiratory arousal threshold (ArTH) has been linked to reduced continuous positive airway pressure (CPAP) adherence in obstructive sleep apnea (OSA) via a multi-trait model developed in the RICCADSA trial. Our objective was to validate the prior model in a large, real-world cohort and explore alternative linear and non-linear approaches for predicting CPAP adherence. Does a previously derived multi-trait model linking low ArTH to poor CPAP adherence remain valid in a diverse real-world population and do alternative linear or non-linear approaches offer improved predictive performance? Adults with OSA from the SNOOzzzE-cohort who initiated CPAP within 1 year of in-lab polysomnography (2017-2019) were included. Pathophysiological traits (Vpassive, Vactive, loop gain, ArTH, ventilatory response to arousal) were estimated from polysomnography. Poor (vs good) adherence was defined as ≤2.48h/night at month 1 (1 Among 744 participants (45% women, 47% non-White), median CPAP adherence was 4.8 h/night at 1 month. The prior model's AUC was 0.51 (95%-CI 0.46-0.55), with no usage differences between predicted poor vs good adherers. A new linear model overfit in training (AUC=0.85) but failed in testing (AUC=0.55). LPA identified a "Low ArTH Driven" cluster with persistently lower adherence at months 2-3 (P<.05) and a "Low ArTH & High loop gain" cluster whose usage stabilized after month 1. The prior model did not generalize to this diverse clinical cohort. LPA identified a "Low ArTH Driven" endotype with persistently low CPAP adherence, suggesting potential for targeted interventions pending external validation. Show less

Metabolic syndrome (MetS) is linked to later-life cognitive decline and brain aging, but early detection of vulnerability in midlife remains challenging. This study applied two methods to detect subtle changes in midlife adults with MetS: (1) latent profile analysis (LPA) to identify cognitive performance patterns and (2) an MRI-derived brain-predicted age metric to assess structural brain aging. Participants were cognitively unimpaired, community-dwelling adults from prior studies on metabolic and brain health ( MetS prevalence differed across cognitive profiles (χ Cognitive profiles and brain-predicted age metrics identify early vulnerability in midlife MetS, underscoring the importance of early intervention. Show less

Lipoprotein(a) (Lp(a)) is a plasma lipoprotein with atherogenic, prothrombotic, and proinflammatory properties. Elevated Lp(a) levels are linked to the development of early atherosclerosis in childhood and contribute to a higher risk of cardiovascular disease (CVD) in adulthood. This study aimed to assess the clinical significance of Lp(a) levels in Portuguese pediatric patients who underwent serum Lp(a) testing as part of a lipid disorder screening prompted by obesity, hypercholesterolemia, and/or a family history of premature CVD. We also evaluated the correlation between Lp(a) levels and CVD risk factors. This cross-sectional retrospective study included 792 pediatric patients. Data on demographics, clinical history, body mass index, and laboratory values, including Lp(a), were collected. Lp(a) levels were categorized into 3 groups: <75 nmol/L, 75-125 nmol/L, and >125 nmol/L. A multivariate analysis was used to identify factors associated with Lp(a) ≥ 75 nmol/L. The most prevalent comorbidities in this sample were obesity and associated low-grade inflammation, each affecting at least one-third of participants. The median Lp(a) level was 31.80 nmol/L, with 9.1% and 21.6% of children having intermediate (75-125 nmol/L) and high (>125 nmol/L) Lp(a) levels, respectively. Higher total cholesterol, non-high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C) levels were correlated with elevated Lp(a) levels. The multivariate analysis identified an elevated LDL-C level as a predictor of a higher Lp(a) level. This study highlights the alarming prevalence of elevated Lp(a) levels in Portuguese pediatric patients who underwent serum Lp(a) testing due to lipid disorder screening, with >30% at intermediate/high CVD risk. As Lp(a) levels are mostly genetically determined and tend to persist into adulthood, these findings emphasize the importance of including Lp(a) screening in the cardiovascular risk assessment of children with CVD risk factors to enable timely prevention strategies for adultonset CVD. Show less

The aim of this study was to explore the prospective association between compositions of accelerometry-measured occupational physical behaviors and the risk of knee pain among eldercare workers. We performed a prospective study among 377 eldercare workers employed across 20 Danish nursing homes. Occupational physical behaviors were measured using thigh-worn accelerometers over 1-4 working days. Workers reported intensity of and days with knee pain in a questionnaire at baseline and after one year. We explored associations between compositions of occupational physical behaviors [ie, sedentary, standing, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)] and knee pain, adjusting for potential confounders. No significant associations were found. Trends were found for increased occupational time spent in MVPA and decreased risk of days with knee pain [relative risk (RR) 0.58, 95% confidence interval (CI) 0.32-1.05, P=0.07] in main analyses, and for decreased risk of knee pain intensity among non-knee pain cases (RR 0.36, 95% CI 0.12-1.13, P=0.08) in sensitivity analyses. No significant associations were found between baseline occupational physical behaviors and knee pain at one-year follow-up. However, a non-significant trend suggested that increasing occupational MVPA might be associated with reduced risk of knee pain at follow-up, though studies with larger samples are needed to confirm this finding. Show less

This study was conducted to examine the effect of hope and psychological well-being on quality of life in elderly cancer patients using latent profile analysis (LPA). The study was conducted with 398 elderly cancer patients in Ataturk University Research in Turkey between September 2024 and January 2025. R programming language 4.1.3, G*Power 3.1 and SPSS-22 program were used in the analysis of the study. In our study, in the first stage of LPA analysis, BIC values were obtained by iterating each model and each class for 4 models and 9 classes. Since the lowest BIC value was found in the EEE model, the EEE model was considered as the appropriate model in the study and the class analysis was performed over this model. It is concluded that the best fitting class is the 2-class solution. As a result of LPA, class 1 has the lowest arithmetic mean in all indicators. According to the latent classes of the individuals in our study; it was found that the quality of life of individuals with Low Psychological Status was significantly lower than individuals with High Psychological Status (p < 0.05). In our study, two classes were found as a result of LPA. According to the classes, it was found that the quality of life of individuals with low psychological status was lower than individuals with high psychological status. Increased hope and psychological well-being were found to improve quality of life in elderly cancer patients. Longitudinal studies on quality of life in elderly cancer patients are recommended. Show less

Interventions have focused on evaluating effective strategies for increasing physical activity (PA) and reducing sedentary behavior (SB) in children and adolescents, which is still a challenge mainly in low- and middle-income countries. Thus, this study aimed to assess the effect of the Movimente Study on device-measured PA and SB in two-time segments of the school day amongst Brazilian adolescents. Six elementary schools were randomized into the intervention (IG) or control group (CG). Participants were in 7th -9th grades. A school year (2017) multicomponent intervention was delivered consisting of three components: (1) teacher training, (2) education curriculum, and (3) school environment. PA and SB were assessed using GT3x + ActiGraph hip-worn accelerometers. The trial's primary outcome was overall device-measured PA and SB. Exploratory secondary analyses examined PA and SB within in-School (08:00-11:59) and out-of-school (12:00-22:00) time segments. A two-level linear mixed model assessed the effect of the intervention on light-intensity PA (LPA), moderate- to vigorous-intensity PA (MVPA), SB, and MVPA/SB ratio within and between groups. There was a significant effect on the IG compared to the CG for MVPA (Coefficient [Coef.] = 16.2; 95% Confidence Interval [95%CI] = 6.9;25.5; p-value = 0.001), SB (Coef. = -22.7; 95%CI = -44.7;-0.7; p-value = 0.043), and MVPA/SB ratio (Coef. = 3.2; 95%CI = 1.2;5.3; p-value = 0.002) performed in the out-of-school segment, but not in the In-school segment. However, there were no significant differences within- nor between-group differences in LPA in both day segments. The Movimente Study was associated with greater increases in MVPA, improvements in the MVPA/SB ratio, and reductions in SB during the out-of-school period compared with control peers. Clinical Trials - NCT02944318. Registration Date: 10/24/2016. Show less

A few species have evolved multiple sex chromosome systems with more than two Xs or Ys due to sex chromosome-autosome translocations. Among vertebrates, frogs (Anura) have the highest known number of such neo-sex chromosome systems, making them interesting for studying how such systems evolve. In this work, we investigated two Leptodactylus species, L. pentadactylus (LPE) and L. paraensis (LPA), with large ring multivalents in male meiosis, using genomic and cytogenetic investigation of repetitive DNA sequences, including satellite DNAs (satDNAs), and transposable elements (TEs). SatDNA mapping identify individual chromosomes in the LPE ring, and morphologies suggest that all chromosomes are shared with the LPA ring although a common ring origin is not firmly supported. In situ mapping suggests recent satDNA accumulation in subtelomeric regions since the split from the outgroups, likely unrelated to the translocations that created sex-linkage, which probably involved breaks in the pericentromeric regions. Show less