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Fear of progression (FoP) is a prevalent psychological issue among stroke patients. Previous studies failing to distinguish characteristics of patient groups with varying FoP levels. Latent profile analysis (LPA) classifies individuals into distinct subgroups via continuous FoP indicators, boosting classification accuracy by accounting for variable uncertainty. Given FoP's heterogeneity, investigating FoP profiles and their influencing factors in stroke patients is clinically significant for personalized psychological care and improved patient quality of life. A total of 366 stroke patients were selected as study subjects through convenience sampling, and a cross-sectional survey was conducted. FoP was assessed using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF, 2 dimensions, 12 items). Independent variables included demographic characteristics, clinical indicators, the Recurrence Risk Perception Scale for Stroke patients (RRPSS), and the Medical Coping Modes Questionnaire (MCMQ). LPA was performed on the FoP-Q-SF items to identify subgroups. The R3STEP method was used to analyze influencing factors of subgroup membership, and the BCH method was applied to compare differences in distal outcomes across subgroups. Statistical significance was set at The study sample had a mean age of 63.93 ± 10.58 years, with 70.5% males and 65.0% first-ever stroke patients. Two latent profiles were identified: Low-FoP Adaptive Type (C1, 48.6%) and High-FoP Sustained Type (C2, 51.4%). The R3STEP showed that age 18-59 years (OR = 0.476, 95%CI = 0.245-0.924, This study revealed significant heterogeneity in FoP among stroke patients. Age, hypertension comorbidity, excessive recurrence risk perception, MCMQ-confrontation, and MCMQ-avoidance were associated with high FoP. Healthcare providers should prioritize identifying high-risk individuals and develop tailored interventions to reduce FoP and improve rehabilitation outcomes. Show less

To identify distinct profiles based on socioeconomic status (SES), marital status, home and neighborhood environments, and psychological symptoms, in a sample of primarily Mexican-origin mothers, and to examine how these profiles relate to maternal diurnal cortisol. Mexican-origin mothers (N = 143) were assessed for their objective (education, income-to-needs ratio) and subjective SES (perceived financial concern), marital status, home chaos, neighborhood environments (cohesion and quality), and maternal depressive symptoms when their child was approximately 6-months old. Maternal salivary cortisol levels were collected around the time of their wake-up and at their child's bedtime. Latent profile analysis (LPA) was used to identify distinct profiles of maternal risk and resilience. LPA revealed three distinct profiles with unique patterns of risk and resilience. The Higher-Risk profile (36%) was characterized by low SES, poor home and neighborhood environments, and heightened depressive symptoms. The Resilient profile (46%) displayed low objective SES but low financial concern, positive home and neighborhood environments, and fewer depressive symptoms. Lastly, the Lower-Risk profile (18%) showed relatively high SES, positive home and neighborhood environments, and fewer depressive symptoms. Mothers in the Higher-Risk profile exhibited less pronounced declines in cortisol from wake-up to bedtime compared to those in the Resilient and Lower-Risk profiles. The Resilient group showed a diurnal pattern similar to the Lower-Risk group. This study highlights that even in the context of objectively low SES, positively perceived SES, supportive home and neighborhood environments, and low depressive symptoms may serve as resilience factors, promoting healthier cortisol patterns among low-income Mexican-origin mothers. Show less

People with HIV (PWH) and undetectable virus experience elevated cardiovascular risk independent of traditional risk factors. Vascular inflammation may contribute to this residual risk. The perivascular fat attenuation index (FAI), derived from coronary computed tomography angiography (CCTA), is a biomarker of coronary inflammation. Lipoprotein(a) [Lp(a)] carries oxidized phospholipids that may promote inflammation. Statins have demonstrated cardiovascular benefit in PWH, including pleiotropic anti-inflammatory effects. This study assessed the associations of Lp(a) and of statin use with coronary inflammation (FAI) in men with HIV (MWH). We analysed FAI of the left anterior descending (LAD) and the right coronary arteries (RCA) in 583 men from the Multicenter AIDS Cohort Study, a prospective, multicentre cohort study, including 280 with undetectable HIV RNA, <50 copies/ml. Associations between log Lp(a) was associated with increased coronary inflammation, independent of traditional cardiovascular risk factors, in MWH with undetectable virus. Statin therapy did not modify the relationship between coronary inflammation and Lp(a). Show less

This study aimed to identify different symptom profiles of complicated grief/bereavement-related posttraumatic stress disorder (PTSD) and examine the associations with social life factors, posttraumatic growth, and quality of life in a sample of parents whose children died in Sewol ferry accident. A total of 272 bereaved parents affected by the Sewol ferry accident participated and completed self-report scales about traumatic loss-related symptoms. The latent profile analysis (LPA) of complicated grief and posttraumatic symptoms was classified. To examine the predictors (interpersonal stress/familial conflict/social support) and outcomes (posttraumatic growth/quality of life) of the traumatic loss symptom profiles, an automatic three-step approach was chosen. The LPA identified three symptom profiles of complicated grief and posttraumatic stress: low symptomatology group (30.4%), moderate symptomatology group (49.6%), and high symptomatology group (20.0%). Higher perceived interpersonal stress significantly increased the odds of moderate and high symptomatology, while higher family stress was a significant predictor for high symptomatology compared to both low and moderate symptomatology groups. In addition, higher perceived social support significantly decreased the odds of being in both moderate and high symptomatology groups compared to the low group. The low symptomatology group showed the highest quality of life, followed by the moderate and high groups. Posttraumatic growth was also significantly different between the classes, with the moderate symptomatology group reporting higher growth than the low symptomatology group. Our findings suggest that managing the mental health of people who have experienced a traumatic loss will be a critical component of their quality of life in the future. In addition, interventions to help reduce family conflict and interpersonal stress may be necessary to reduce difficulties associated with psychopathology. Show less

Lipoprotein(a) [Lp(a)] is a causal risk factor for cardiovascular disease, but its impact on long-term coronary plaque progression remains unclear. This study synthesizes evidence from CCTA, IVUS, and OCT to clarify the relationship between high-risk Lp(a) and coronary plaque burden and high-risk plaque features. We conducted a comprehensive search of multiple databases up to July 2025 for studies evaluating Lp(a) and atherosclerotic plaque progression. Statistical analysis was performed using a random-effects model in RevMan 5.4, reporting odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI). The protocol is registered in PROSPERO (CRD420251113955). Our final analysis included 16 studies comprising 19,822 participants with a mean age of 62 years and a median imaging follow-up ranging from 10 months to 10.2 years. On analysis, high-risk Lp(a) levels were significantly associated with the presence of coronary plaque (OR 1.53; 95% CI, 1.03-2.29; p = 0.04) compared with low Lp(a) levels. Additionally, patients with elevated Lp(a) exhibited significantly greater progression in percent atheroma volume (ΔPAV) than those with low levels (MD 4.31%; 95% CI, 1.08-7.53; p = 0.009). Subgroup analysis by plaque phenotype revealed a statistically significant increase in low-attenuation plaque (LAP) presence among individuals in the high-risk Lp(a) category (OR 1.92; 95% CI, 1.13-3.27; p = 0.02). High-risk Lp(a) is associated with greater coronary plaque prevalence, accelerated progression, and increased LAP. These findings underscore Lp(a) as a driver of high-risk, rupture-prone plaques and a critical biomarker and potential therapeutic target in cardiovascular risk management. Show less

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

Although recommended for cardiovascular (CV) risk stratification in adults, the role of lipoprotein(a) [Lp(a)] in hypertension is not fully established. To evaluate Lp(a) levels in adult outpatients with essential arterial hypertension. A retrospective, observational study was conducted in outpatients of both sexes, aged ≥ 18 years, with treated or untreated essential hypertension, who were consecutively evaluated at the Hypertension Unit, Excellence Hypertension Center, Sant'Andrea Hospital, Rome, Italy. Participants underwent office and out-of-office blood pressure (BP) measurements, as well as assessment of hypertension-mediated organ damage (HMOD). BP measurements were performed, and hypertension phenotypes were classified according to 2023 European hypertension guidelines. Lp(a) levels were measured, and the study population was stratified according to a Lp(a) cut-off value of ≥50 mg/dl. Due to the non-uniform distribution, absolute Lp(a) values were logarithmically transformed. A total of 230 patients with available Lp(a) values were included (42.6% women, mean age 66.3 ± 11.5 years, BMI 27.1 ± 4.5 kg/m2, office BP 137.1 ± 18.1/83.7 ± 11.0 mmHg, 24-hour BP 129.8 ± 14.5/79.6 ± 9.8 mmHg, Lp(a) 51.4 ± 65.3 mg/dL), among whom 32.2% had Lp(a) ≥50 mg/dl. There were significantly higher proportions of men (74.3% vs. 49.4%; P < 0.001), dyslipidaemia (97.3% vs. 75.0%; P < 0.001) and comorbidities (55.4% vs. 30.8%; P < 0.001) in patients with high Lp(a) than in those with normal Lp(a), who also received more frequently lipid lowering therapies (P < 0.001) and aspirin (P = 0.003). However, lower office systolic BP values (133.5±18.8 vs. 138.8±17.6 mmHg: P = 0.036) were observed in patients with Lp(a) ≥50 mg/dL than in those with < 50 mg/dl. Also, no significant differences for Lp(a) levels were observed among various hypertension phenotypes, as defined by office (P = 0.156) or out-of-office BP values (P = 0.065). No significant correlations were found between Lp(a) and office or out-of-office BP levels, both in treated and untreated hypertensive outpatients. In our population, Lp(a) levels were not associated with either office or out-of-office BP values, irrespective of antihypertensive treatment status. The role of Lp(a) in hypertension warrants further investigation. Show less

Coronary artery disease (CAD) polygenic risk score (PRS), low-density-lipoprotein cholesterol (LDL-C), lipoprotein(a) (Lp(a)), and high-sensitivity C-reactive protein (hsCRP) are biomarkers that predict CAD. It is unclear whether integrating genomics with lipid and inflammatory biomarkers could complement traditional risk scores in identifying people at risk of CAD. This study assesses the predictive value of CAD PRS, LDL-C, Lp(a), and hsCRP for incident CAD across different age and sex groups. Participants (n = 215,695) from the UK Biobank aged 40 to 69 years with baseline CAD PRS, LDL-C, Lp(a), and hsCRP values were followed for 12 years to assess the incidence of CAD. We evaluated a multivariable-adjusted Cox model that included all 4 biomarkers, net reclassification index, C-statistics, and population attributable risk across different age and sex groups. Over a 12-year follow-up, 4,721 men and 2,425 women developed CAD. The HRs for incident CAD associated with each biomarker elevation were 1.79 (95% CI: 1.70-1.89) for CAD PRS, 1.60 (95% CI: 1.48-1.66) for LDL-C, 1.20 (95% CI: 1.12-1.29) for Lp(a), and 1.64 (95% CI: 1.57-1.72) for hsCRP. CAD PRS demonstrated a stronger association in men (HR per SD: 1.49; 95% CI: 1.45-1.54) than women (HR per SD: 1.37; 95% CI: 1.31-1.44; P-interaction ≤ 0.001). All biomarkers conferred greater HRs at younger ages (P < 0.0001). Individuals with all biomarkers elevated had a 4.65-fold increased risk of CAD compared with those with no elevated biomarkers. A combined 4-biomarker model had a higher C-statistic of 0.753 compared with the pooled cohort equations (C-statistic of 0.740). The C-statistic of the combined 4-biomarker model was also higher in younger individuals in both sexes and yielded a 32.0% continuous net reclassification index when compared with the pooled cohort equations. CAD PRS, LDL-C, hsCRP, and Lp(a) show independent age- and sex-specific associations with CAD. Measuring all 4 biomarkers may improve midlife CAD risk prediction for both male and female patients. Show less

Lipoprotein(a) (Lp[a]) can refine atherosclerotic cardiovascular disease risk assessment and guide lipid-lowering therapy intensification (LLTI). However, the association between Lp(a) testing and LLTI across large health systems is not well characterized. Using Veterans Affairs electronic health record data, we conducted a retrospective cohort study of veterans undergoing lipid testing from January 1, 2017, to June 30, 2024. We first compared a 1:1 propensity-matched cohort with concurrent low-density lipoprotein cholesterol (LDL-C) and Lp(a) testing with those with LDL-C testing alone. We then compared veterans with elevated versus nonelevated Lp(a) (>50 versus <50 mg/dL). The primary outcome was LLTI within 12 months, defined as therapy initiation, dose escalation, or addition of another lipid-lowering agent. LDL-C goal attainment (<100 mg/dL primary prevention; <70 mg/dL secondary prevention) was assessed within 12 months. Multivariable logistic regression adjusted for sociodemographic and clinical factors. Among 6 941 840 veterans with LDL-C testing, 10 384 (0.1%) underwent Lp(a) testing. The propensity-matched cohort included 20 768 veterans (mean±SD age, 58.4±15.3 years; 12.4% women; 19.2% Black individuals). Elevated Lp(a) (>50 mg/dL) was present in 25% (n=2562). Lp(a) testing was associated with greater LLTI (odds ratio [OR], 2.11 [95% CI, 1.95-2.29]), LDL-C testing (OR, 1.27 [95% CI, 1.19-1.36]), and LDL-C goal attainment (OR, 1.22 [95% CI, 1.12-1.33]). Compared with Lp(a) <50 mg/dL, Lp(a) >50 mg/dL was associated with increased LLTI (OR, 1.73 [95% CI, 1.55-1.94]). Lp(a) >100 mg/dL was associated with lower LDL-C goal attainment (OR, 0.68 [95% CI, 0.56-0.84]). Lp(a) testing was associated with increased LLTI and LDL-C goal attainment. Elevated Lp(a) identified individuals more likely to undergo LLTI, suggesting testing may motivate preventive treatment optimization. Show less

To identify latent classes based on symptom clusters and to explore the association between these distinct symptom experience subtypes and social isolation in older adults with comorbid diabetes mellitus (DM) and coronary heart disease (CHD). A cross-sectional study was conducted among 337 older adults with DM and CHD recruited from the Department of Endocrinology and Cardiology of Nantong Sixth People's Hospital between February 2023 and October 2025. Data were collected using a general information questionnaire, the Chinese version of the Memorial Symptom Assessment Scale (MSAS), and the Lubben Social Network Scale-6 (LSNS-6). Exploratory factor analysis (EFA) was used to identify symptom clusters. Latent profile analysis (LPA) was then employed to classify patients into different symptom experience subtypes based on the symptom cluster scores. One-way ANOVA, Chi-square tests, and multiple linear regression were used to analyze the association between latent classes and social isolation. EFA extracted three symptom clusters (cardiopulmonary-fatigue, emotional-perceptual, and metabolic), accounting for 62.3% of the total variance. LPA identified three distinct latent classes: Class 1 "Low Burden-Balanced Pattern" (45.4%), Class 2 "Psycho-Somatic Co-dominant Pattern" (31.8%), and Class 3 "Metabolic-Physical Dominant Pattern" (22.8%). Univariate analysis revealed significant differences in social isolation scores (LSNS-6) across the three classes ( The findings reveal significant heterogeneity in symptom experiences among older adults with comorbid DM and CHD, which can be categorized into distinct latent classes. The subtype characterized by a Psycho-Somatic Co-dominant Pattern shows the strongest association with social isolation. In clinical practice, early identification of this high-burden subgroup may facilitate the provision of integrated interventions that address physical, psychological, and social dimensions. Show less

Current treatments for idiopathic pulmonary fibrosis (IPF) slow but do not stop/reverse disease progression. The lysophosphatidic acid (LPA) axis is identified as a therapeutic target for IPF. This study aims to assess BI 1819479, an LPA pathway inhibitor, in patients with IPF (ClinicalTrials.gov Identifier: NCT06335303). In this placebo-controlled, phase II trial, patients will be randomised (2:1:1:1) to receive one of three oral doses of BI 1819479 or placebo, stratified by nintedanib/pirfenidone use. Patients aged ≥40 years with IPF, forced vital capacity (FVC) ≥45% of predicted normal and haemoglobin-corrected diffusing capacity for carbon monoxide ≥25% of predicted normal at screening will be included. Patients with relevant airway obstruction (pre-bronchodilator forced expiratory volume in 1 s/FVC <0.7), acute IPF exacerbation ≤12 weeks prior to screening, treatment with immunosuppressive medications (other than oral corticosteroids) or prednisone >15 mg·day This trial evaluates the efficacy, safety and dose range of BI 1819479 in patients with IPF, offering a potential additional treatment option, and will establish appropriate dosing for phase III trials. Show less

Myopia is a critical public health issue; however, the roles of multidimensional psychological resources (i.e., resilience and emotion regulation) and potential gender differences remain underexplored. This cross-sectional study aimed to investigate the association between latent psychosocial profiles and myopia severity, and to examine the moderating role of gender in this association among adolescents. In total, 1008 Chinese seventh-grade students completed assessments of psychological resilience, emotion regulation, and depressive and anxiety symptoms. Myopia was measured as spherical equivalent refraction (SER). Latent profile analysis (LPA) was used to identify distinct psychological profiles, and moderation analysis tested gender's role in the profile-myopia association. LPA revealed three distinct psychosocial profiles: "Low-Resource", "Emotion-Driven", and "Balanced-Adaptive". The Low-Resource profile exhibited the highest levels of depression, anxiety, and myopia severity. A significant moderating effect of gender was found. Among females, both the Emotion-Driven and Balanced-Adaptive profiles were associated with significantly less myopia severity compared to the Low-Resource profile-an association not observed in males. Specific psychological resource profiles were linked to myopia severity, a relationship that was significantly moderated by gender and was prominent only in female adolescents. These findings highlight the importance of person-centered approaches and gender-specific considerations in understanding the psychosomatic pathways of myopia. Show less

Lipoprotein(a) [Lp(a)] is a genetically determined, proatherogenic, and prothrombotic lipoprotein associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). Elevated Lp(a) levels are associated with progressive ASCVD even when guideline-recommended low-density lipoprotein cholesterol (LDL-C) targets are achieved under optimal lipid-lowering therapy. There is currently no approved pharmacological therapy specifically targeting Lp(a) reduction in routine clinical practice; therefore, current management strategies for patients with elevated Lp(a) primarily focus on aggressive control of modifiable cardiovascular risk factors and intensive LDL-C lowering. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors provide a modest reduction in Lp(a) levels and have been associated with greater cardiovascular benefit in patients with high baseline Lp(a); however, this degree of reduction is often insufficient in individuals with markedly elevated Lp(a) levels and progressive ASCVD. At present, lipoprotein apheresis remains the only therapeutic option capable of achieving substantial and sustained reductions in Lp(a) concentrations and is recommended in selected high-risk patients with progressive ASCVD despite optimal medical therapy. Meanwhile, Lp(a)-specific therapies, including antisense oligonucleotides and small interfering RNA agents, are in advanced clinical development and have shown marked reductions in Lp(a) levels in early phase trials. These emerging therapies are expected to significantly change future treatment strategies for patients with Lp(a)-driven residual cardiovascular risk. Show less

Severe aortic stenosis can be treated with transcatheter aortic valve implantation (TAVI). There is emerging evidence suggesting that high lipoprotein(a) [Lp(a)] levels may be associated with worse outcomes after TAVI. To compare major adverse cardiac and cerebrovascular events (MACCE) within 12 months after TAVI and long-term survival between patients with high and low Lp(a) levels. In this prospective, multicenter cohort study we included patients with severe aortic stenosis qualified for TAVI with stored plasma available for Lp(a) measurement. Patients were stratified into high and low Lp(a) groups (cutoff 30 mg/dL). Two primary end points were analyzed: (i) 12-month MACCE, and (ii) long-term overall survival. Secondary end points were individual components of MACCE. Between November 2018 and September 2021, TAVI was performed across 3 clinical sites; stored plasma was available for Lp(a) measurement in 82 patients. We observed no difference in MACCE occurrence between high and low Lp(a) groups. In unadjusted analyses, patients with elevated Lp(a) had worse long-term survival during a median follow-up of 2.8 years (log-rank P = 0.045) but this difference lost significance after adjustments for age and sex in a Cox regression model (hazard ratio, 2.85; 95% CI, 0.85 to 9.55, P = 0.054). None of the secondary end points differed significantly between the groups. Patients with elevated Lp(a) have a comparable risk of 12-month MACCE after TAVI to those with low Lp(a) but might have worse long-term survival. Long-term findings should be considered exploratory and requires further confirmation. Show less

Lipoprotein(a) (Lp(a)) is a proatherogenic lipoprotein associated with increased cardiovascular risk and is minimally responsive to statins or lifestyle changes. While Lp(a) is linked to adverse cardiovascular events, its role in predicting repeat revascularization after percutaneous coronary intervention (PCI) remains unclear. This review evaluates the relationship between Lp(a) levels and coronary revascularization outcomes. A systematic review and meta-analysis of studies from MEDLINE and EMBASE through June 18, 2025, evaluated the association between elevated Lp(a) and revascularization outcomes post-PCI. Random-effects models using the DerSimonian-Laird method were used to pool odds (ORs) and hazard ratios (HRs). Heterogeneity was assessed using the I Twenty studies were included in the systematic review, of which eighteen were included in the meta-analysis. Elevated Lp(a) levels were associated with a higher risk of any repeat revascularization, with pooled OR 1.33 (95% CI: 1.17-1.52) and HR 1.15 (95% CI: 1.05-1.25). High Lp(a) was also linked to increased risk of target vessel revascularization (TVR) (OR 1.42; 95% CI: 1.12-1.81). A non-significant trend towards increased target lesion revascularization (TLR) was observed (OR 1.25; 95% CI: 0.96-1.64). Elevated Lp(a) levels were associated with a higher risk of repeat revascularization and TVR, with a non-significant trend towards increased TLR. Further studies are warranted to confirm these findings and explore the potential benefit of Lp(a)-lowering strategies. Show less

Family members of patients with digestive tract cancer represent a high-risk population for cancer development due to shared genetic and lifestyle factors, yet their own disease self-monitoring behaviors remain largely uncharacterized. Understanding the typologies and determinants of these behaviors is essential for precision prevention. A cross-sectional study was conducted among 414 family members of hospitalized patients with esophageal, gastric, or colorectal cancer in Sichuan Province, China (March-October 2023). Self-reported data were collected using validated questionnaires assessing socio-demographics, cancer risk perception, and digestive tract cancer self-monitoring behaviors. Latent profile analysis (LPA) was applied to identify subgroups of monitoring behaviors, and multinomial logistic regression was used to determine influencing factors. LPA revealed three distinct behavioral profiles: poor behavior group (47.10%), average behavior group (38.16%), and good behavior group (14.74%). The mean total self-monitoring score was 2.76 ± 0.69. Multivariate analysis showed that low educational level, family per capita monthly income ≤ 2000 CNY, and not living with patient were significant risk factors for poor monitoring behaviors. Conversely, having existing chronic disease and higher cancer risk perception were strongly associated with better monitoring performance. Nearly half of family members of digestive tract cancer patients exhibit insufficient self-monitoring of early symptoms. Education level, family per capita monthly income, cohabitation, comorbidity, and cancer risk perception are key determinants of behavioral heterogeneity. Tailored, risk-profile-based interventions that enhance risk awareness and promote regular screening are urgently needed to strengthen family-centered cancer prevention. Show less

The utility of coronary artery calcium (CAC) scoring in individuals with elevated lipoprotein(a) [Lp(a)] for atherosclerotic cardiovascular disease (ASCVD) risk assessment is currently unclear given the propensity of Lp(a) toward noncalcified plaque. The authors aimed to evaluate the interaction between elevated Lp(a) (>50 mg/dL) and CAC score, and the association of Lp(a) with ASCVD risk across strata of CAC. A pooled cohort of participants without known ASCVD from 4 U.S.-based prospective cohort studies with baseline Lp(a) and CAC measurements was used. The association between elevated Lp(a) across CAC strata and incident ASCVD (myocardial infarction, stroke, coronary revascularization) was evaluated in multivariable Cox regression models. The study included 11,319 participants (mean age 56 years, 54% women) with 1,569 incident ASCVD events over 14.8 year mean follow-up. Lp(a) >50 mg/dL (HR: 1.24; 95% CI: 1.09-1.41) and CAC >0 (HR: 2.44; 95% CI: 2.14-2.77) were independently associated with ASCVD risk (P interaction = 0.80). Among individuals with CAC = 0, ASCVD incidence rates were low overall, but higher with Lp(a) >50 mg/dL vs ≤50 mg/dL (4.9 vs 3.8/1,000 person-years, HR: 1.28; 95% CI: 1.01-1.60). Among those with CAC >0, increased risk was again noted with elevated Lp(a) (21.2 vs 18.2/1,000 person-years, HR: 3.03; 95% CI: 2.52-3.64). Similar results were observed when examining further CAC strata with the greatest risk noted with both CAC ≥300 and Lp(a) >50 mg/dL (HR: 6.12; 95% CI: 4.80-7.81). Consistent results were noted by age and sex with greater absolute risk in general among individuals >50 years of age and men. Elevated Lp(a) is associated with higher relative risk across CAC strata, including CAC of 0. Among individuals with CAC of 0, absolute event rates remain low even when Lp(a) is elevated. CAC scoring remains a powerful tool for risk assessment among individuals with elevated Lp(a). Show less

Lipoprotein(a) (Lp(a)) is increasingly recognised as an independent and causal risk factor for atherosclerotic cardiovascular disease. Although the underlying mechanisms remain incompletely defined, evidence supports a multifactorial role for Lp(a) in atherogenesis. Lp(a) contributes to endothelial dysfunction, promotes vascular inflammation and enhances lipid retention and oxidation within the arterial wall. These changes drive foam cell formation and smooth muscle cell activation, hallmarks of early plaque development. In addition, Lp(a) exerts prothrombotic effects through structural homology with plasminogen, interfering with fibrinolysis and promoting thrombosis, which may increase the risk of plaque rupture and acute events. Collectively, these overlapping mechanisms underscore the unique contribution of Lp(a) to both the development and progression of atherosclerosis. As novel targeting therapies emerge, a deeper understanding of Lp(a) biology will be essential for translating these insights into clinical benefit. Show less

The effects of extruded flaxseed-pulse mixture (LinPRO-24) on growth performance, tissue fatty acid composition, carcass traits, and meat quality in broilers were investigated. A total of 540-day-old male 308 Ross chicks were placed in pens (30 chicks/pen) and allocated to three diets (n = 6) in a completely randomized design. The diets were: CON (basal corn-soybean meal diet); LPA (CON+2.5% LinPRO-24); and LPB (CON+ 5.0% LinPRO-24). Diets were isocaloric and isonitrogenous, formulated for starter (day 1-10), grower (day 11-24), and finisher (day 24-34). Feed intake and body weight (BW) were recorded daily, and mortalities as they occurred to calculate average daily gain (AWG) and FCR. On day 34, visceral organs, breast tissue, and leg tissue were sampled. The CON group exhibited higher overall BW, AWG, and AFI than LPB (P < 0.05). Breast and leg tissues of birds fed LPB had the highest concentration of Alpha-linolenic acid (ALA) and total ω-3 PUFA followed by LPA; both had a higher ALA concentration than the CON group (P < 0.05). Thus, the ω-6:ω-3 ratio in these tissues was lower for LPA and LPB groups (P < 0.05). Additionally, both LPA and LPB groups had lower Docosatetraenoic acid (DTA, C22:4 ω-6), higher Docosapentaenoic acid (DPA, C22:5 ω-3) and total PUFA content, resulting in a reduced SFA:PUFA ratio in leg tissue compared with the CON group (P < 0.05). However, LPB negatively affected the water-holding capacity (WHC) in breast meat compared with the CON and in leg tissue compared with LPA treatment (P < 0.05). Moreover, LPB increased muscle hardness and gumminess in the breast compared with the CON group (P < 0.05), thereby negatively affecting meat textural qualities. Overall, both LPA and LPB diets increased the ω-3 PUFA content in poultry meat, thereby reducing the ω-6:ω-3 ratio. However, the current study suggests that the use of LinPRO-24 at 2.5% may be more appropriate for improving the fatty acid profile of broiler meat without compromising production performance and meat quality. Show less

Research focused on adult eating styles would benefit from investigating whether latent profiles of appetitive and emotion-related impulsivity traits differ in eating disorder (ED) and general psychopathology. This study identified and validated latent eating profiles based on appetitive and emotion-related impulsivity traits. We conducted a cross-sectional study in a non-clinical sample of 232 adults who completed an online battery of questionnaires assessing appetitive traits, emotion-related impulsivity, ED symptomatology, anxiety, depression, stress, and other clinical and background characteristics. We fitted latent profile analysis (LPA) models with 2-8 classes on the dataset without multivariate outliers (N = 223). After retaining the best profile solution, we compared latent classes using ANCOVAs and Tukey post-hoc tests, controlling for age. The best-fitting model revealed four distinct profiles: Resilient Eaters (23.30%), with the lowest food responsiveness and emotion-related impulsivity; Moderate Eaters (46.27%), showing higher food avoidance and behavioral emotion-related impulsivity; Hedonic Eaters (14.03%), characterized by the highest enjoyment of food and lower emotion-related impulsivity; and Impulsive Eaters (16.40%), with the highest food responsiveness and emotion-related impulsivity. Resilient Eaters exhibited the most adaptive profile, with higher general and ED-specific flexibility and lower general ED psychopathology, depression, anxiety, and stress, compared to Moderate and Impulsive Eaters. Moderate and Hedonic Eaters showed intermediate levels of ED symptomatology and psychological distress, whereas Impulsive Eaters displayed the most maladaptive profile. Classifying eating profiles based on appetitive and impulsive traits has the potential to advance screening for complex forms of ED psychopathology. Show less

This study aimed to identify distinct in-hospital cardiac rehabilitation (CR) adherence profiles and explore their associated clinical and sociodemographic factors among patients following percutaneous coronary intervention (PCI). A cross-sectional survey was conducted among patients undergoing Phase I cardiac rehabilitation following percutaneous coronary intervention (PCI) who were hospitalized in the cardiology department between June and July 2025 (n=384). Data were collected using a general information questionnaire and a treatment adherence questionnaire (Since the study population consisted of inpatients undergoing PCI followed by phase I cardiac rehabilitation, the dimension of follow-up compliance was excluded). LPA, a person-centered method that identifies unobserved subgroups (profiles) based on response patterns, was prespecified to classify CR adherence profiles. Multinomial logistic regression was performed to examine factors associated with profile membership. Clinical indicators (number of diseased vessels, LVEF, LDL-C, and serum creatinine) were included as candidate predictors; after LASSO selection, LDL-C and number of diseased vessels were retained and entered the final multinomial logistic regression model as continuous variables (original values). Three distinct CR adherence profiles were identified: Low CR Adherence (125/384, 32.55%), Medium CR Adherence (169/384, 44.01%), and High CR Adherence (90/384, 23.44%). Profile membership was significantly associated with gender, living situation, family monthly income, residential distance, smartphone use/proficiency and LDL-C ( CR adherence among post-PCI patients was overall moderate-to-low, with substantial heterogeneity across adherence patterns. The associated sociodemographic and contextual factors may help inform profile-based, tailored support to improve CR adherence after PCI. Given the cross-sectional design, these associations are non-causal and should be validated in future multicenter longitudinal and intervention studies. Show less

Nurses' voice behavior is critical for patient safety and organizational improvement. However, its manifestation is not uniform among nurses. This study aimed to identify latent profiles of nurses' voice behavior using Latent Profile Analysis (LPA) to understand this heterogeneity and explore its influencing factors, with a specific focus on differences across work motivation dimensions (rooted in Self-Determination Theory, SDT). A multicenter cross-sectional design was adopted. Data from 701 clinical nurses across six hospitals in Guangxi Province were analyzed: LPA identified four distinct profiles, and Multinomial Logistic Regression was used to examine predictors. Work motivation was measured by the Multidimensional Work Motivation Scale (MWMS), and voice behavior by the Voice Behavior Scale (VBS). LPA identified four distinct profiles (Conservative, 5.42%; Balanced Risk-Taker, 26.39%; Transitional, 34.38%; Challenging, 33.8%), and Multinomial Logistic Regression was used to examine predictors. Work motivation was measured by the Multidimensional Work Motivation Scale (MWMS), and voice behavior by the Voice Behavior Scale (VBS). Results showed autonomous motivation (e.g., intrinsic drive) strongly predicted active voice behavior, while amotivation predicted conservative profiles. Nurses exhibited high work motivation (MWMS: 93.02 ± 21.09) and moderately high voice behavior (VBS: 39.27 ± 8.736). The research found that nurses exhibited high work motivation and moderately high voice behavior, with autonomous motivation being a pivotal predictor. Differentiated strategies targeting intrinsic motivation enhancement are critical for fostering nursing innovation and improving care quality. Show less

To assess the predictive value of serum lipoprotein(a) [Lp(a)] for contrast-induced nephropathy in patients with type 2 diabetes mellitus (T2DM). Consecutive T2DM patients who underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI) between January 2019 and December 2021 were enrolled. Baseline Lp(a) was measured before the operation. CIN was defined as an increase in serum creatinine of more than 25% or 44 μmol within 72 h of contrast administration. The relationship between Lp(a) and CIN risk was analyzed. A total of 928 T2DM patients were included. CIN developed in 11.1% (103/928) of patients. The Lp(a) level was significantly higher in patients with CIN than in non-CIN patients (311.12 ± 278.66 vs. 254.19 ± 274.56 mg/L, A higher serum Lp(a) level indicates an increased risk of CIN in T2DM patients undergoing CAG or PCI and can serve as an independent predictor of CIN in this population. This study's findings will aid in the clinical prevention and treatment of contrast agent-induced kidney disease. Show less

Resilience is a critical indicator of the personal recovery process for people with serious mental illness (SMI). However, little is known about resilience subtypes among this population. Grounded in Kumpfer's resilience model (KRM), the study aims to identify latent types of resilience among people with SMI using latent profile analysis (LPA). A cross-sectional survey design was used. A total of 297 individuals with self-reported SMI completed an online survey, including demographic variables and measures that resemble core components of the KRM. The LPA identified three resilience profiles: Maladaptive, Homeostatic and Resilient. One-way analyses of variance (ANOVA) revealed distinct patterns of the three resilience profiles on all factors in the KRM and the outcome variable-adaptation to psychiatric disability. ANOVA and Chi-square tests indicated several demographic variables predict profile membership, including age, marital status, highest educational attainment, employment status, average weekly work hours and primary SMI diagnosis. However, sex, race-ethnicity, annual income and years since SMI diagnosis do not predict profile membership. The study contributes to the understanding of resilience subtypes and associated protective and risk factors for resilience among people with SMI, suggesting early, tailored strength-based interventions to promote resilience and personal recovery. Show less

Risk estimation tools have been developed to predict coronary heart disease (CHD) in type 2 diabetes (T2D). To evaluate augmentation following the addition of lipoprotein(a) [Lp(a)] to risk calculation, we performed a pilot study. A total of 90 successive T2D patients were included. Details of clinical and biochemical features were obtained. Lp(a) was determined using ELISA. CHD risk estimation was performed using Framingham, QRISK-3, SCORE-2D, INTERHEART, and European Atherosclerosis Society (EAS) algorithms with and without Lp(a). Descriptive statistics are reported. Mean age of patients was 55.0 ± 8 years, BP systolic/diastolic 133.7 ± 12/95.0 ± 9 mm Hg, body mass index (BMI) 26.0 ± 1.9 kg/m Substantial variation in coronary artery disease (CAD) risk prediction using various clinical algorithms is observed in T2D. The EAS algorithm provides the most robust estimate. The addition of Lp(a) to the risk algorithms augments risk stratification significantly. The results of this pilot study need confirmation with larger prospective studies. Show less

Problematic mobile phone use (PMPU) has become a prominent public health concern among Chinese adolescents and emerging adults, yet prior research has largely relied on variable-centered approaches that overlook within-group heterogeneity and provide limited insight into multilevel mechanisms. To address these gaps, this study adopted an integrated analytic framework combining latent profile analysis (LPA), structural equation modeling (SEM), and psychological network analysis. A total of 2345 Chinese university students completed measures of alexithymia (TAS-20), social interaction anxiety (IAS), and PMPU (MPAI). LPA identified three distinct PMPU profiles: Low-risk (62.7%), moderate-risk (24.8%), and high-risk (12.5%). SEM results indicated that alexithymia was positively associated with PMPU in the overall sample, with social interaction anxiety partially mediating this association. Profile-specific analyses further showed that the indirect pathway was significant in the low-risk and moderate-risk profiles but not in the high-risk profile, in which only a direct effect emerged. Network analyses in the low- and moderate-risk groups revealed profile-specific central and bridge nodes, primarily IAS items, highlighting potential symptom targets linking alexithymia and PMPU. Overall, findings underscore meaningful heterogeneity in PMPU and support profile-tailored prevention and intervention strategies emphasizing emotion-processing skills and social anxiety reduction. Show less

Child maltreatment measurement has been a longstanding issue, with discrepancies across administrative records, parent-reports, and self-reports. One proposed solution is "triangulation," or integrating data from multiple reporters and sources. However, it remains unclear how best to operationalize this concept. This study examines the concept of "triangulation" by employing different analytic methods to determine whether these methods reveal a common underlying construct of physical abuse and whether they predict adult depression. Data come from the Lehigh Longitudinal Study, a 40+ year prospective study that began in the 1970s with children ages 18 months to 6 years of age. Data were collected in early childhood, middle childhood, adolescence, and adulthood (ages 36 and 46, on average). We applied five analytic approaches - network analysis, ordinary least squares (OLS) regression, structural equation modeling (SEM), latent profile analysis (LPA), and a cumulative index regression - to assess the relationships among multiple reporters of childhood physical abuse and adult depression. SEM best modeled the latent construct of physical abuse and significantly predicted adult depression, with adult self-reports playing a particularly strong role. Network analysis also highlighted strong intercorrelations among self-reports and meaningful links with depression. SEM and network analysis were the most informative for triangulation and prediction of adult depression. Adult self-reports of abuse were most related and most predictive of adult depression. Show less

Inserting a sulfur atom into the 1,2-dithiolane ring of lipoic acid (LA racemate) is a promising approach for improving the diversity of lipoic acid (LA racemate). For this purpose, we prepared 1,2,3-trisulfur-lipoic acid derivatives (trisulfur lipoic acid ( Show less