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Capillary zone electrophoresis (CZE)-mass spectrometry (MS) has attracted tremendous attention in top-down proteomics (TDP). However, its reproducibility and long-term repeatability for TDP remain concerns, most likely due to capillary coating. Here, we present an improved procedure for making linear polyacrylamide (LPA) coating, the most widely used coating in CE-MS-based proteomics, to boost the reproducibility and long-term repeatability of CZE-MS-based TDP. We focused on the step of degassing the polymerization solution, a critical step for achieving consistent LPA coating quality. The CZE-MS system using LPA-coated capillaries prepared with the optimal degassing procedure produced excellent reproducibility and repeatability for proteoform analysis. The 210 CZE-MS runs of three protein samples (a standard protein mixture, an Show less

Research using latent profile analysis (LPA) has yielded inconsistent results regarding the number of personality profiles among athletes, the specific configuration of the Big Five traits, and their interpretation. This study seeks to explore personality types by excluding additional variables from the LPA model, aiming to assess how well personality profiles are universal (independent of gender and cultural context) and can predict academic achievement in student athletes. A cross-sectional study was conducted using a paper-and-pencil questionnaire among 424 student athletes from two universities in Poland and Ukraine. The average age of participants was 20 years old ( Show less

Latent structure analysis methods, including latent profile analysis (LPA), latent class analysis (LCA), item response theory (IRT), exploratory factor analysis (EFA), and confirmatory factor analysis (CFA), are widely used in psychological and educational research to model unobserved constructs and identify heterogeneity across individuals. However, applying these methods often requires advanced statistical expertise and the use of multiple specialized software packages with different workflows, which can limit accessibility and increase analytical complexity. This paper introduces Show less

Increased lipoprotein(a) (Lp[a]) is a genetically determined causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Historically, Lp(a) testing has been uncommon in Australia. This study aims to assess the prevalence and trends in Lp(a) testing in Australia, and the associated patient characteristics. This retrospective cross-sectional study examined over 1.1 million de-identified electronic medical records from patients seen in the Advara HeartCare network from 2011 to 2022. Adult patients from 2011 to 2021 comprised the historical group, while those from 2022 formed the baseline group. A natural language processing algorithm identified patients with ASCVD and Lp(a) testing, and extracted demographics, characteristics, and cardiovascular comorbidities from clinical letters. Patients with ASCVD in the baseline group were followed up for 18 months to assess trends in Lp(a) testing. Testing Lp(a) was infrequent among patients with ASCVD but increased gradually over time. In the historical cohort, of 164,121 patients identified with ASCVD, 1,501 (0.9%) underwent Lp(a) testing. Of these, 44.8% had Lp(a) levels <30 mg/dL, and 25.0% >90 mg/dL. In the baseline cohort, 1,460 (2.6%) of 55,427 patients with ASCVD underwent Lp(a) testing. Of 730 with recorded Lp(a) values, 30.2% had Lp(a) levels ≥70 mg/dL, and 86.8% were on lipid-lowering therapy. Dyslipidaemia was the most common comorbidity (72.8%), followed by Stage 1 or 2 chronic kidney disease (40.1%). During 18-month follow-up from the baseline period, 329 additional patients underwent Lp(a) testing in 2023. The study revealed that Lp(a) testing is underutilised among patients with ASCVD in Australia despite recent guidelines recommending it. This emphasises the need to expand Lp(a) testing to improve health outcomes for high-risk patients. Show less

Lysophosphatidic acid (LPA) is a bioactive lipid that signals through G protein-coupled receptors (LPA1-6) and regulates multiple cellular processes, including fibrosis. Although LPA signaling has been implicated in fibrotic diseases in several organs, its role in skeletal muscle remains unclear. Here, we show that LPA/LPA1 signaling promotes fibrogenesis after sciatic nerve transection. Denervation induces differential expression of LPA signaling axis components and a transient early increase in intramuscular LPA levels. Pharmacological inhibition of LPA1/3 with Ki16425, or genetic deletion of LPA1, reduces extracellular matrix accumulation and expansion of fibro/adipogenic progenitors (FAPs) in denervated muscle. Although LPA blockade suppresses atrophy-related gene expression, it does not fully preserve myofiber size. Mechanistically, denervation increases YAP/TAZ expression, nuclear localization in FAPs, and transcriptional activity, effects that are attenuated by LPA axis inhibition. Furthermore, pharmacological inhibition of YAP/TAZ with verteporfin reduces fibrosis after denervation, supporting their role as critical downstream mediators. Finally, transient denervation activates the LPA axis, promotes muscle fibrosis, reduces axonal density in the sciatic nerve, and increases neuromuscular junction instability, effects reversed by Ki16425. Together, these findings identify the LPA/LPA1/YAP/TAZ pathway as a key driver of denervation-induced muscle fibrosis and a potential therapeutic target in neuromuscular disorders. Show less

Fluoroquinolones (FQs) are key components of World Health Organization (WHO)-recommended regimens for multidrug-resistant tuberculosis (MDR-TB). Accurate detection of FQ resistance is essential for optimizing treatment. This study evaluated the concordance between the Second-Line Line Probe Assay (SL-LPA) and Liquid Culture Drug Susceptibility Testing (LC-DST) for detecting FQ resistance in Mycobacterium tuberculosis isolates. In this retrospective study, 1402 non-duplicate clinical isolates of MDR TB were tested using SL-LPA and LC-DST at a reference laboratory. Genotypic resistance was identified through mutations in the gyrA and gyrB genes identified by SL-LPA, while phenotypic resistance was determined using MGIT-based LC-DST at critical concentrations for fluoroquinolones. Targeted nanopore sequencing was performed on a subset of isolates with discordant molecular and phenotypic results to investigate resistance-associated mutations. SL-LPA detected FQ resistance in 907 (64.7%) isolates, whereas LC-DST identified resistance in 852 (60.8%) isolates. Using LC-DST as the reference standard, SL-LPA showed a sensitivity of 93.2%, specificity of 98.6%, positive predictive value of 99.2%, and negative predictive value of 88.7%. Overall concordance between the two methods was observed in 1292 (92.2%) isolates. Discordant results occurred in 110 (7.8%) isolates, mainly involving low-level resistance mutations or inferred resistance due to missing wild-type bands on SL-LPA. Nanopore sequencing of 15 discordant isolates identified high-confidence mutations (Asp94Tyr, Asp94Gly, Asp94Asn) and interim or low-confidence mutations (Ala90Val, Ser91Pro, Asp94Ala, gyrB Asn499Asp, Asp461Asn). SL-LPA demonstrates excellent specificity and positive predictive value for detecting FQ resistance; however, discordance associated with low-confidence mutations and heteroresistance highlights the importance of integrating molecular assays with phenotypic DST and sequencing to improve MDR-TB resistance detection and guide treatment decisions. Show less

Elevated lipoprotein(a) (Lp(a)) and Lp(a)-raising genetic variants (e.g. rs3798220) are independent cardiovascular risk factors lacking preventive strategies. Given the prothrombotic properties attributed to high Lp(a), aspirin was hypothesized to confer benefit in primary prevention. We performed a systematic review and meta-analysis to evaluate the impact of aspirin on cardiovascular and bleeding outcomes in this population. MEDLINE, Web of Science and CENTRAL were searched (November 2025) for randomized and observational studies assessing aspirin use in primary prevention among individuals with Lp(a) ≥ 50 mg/dL or Lp(a)-associated genetic variants. The primary outcome was major adverse cardiovascular events (MACE). Secondary outcomes included myocardial infarction (MI), coronary artery disease (CAD), cardiovascular mortality, and bleeding. Random-effects meta-analyses pooled the Hazard ratios (HR) with 95% confidence intervals (CI). Certainty of evidence was assessed using GRADE. Seven studies including 6498 participants met inclusion criteria. Aspirin was not associated with a reduction in MACE (HR 0.99, 95% CI 0.79-1.24; I Aspirin was not associated with a reduction of MACE among individuals with elevated Lp(a). A potential benefit for MI requires confirmation in adequately designed and powered prospective studies. Pooled data from rs3798220-C carriers suggest a potential significant benefit that warrants further investigation REGISTRATION: PROSPERO identifier no. CRD42024520731. Show less

In recent studies elevated lipoprotein(a) (Lp(a)) levels have been identified as an independent and causal risk factor for atherosclerosis and coronary heart disease. This study aims to perform a comparative early health technology assessment (HTA) of olpasiran and pelacarsen for secondary prevention of coronary heart disease (CHD) in patients with atherosclerotic cardiovascular disease, familial hypercholesterolemia, and elevated Lp(a). We developed a Markov state transition model to simulate the progression of a cohort of 597 patients with history of coronary heart disease (CHD) as myocardial infarction, coronary artery disease or peripheral artery disease, familial hypercholesterolaemia in the treatment arms of OCEAN(a)-Outcomes trial (NCT05581303) [16] and Lp(a) HORIZON trial (NCT04023552). Baseline risks of CHD, costs and utilities were obtained from published sources. Clinical trial data were used to derive reductions in lipoprotein(a). Mendelian randomization study data were used to estimate clinical benefits. Annual discounting was 3.5%. The treating strategy comprising olpasiran 150 mg every 3 months in addition to standard of care saved 3.29 QALYs, compared with standard of-care alone. With 3.5% annual discounting, there were 0.23 QALYs saved. The treating strategy comprising pelacarsen 80 mg every month in addition to standard of care saved 8.63 QALYs, compared with standard of-care alone (undiscounted). With 3.5% annual discounting, there were 0.58 QALYs saved. We found that olpasiran was highly cost-effective at the annual price of 10,424.78 BGN, compared with standard-of-care alone. Pelacarsen was highly cost-effective at the annual price of 6105.99 BGN. The threshold applied is that of gross domestic product (GDP) per capita as indicated by the National Council on prices and reimbursement of medicinal products in Bulgaria. Show less

Previous studies indicate that ambulance personnel have an increased risk of ill health. Shift work and time spent on physical behaviours during work and leisure are factors that could be related to health, however the research is limited. Thus, the aim of this study was to describe patterns of physical behaviours during and after work among Swedish ambulance personnel and to analyse the associations between physical behaviours and different work shifts. In this observational study, the physical behaviours of 63 ambulance personnel were measured over seven days using two accelerometers. Accelerometer data was processed using the MATLAB program Acti4, to identify physical behaviours i.e. sleep, being sedentary, light physical activity (LPA), and moderate to vigorous physical activity (MVPA), during and after work. To determine the association between shift types (independent) and patterns of physical behaviours (dependent), a Multivariate Analysis of Variance was performed on data processed according to compositional data analysis. At work, the highest proportion of both MVPA and being sedentary occurred during day shifts, compared to night and 24-h shifts (MVPA: 7% vs 4% and 5%; sedentary time: 62% vs 44% and 54% respectively). Night and 24-h shifts included 31% and 18% sleep, respectively. During the after-work periods, the highest proportions of MVPA were observed after 24-h shifts (8%). Overall, there was no statistically significant difference in physical behaviours during work and after work for various shift types. However, in a sub-analysis restricted to night and 24-h shifts, a statistically significant association between shift type and composition of physical behaviours during work was observed (η In general, ambulance personnel were physically active both during and after work. At the same time, work hours entailed a substantial amount of sedentary time. Shift type was not associated with the pattern of physical behaviours among ambulance personnel. However, during 24-h shift a lower proportion of the time was spent sleeping compared to during night shift. Studies with larger sample sizes are needed to confirm these results. The online version contains supplementary material available at 10.1186/s12889-026-27335-y. Show less

Lipoprotein(a) [Lp(a)] is a genetically determined, highly atherogenic lipoprotein that contributes to cardiovascular disease and calcific aortic valve stenosis. Increased Lp(a) levels warrant intensified management of cardiovascular risk factors. With targeted Lp(a)-lowering therapies in clinical development, identification of individuals with increased levels has increasing therapeutic implications. Guidelines differ, recommending testing in either high-risk groups or universally once in a lifetime, yet testing rates remain low. We performed a retrospective analysis of laboratory data from a large tertiary referral centre in Queensland, Australia, evaluating trends in Lp(a) testing between 1 January 2015 and 31 December 2024. Lp(a) testing increased markedly over the 10-year study period. In Queensland, annual test volumes rose from 652 in 2015 to 4,364 in 2024. Including interstate referrals, test numbers increased from 2,686 in 2015 to 23,135 in 2024. The steepest rise occurred in the final 2 years of observation. Despite these increases, testing rates relative to the screened population remained low, and testing generally occurred late in individuals in their 50s. Lp(a) testing has grown substantially in Queensland and Australia over the past decade, likely reflecting increased recognition of its causal role in cardiovascular disease, evolving guideline recommendations, test accessibility, and the emergence of novel therapies. However, overall testing remains limited. Broader implementation of guideline-based testing and greater clinician awareness will be critical to ensure timely identification of individuals who may benefit from available and emerging therapeutic strategies. Show less

Elevated lipoprotein(a) [Lp(a)] is associated with a higher risk of atherosclerotic cardiovascular disease (ASCVD). Although Lp(a) is a genetically determined risk factor, the plasma proteomic features associated with Lp(a) and whether they provide information about ASCVD risk beyond Lp(a) concentration are not well characterized. We sought to identify plasma proteomic features associated with Lp(a) concentration and to evaluate whether an Lp(a)-associated proteomic signature is associated with ASCVD phenotypes in young, healthy adults. In the Coronary Artery Risk Development in Young Adults (CARDIA) study, we measured Year 7 Lp(a) and 184 cardiovascular proteins using the Olink proximity extension assay in 3,920 participants without prior coronary heart disease. Lp(a)-associated proteomic signatures were derived using LASSO regression in a split-sample design and tested for association with coronary artery calcification (CAC), incident CHD, and hs-CRP over 27 years of follow-up. External replication was performed in the UK Biobank (n=37,996). Lp(a) was associated with CAC (OR 1.23 [1.13-1.34]; p<0.0001) and incident CHD (HR 1.23 [1.07-1.41]; p=0.004). Lp(a) correlated with proteomic features reflecting immune activation, coagulation, and vascular dysfunction. A quantitative Lp(a) proteomic score was independently associated with incident CAC (standardized beta = 0.40, p<0.0001) and hs-CRP (standardized beta = 0.11, p = 0.00015) after adjustment for Lp(a) concentration. In the UK Biobank, a recalibrated Lp(a)-associated proteomic score was associated with CRP, incident CHD, and all-cause mortality. In young adults, Lp(a) is associated with distinct proteomic features that independently predict ASCVD phenotypes beyond Lp(a) concentration, generating hypotheses regarding biological pathways linked to Lp(a)-related cardiovascular risk. Show less

Intermediate monocytes (IM) exhibit proinflammatory properties and contribute to atherosclerosis. Elevated lipoprotein(a) [Lp(a)] levels modulate monocyte behavior, while proprotein convertase subtilisin/kexin type 9 (PCSK9) has been implicated in inflammatory pathways beyond lipid metabolism. The effects of PCSK9 inhibition on monocyte subset distribution in high-risk coronary artery disease patients remain unclear. To assess the effects of lipoprotein fractions and PCSK9 inhibitor (PCSK9i) therapy on monocyte subset distribution in patients with stable coronary artery disease and highly elevated Lp(a) levels. We followed 100 statin-treated patients in the stable phase after myocardial infarction with highly elevated Lp(a), randomized to PCSK9i or placebo for six months. Biochemical, genetic, and cellular analyses were performed at baseline and follow-up. At baseline, IM levels correlated with total cholesterol (ρ = -0.202, In high-risk patients, PCSK9 inhibition modulates monocyte-lipoprotein interactions without affecting the monocyte subset distribution. PCSK9 may promote vascular inflammation through CCL2 regulation, which appears more closely related to Lp(a) composition than its circulating concentration. NCT04613167; https://www.clinicaltrials.gov/study/NCT04613167, date of registration: 6th of October 2020. Show less

To explore the latent profiles of self-stigma and their relationship with meaning in life among individuals with substance use disorders(SUDs). A total of 1001 participants were recruited from six drug rehabilitation centers in Sichuan Province between July and August 2025 and completed the self-stigma Scale for Drug Addicts (SSSDA) and the Meaning in Life Questionnaire (MLQ). Latent profile analysis (LPA) was used to identify latent profiles of self-stigma. Multinomial logistic regression was employed to analyze influencing factors, and analysis of variance (ANOVA) was used to compare differences in meaning in life across the different profiles. The self-stigma of individuals with SUDs can be categorized into four latent profiles: the "stigma-resistant profile"(10.0%), "moderate stigma-concealment profile"(46.3%), "internalized stigma profile"(19.5%), and "low internalization-adaptation profile"(24.3%). Among these, the "moderate stigma-concealment profile", "internalized stigma profile", and "low internalization-adaptation profile" represent categories with higher levels of self-stigma. Risk factors associated with these profiles include male sex, low income, a history of being left-behind children, low social support, multiple rehabilitation attempts, as well as mental illness or HIV infection. Statistically significant differences were found among the four profiles in the total score of meaning in life and its sub-dimensions-presence of meaning and search for meaning (p < 0.001). The "stigma-resistant profile" presented the highest level of MIL, whereas the "internalized stigma profile" presented the lowest level. Significant heterogeneity exists in self-stigma among individuals with substance use disorders (SUDs), and the level of self-stigma is significantly negatively correlated with MIL. Show less

Insufficient physical activity is prevalent among perinatal women, and digital health interventions offer a promising avenue to promote engagement in physical activity within this population. However, previous studies have relied heavily on self-reported data, lacking a systematic synthesis based on objective measurements. This study aims to systematically evaluate the effects of digital health interventions on objectively measured physical activity and sedentary behavior in perinatal women. A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library databases from inception to December 20, 2025. Fourteen randomized controlled trials (RCTs) involving 2,101 participants were included. The Risk of Bias 2.0 (RoB 2.0) tool was used to assess bias risk, random-effects models were employed to pool effect sizes, and the quality of evidence was evaluated using the GRADE system. The meta-analysis showed that, following the exclusion of outliers via sensitivity analysis, digital health interventions significantly increased daily step counts (MD = 0.68, Digital health interventions can effectively and robustly enhance daily baseline activity levels in perinatal women, with the observed increments potentially reaching the minimal effective dose for improving metabolic health. However, current intervention designs face challenges in driving high-intensity behavior change and disrupting sedentary habits. Future research should explore more targeted and personalized intervention strategies. This systematic review and meta-analysis has been registered in PROSPERO (www.crd.york.ac.uk/prospero), identifier CRD420261280936. Show less

Public responses to climate change are influenced by interpretations of scientific information and individual differences. Understanding these factors can improve targeted climate communication. We conducted a nationally representative survey of Lithuanian adults ( LPA using three climate-belief indicators supported a two-class solution among respondents with complete data ( The findings reveal heterogeneity in climate-change beliefs in Lithuania and suggest that audience segmentation and psychologically informed communication strategies may enhance climate-related science communication. Show less

Tetralogy of Fallot with pulmonary atresia (ToF-PA) requires precise delineation of extracardiac pulmonary blood supply to guide optimal palliation, especially in duct-dependent physiology. We report an 8-month-old infant with late-onset central cyanosis and recurrent cry-triggered hyper cyanotic spells. Computed tomography (CT) thoracic angiography showed classic ToF with short-segment pulmonary atresia, a malaligned perimembranous ventricular septal defect, and hypoplastic yet confluent branch pulmonary arteries. A long, tortuous patent ductus arteriosus (PDA) provided dominant pulmonary flow, with severe focal juxtaductal stenosis just before insertion into the left pulmonary artery and reduced distal pulmonary arborization. A small ostium secundum atrial septal defect was identified. Minor systemic collaterals were seen, without large dominant major aortopulmonary collateral arteries, suggesting duct-dominant physiology potentially amenable to pulmonary artery rehabilitation. This case highlights late deterioration from progressive PDA-left pulmonary artery narrowing and underscores CT angiography as a key decision map for catheter or surgical palliation and operative planning. Show less

Lipoprotein(a) [Lp(a)] has emerged as a critical determinant of residual cardiovascular risk. However, its impact on plaque morphology remains underinvestigated. This study aimed to elucidate the relationship between the serum Lp(a) levels, coronary plaque vulnerability, and vascular remodeling characteristics by utilizing intravascular ultrasound (IVUS). We retrospectively enrolled 292 consecutive patients with coronary artery disease who underwent IVUS. Target lesions were classified into vulnerable (n = 83) or stable (n = 209) plaque groups based on the IVUS criteria. Multivariate binary logistic regression was performed to identify independent predictors. The morphological parameters were further compared between the high (＞18.8 mg/dL) and low (≤ 18.8 mg/dL) Lp(a) groups. The vulnerable plaque group exhibited significantly higher median serum Lp(a) levels than the stable group (14.56 vs. 11.04 mg/dL, P = 0.011). After adjusting for age, sex, LDL-C, smoking, diabetes, and hypertension, Lp(a) ＞18.8 mg/dL remained an independent predictor of plaque vulnerability (OR = 1.76; 95% CI: 1.00-3.07; P = 0.049). Notably, the LDL-C levels did not predict vulnerability in this cohort. Furthermore, the high Lp(a) group demonstrated significantly larger vascular dimensions (EEM CSA: 14.67±4.95 vs. 13.22±4.20 mm Elevated serum Lp(a) levels are independent predictors of coronary plaque vulnerability. The underlying mechanism involves Lp(a) promoting compensatory vascular enlargement, accompanied by an increased plaque volume. These findings underscore the necessity of Lp(a) screening to identify any residual risk, particularly in patients with effectively controlled low-density lipoprotein cholesterol (LDL-C). Show less

Aortic aneurysm (AA) is a life-threatening vascular disease with high fatality upon rupture. While physical activity (PA) reduces cardiovascular risk, its role in AA prevention remains uncertain, particularly when assessed objectively. We analyzed 93,165 UK Biobank participants (56% women; median age 57 years) with valid 7-day wrist-worn accelerometer data. PA was categorized as light (LPA), moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA). Diagnosed AA was ascertained through linked hospital, death, and primary care records. Cox models estimated hazard ratios (HRs) for AA across quartiles and per-standard deviation (SD) increments, with adjustment for demographic, lifestyle, and cardiometabolic factors. Over a median 7.9-year follow-up, 499 clinically recorded AA cases occurred. Higher accelerometer-measured PA was inversely associated with AA risk. Per-SD increments in total PA, MPA, VPA, and MVPA corresponded to 17%, 22%, 19%, and 23% lower risks, respectively. Compared with the lowest quartile, the highest MVPA quartile had a 44% lower AA risk (HR = 0.56, 95% CI 0.42-0.76). Subtype analyses revealed stronger protective effects for abdominal aortic aneurysm (AAA) than thoracic aortic aneurysm (TAA), while LPA was not significantly associated. These findings demonstrate that higher levels of accelerometer-measured MVPA are robustly associated with a decreased risk of clinically detected AA in a dose-dependent manner. The associations were particularly pronounced for AAA. This study provides objective evidence supporting the potential benefits of MVPA for aortic health. Show less

Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerosis. Drug-eluting stents (DES) were developed to delay the progression of atherosclerosis. However, the diagnostic and prognostic value of Lp(a) in patients undergoing percutaneous coronary intervention (PCI) with DES remains unknown. We aim to evaluate the prognostic impact of serum Lp(a) level on cardiovascular outcomes and predictive value on repeat revascularization in patients undergoing PCI with DES. We conducted a literature search from the inception of PubMed to May 2025. Eligible studies include adult patients, with the majority (>90%) undergoing PCI with DES. Primary outcomes were the prognostic value of Lp(a) in predicting major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, cardiovascular (CV) mortality, and all-cause mortality. Secondary outcomes were the diagnostic value of Lp(a) for repeat revascularization, target vessel revascularization (TVR), and target lesion revascularization (TLR) evaluated in terms of sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). Eleven cohorts were included, comprising a total of 27,618 patients (mean age 61 ± 10.2 years, mean follow-up 4.5 ± 1.98 years). For primary outcomes, high Lp(a) level was associated with increased risks of MACE (odds ratio [OR] 1.25, 95% CI 1.09-1.42), MI (OR 1.75, 95% CI 1.08-2.83), stroke (OR 1.28, 95% CI 1.04-1.59), CV mortality (OR 1.37, 95% CI 1.02-1.83), and all-cause mortality (OR 1.29, 95% CI 1.04-1.59). For secondary outcomes, high Lp(a) level showed sensitivity of 46%, 35%, and 39% and specificity of 64%, 74%, and 79% in predicting repeat revascularization, TLR, and TVR, respectively. The AUROC for repeat revascularization, TLR, and TVR were 0.527, 0.536, and 0.537, respectively. High Lp(a) level in patients who underwent PCI with DES was associated with poor prognosis; however, the predictive value of Lp(a) in this population remains inconclusive. Show less

To compare a flow-independent, 3D isotropic non-contrast MRA (REACT), with time-resolved contrast-enhanced MRA (4D CE-MRA) for postoperative assessment of the pulmonary arteries in patients with congenital heart disease (CHD), with emphasis on different implant types. In this retrospective single-center study, 53 patients with CHD underwent clinically indicated cardiovascular magnetic resonance (CMR) including both 4D CE-MRA and REACT at 1.5T. Three radiologists independently scored image quality (IQ) as well as motion and susceptibility artifacts on 5-point Likert scales and measured the diameters of the pulmonary arteries (PAs) [main (MPA), left (LPA) and right pulmonary artery (RPA)]. Subgroup analysis was performed for stents, conduit/patch/valve (CPV), and no implant. Pooled across readers and PA segments, REACT achieved higher overall IQ than 4D CE-MRA (median 3.67 [3.00-4.17] vs. 3.00 [2.33-3.33]; p < 0.001) and provided significantly better motion scores (p < 0.001), whereas susceptibility scores were comparable between techniques. The proportion of fully diagnostic studies (3/3 segments) was similar (REACT 77.4%, 41/53; 4D CE-MRA 83.0%, 44/53; McNemar, p = 0.38). Diameter measurements showed excellent inter-reader agreement (ICC ≈ 0.89-0.95) and minimal bias between techniques; only the RPA yielded slightly smaller diameters in REACT (mean difference -0.85 ± 1.51mm, p < 0.001). In subgroup analysis, stented segments showed no IQ advantage of REACT (p > 0.99) with IQ being limited due to susceptibility artifacts in both 4D CE-MRA and REACT. In the CPV and the no implant group, REACT yielded a one point higher median IQ score (both p = 0.002) and one point less impaired by motion artifacts (CPV: p < 0.001; no implant: p = 0.002), while both techniques provided very high shares of diagnostic image quality (defined as IQ ≥ 2; both > 90%; p > 0.99). REACT enables robust, contrast-free postoperative imaging of the pulmonary arteries in patients with CHD with superior IQ and reduced motion artifacts compared to 4D CE-MRA, while maintaining highly reproducible diameter measurements. Stented segments remain a shared limitation. Show less

Research indicates that impairment of instrumental activities of daily living (IADLs) leads to reduced physical activity (PA) in daily life. However, these studies often rely on subjective measures such as questionnaires and interviews to assess PA. This study examined the association between IADL frequency and objectively measured PA in stable individuals with cardiovascular disease (CVD). In this cross-sectional study, we included people with CVD who had been receiving outpatient care under stable conditions for at least 6 months. IADL frequency was assessed using the Frenchay Activities Index (FAI). PA was measured using accelerometers over 2 weeks to calculate the daily average number of steps, low-intensity PA (LPA), and moderate-to-vigorous-intensity PA (MVPA). A multivariate linear regression model analyzed the associations between the FAI scores (total and sub-items) and PA levels. This study included 1126 stable participants with CVD (median age, 74.0 years; 278 females). After adjusting for clinical confounding factors, a high FAI total score was significantly associated with higher levels of PA (number of steps per day, unstandardized coefficient [В] = 78.1, LPA per day, В = 0.7, and MVPA per day, В = 0.2). In the FAI subitems, 4 housework and 6 leisure activities were positively associated with the daily average number of steps and LPA, and 2 leisure activities were positively associated with daily MVPA. Greater IADL frequency was associated with higher objectively measured PA in stable participants with CVD. Leisure-related activities were associated with increased MVPA, suggesting that encouraging these activities may help promote meaningful PA engagement in this population. Show less

With the widespread use of smartphones among adolescents, smartphone addiction has become a growing mental health concern. Adolescents' limited self-regulation makes them particularly vulnerable to using smartphones to escape real-life stress, heightening addiction risk. However, the heterogeneity of addictive behaviors and the dynamic role of experiential avoidance have been underexplored. This 6-month longitudinal study surveyed 547 Chinese primary and secondary students using the Smartphone Addiction Scale (SAS) and the Acceptance and Action Questionnaire-II (AAQ-II). Latent profile analysis (LPA) and latent transition analysis (LTA) were applied to identify subgroups and examine transitions between these subgroups. Cross-lagged panel network analysis (CLPN) revealed key symptom interactions between experiential avoidance and addiction. The study identified two addiction subgroups: a stable "low-risk group" (84.9 percent) and a "high-risk group," 51.4 percent of whom transitioned to low risk over time. Logistic regression showed that experiential avoidance significantly predicted high-risk membership (odds ratios [OR] = 1.083-1.102) and deterioration within the low-risk group (OR = 1.036). The CLPN identified "online intimacy" (SPA-3) and "hesitation and overcautious" (EA-7) as driver nodes, with "withdrawal symptoms" (SPA-2) serving as a central node. These findings emphasize the crucial role of experiential avoidance in adolescent smartphone addiction and suggest symptom-level targets for early intervention. The results support acceptance and commitment therapy (ACT) as a promising approach for reducing smartphone addiction among youth. Show less

We examined whether the excess cardiovascular disease (CVD) risk among adults with steatotic liver disease (SLD) subtypes could be reduced or eliminated through joint control of low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) [Lp(a)], and high-sensitivity C-reactive protein (hs-CRP). This prospective cohort study included 291,995 participants from the UK Biobank, comprising 77,187 with metabolic dysfunction-associated steatotic liver disease (MASLD), 22,190 with metabolic dysfunction and alcohol-associated liver disease (MetALD), 5474 with alcohol-associated liver disease (ALD), and 187,144 without SLD. Cox proportional hazards models were used to assess CVD risk associated with numbers of LDL-C, Lp(a), and hs-CRP controlled within the target range. During 12 years of median follow-up, 24,251 CVD events were documented, with 19,661 coronary heart disease and 5600 stroke. Among individuals with various SLD subtypes, those with all three factors controlled had the lowest risks of CVD, with HRs (95% CIs) of 0.65 (0.58, 0.72) in MASLD, 0.61 (0.49, 0.76) in MetALD, and 0.57 (0.35, 0.93) in ALD when comparing to zero-factor control. In addition, among individuals with SLD subtypes achieving all three factors within target ranges, the HRs (95% CIs) of CVD were 0.97 (0.88, 1.07) in MASLD, 0.90 (0.75, 1.08) in MetALD, and 0.63 (0.42, 0.95) in ALD, as compared with non-SLD controls. Similar association patterns were observed for coronary heart disease and stroke. Participants with various SLD subtypes who had optimally controlled LDL-C, Lp(a), and hs-CRP showed no excess or even lower risk of CVD as compared with the general population. Not available. Show less

The non-high-density lipoprotein to high-density lipoprotein cholesterol ratio (NHHR) has emerged as a comprehensive lipid index reflecting the balance between atherogenic and anti-atherogenic lipoproteins. However, evidence on how different intensities and durations of physical activity (PA) influence NHHR remains scarce, particularly in aging populations. Data were obtained from China Health and Retirement Longitudinal Study. PA was self-reported and categorized as high- (HPA), moderate- (MPA), or low-intensity (LPA). Multivariable linear regression models assessed associations between PA and NHHR, with subgroup, sensitivity, and dose-response analyses further exploring robustness. Cox regression and mediation analyses examined the associations of PA and NHHR with 10-year all-cause mortality. Higher levels of total, moderate-, and high-intensity PA were significantly associated with lower NHHR. The results were generally consistent with a graded pattern, with lower NHHR observed at higher activity durations, particularly for moderate-to-vigorous activity. Exploratory mediation analyses suggested that NHHR may partially account for the inverse association between PA and mortality. This study adds large-scale, population-based evidence on the associations between different PA intensities and NHHR. Regular moderate-to-vigorous PA is associated with more favorable lipid profiles and lower mortality risk. These findings highlight NHHR as a valuable biomarker linking physical activity to cardiometabolic health and longevity in middle-aged and older adults. Show less

Despite of the highly potent antiretroviral therapies, HIV-1 establishes persistent infection and causes chronic inflammation in AIDS patients. Beyond CD4+ T cells, HIV-1 infects myeloid cells, including circulating monocytes and tissue-resident macrophages, and integrates with host genomes to form stable viral reservoirs. To achieve a functional HIV cure, latency-promoting agents (LPAs) have been developed for the "block-and-lock" strategy to reinforce deep HIV-1 latency and permanently silence proviruses. However, most LPAs have been tested mainly in CD4 Show less

In recent years, the impact of lipoprotein(a) (Lp(a)) on the prognosis of coronary heart disease has been increasingly recognized. Lp(a) is an independent risk factor for cardiovascular disease, and studies have shown that homocysteine (HCY) may influence the association between Lp(a) and the risk of recurrent cardiovascular events. This study investigates the association between Lp(a) levels and recurrent cardiovascular events in patients with varying HCY concentrations. We conducted a 36-month follow-up on 530 patients with coronary heart disease and divided them into low-Lp(a) and high-Lp(a) groups based on Lp(a) levels. The incidence rates of major adverse cardiovascular events (MACE) and acute coronary events (ACE) were compared between the two groups. The association between elevated Lp(a) and cardiovascular risk in different subgroups(based on HCY concentration) was analyzed using Kaplan-Meier curves and Cox proportional hazards models. Elevated Lp(a) remained a significant risk factor for both MACE (HR = 2.07, 95% CI = 1.37-3.12, P = 0.001) and ACE (HR = 2.83, 95% CI = 1.67-4.81, P = 0.001) overall. In subgroup analyses, elevated Lp(a) in patients with moderate-to-high HCY levels constituted a high-risk cohort for MACE and ACE occurrence (HR = 1.87, 95% CI = 1.01-3.46, P = 0.046;HR = 2.85, 95% CI = 1.32-6.18, P = 0.008). Among those with low HCY levels, elevated Lp(a) showed no association with either MACE or ACE (P > 0.05). When HCY is elevated, patients with increased Lp(a) experience amplified risk of recurrent cardiovascular events. This association shifts when HCY is at low levels. Future efforts should emphasize combined assessment of Lp(a) and HCY and explore targeted intervention strategies to reduce residual cardiovascular risk. Show less

The prognostic value of jointly assessing lipoprotein(a) [Lp(a)] and high-sensitivity C-reactive protein (hsCRP) in primary prevention among individuals without standard modifiable risk factors (SMuRFs) remains unclear. We analyzed 50,450 UK Biobank participants free of cardiovascular disease at baseline who were SMuRF-less, defined as absence of current smoking, obesity, hypertension, dyslipidemia, and diabetes. Elevated Lp(a) and hsCRP were defined using cohort-specific 75th percentile cutoffs and established clinical thresholds. Incident atherosclerotic cardiovascular disease (ASCVD), defined as nonfatal myocardial infarction, nonfatal ischemic stroke, or cardiovascular death, was ascertained. Associations were evaluated using Fine-Gray competing-risk regression models to estimate subdistribution hazard ratios (sHRs) with 95% confidence intervals (CI), accounting for competing non-cardiovascular death. Over 15 years of follow-up, 1,104 (2.2%) incident ASCVD events occurred. Using cohort-specific cutoffs, elevated hsCRP was associated with higher ASCVD risk (sHR 1.35, 95% CI 1.16-1.57), while elevated Lp(a) showed a more modest association (sHR 1.24, 95% CI 1.06-1.45). In joint analyses, isolated elevations of hsCRP or Lp(a) were each associated with increased risk, with the highest risk observed among individuals with concurrent elevations (sHR 1.64, 95% CI 1.28-2.09), without evidence of interaction. Similar patterns were observed using clinical cutoffs (Lp(a) ≥125 nmol/L; hsCRP ≥2.0 mg/L), with concurrent elevation conferring the greatest risk (sHR 1.74, 95% CI 1.17-2.59). In SMuRF-less individuals, Lp(a) and hsCRP independently predict ASCVD risk. These findings suggest that combined assessment of Lp(a) and hsCRP may provide complementary information for risk characterization among SMuRF-less adults in primary prevention. Show less

Individuals differ in their sensitivity to external stimuli. The Highly Sensitive Child (HSC) scale can be used to measure sensitivity in children and adolescents. However, the German version has yet to be validated. We examined the psychometric properties of the German self- and the parent report version of the HSC. Measurement invariance (MI) across age groups was tested for the parent report version and latent profile analysis (LPA) was used to identify sensitivity groups. Pooled data from German-speaking countries ( The online version contains supplementary material available at 10.1007/s12144-026-09244-w. Show less