Search Results (781)

Background: Understanding diverse psychological factors is crucial for promoting vaccination. This study focuses on psychological factors influencing HZ vaccination attitudes and intentions among older adults who have not yet received the HZ vaccine in China. Methods: We conducted a cross-sectional survey of 12,357 older adults (aged ≥60 years) who had not previously received the HZ vaccine. Latent Profile Analysis (LPA) was performed using the 5C psychological antecedents of vaccination (Confidence, Constraints, Calculation, Complacency, and Collective Responsibility). Multinomial logistic regression and Chi-square tests were used to identify predictors of profile membership and to investigate the nature of reported barriers. Results: An optimal five-profile solution was identified, with the largest group being “Willing but Obstructed” (44.6%). This profile exhibited high vaccination willingness but perceived the most significant constraints. While household income was not a direct predictor of profile membership, low-income individuals were significantly more likely to report ‘high cost’ as a primary barrier (p < 0.01), revealing that socioeconomic status appears to influence vaccination intention through tangible structural obstacles. Conclusions: Vaccination attitudes among previously unvaccinated older adults are heterogeneous. A substantial proportion are willing to be vaccinated but are hindered by socioeconomic barriers, primarily cost. Addressing the intention–behavior gap may require a shift from universal messaging to equity-focused interventions that directly address structural barriers for vulnerable groups, particularly among those who have not yet initiated vaccination. Full article

Emergency evacuation in complex and dynamic building environments requires robust and adaptive routing strategies capable of responding to evolving hazards, blocked passages, and changing crowd behaviour. Most existing evacuation planners rely on static geometric representations and lack semantic awareness of the environment, limiting their ability to perform informed re-planning and backtracking when routes become unsafe. This paper proposes a neuro-symbolic evacuation planning framework that integrates Lifelong Planning A* (LPA*) with ontology-driven semantic reasoning and a Bidirectional Long Short-Term Memory (BiLSTM) prediction model. The building’s spatial and semantic knowledge is represented using the Web Ontology Language (OWL) and Resource Description Framework (RDF), enabling automated inference of implicit connections and enforcement of safety policies. The BiLSTM model learns temporal patterns from ontology-consistent evacuation trajectories and provides guidance for remaining-cost estimation and early prediction of routes likely to require backtracking, which is combined with a bounded semantic heuristic to preserve admissibility and optimality guarantees. Simulation results in a multi-floor academic building show that the proposed BiLSTM-guided semantic LPA* framework reduces average evacuation time by up to 9.6%, decreases node expansions by up to 32%, and increases evacuation success rates to 96.2% compared with a purely semantic baseline. The BiLSTM model also achieves strong predictive performance, with a test AUC of 0.92 for backtracking prediction and a next-state accuracy of 87.1%. The proposed framework is designed to support explainable, policy-compliant, and incrementally adaptable evacuation guidance under rapidly evolving emergency conditions. Full article

Extensive evidence now confirms Lipoprotein(a) [Lp(a)] as a causal, independent risk factor for atherosclerotic cardiovascular disease. Elevated Lp(a) levels are detected in approximately 20% of the global population, positioning it as a major contributor to residual cardiovascular risk. Circulating Lp(a) levels are determined predominantly by genetic factors, so they are largely unresponsive to lifestyle modifications or conventional lipid-lowering therapies. Therefore, multiple international guidelines now endorse a one-time, lifetime measurement of Lp(a), as lowering Lp(a) concentrations is expected to have a positive impact on the reduction of cardiovascular risk. Currently, the therapeutic landscape of Lp(a) lowering drugs is rapidly evolving. Some RNA-based therapies (antisense oligonucleotides (ASOs) and small interfering RNAs (siRNAs)) have been demonstrated to reduce plasma Lp(a) concentrations by up to 98% in early-phase clinical trials. The efficacy and safety of these compounds are currently being evaluated in large-scale cardiovascular outcome trials. The results of these studies will be critical in validating the “Lp(a) hypothesis”: specific reduction of Lp(a) levels can lead to a measurable decrease in cardiovascular events. The purpose of this narrative review is to examine and discuss the available evidence on the role of Lp(a) as a risk factor and pharmacological target to provide a practical tool for decision-making in clinical practice. Full article

Background/Objectives: Prostate cancer (PCa) cells are known to heavily depend on lipids to support their growth. We hypothesized that hyperlipidemic factors, for which inhibitors are already available and used to treat cardiovascular disease, would be dysregulated in metastatic PCa (mPCa). The goal of this case-control study, including 35 men per group, was to compare the levels of PCSK9, ANGPTL3, Apo CIII, leptin, and the lipid profile in patients with mPCa versus localized Gleason 8/9 PCa (lPCa) and patients at risk of developing PCa (controls). Methods: Protein levels were assessed using ELISAs, while lipids were measured using the Roche Cobas analytical platform. Results: The following circulating analytes were higher in mPCa: triglycerides (in mmol/L; controls 1.7 ± 1.2, lPCa 1.5 ± 0.7, mPCa 2.3 ± 1.2, p = 0.0004), Apo CIII (in µg/mL; control 110.7 ± 55.7, lPCa 115.0 ± 57.64, mPCa 159.9 ± 96.7, p = 0.0179), ANGPTL3 (in ng/mL; controls 41.7 ± 20.0, lPCa 42.8 ± 24.1, mPCa 57.3 ± 26.9, p = 0.0390), and leptin (in ng/mL, controls 9.6 ± 9.1, lPCa 8.2 ± 7.9, mPCa 17.7 ± 17.8, p < 0.0001). Surprisingly, PCSK9 levels were negatively correlated with LDL in the entire cohort. Conclusions: In this cohort of men, whole-body lipid metabolic rewiring is a feature restricted to the metastatic phase of prostate cancer, suggesting it may play a significant role in the progression toward more aggressive cancer forms. Given the availability of drugs targeting ANGPTL3 and Apo CIII, the therapeutic potential of these drugs should be evaluated in metastatic PCa. Full article

Episodic future thinking (EFT) has been confirmed as a promising cognitive intervention for enhancing prospective memory (PM), yet emerging evidence suggests its effects may depend on the specificity of induction. The current study investigated this issue by dichotomizing EFT into two distinct methods: specific (researcher-guided detailed mental simulations) versus non-specific (participants’ self-guided imagination), implemented through differentially structured future thinking instructions. We also analyzed the distinct cognitive strategies mainly employed under each EFT condition based on the Dynamic Multiprocess Framework. The latent profile analysis (LPA) was further conducted to characterize individual variability in responsiveness to EFT manipulations. Behavioral results revealed comparable PM accuracy improvements across both EFT methods relative to the control group; moreover, specific EFT uniquely accelerated response times for both PM and ongoing task execution. The LPA further identified three distinct EFT response patterns—self-competent, proactive, and reactive—each exhibiting unique state-dependent cognitive characteristics. These findings provide a refined understanding of the EFT-PM relationship: (1) specific EFT facilitates more automatic retrieval of PM intentions, whereas non-specific EFT predominantly engages strategic monitoring; (2) individual differences in baseline mental images influence the effectiveness of EFT methods, suggesting the potential benefits of personalized intervention approaches for PM enhancement. Full article

Introduction/Objectives: Although contemporary guidelines strongly support intensive low-density lipoprotein cholesterol (LDL-C) lowering and the use of advanced lipid biomarkers for cardiovascular risk stratification, implementation in daily clinical practice remains inconsistent. This study aimed to assess current practices, knowledge, and perceived barriers in dyslipidemia management across medical specialties. Methods: We conducted a cross-sectional, anonymous online survey from August to September 2025 among physicians actively involved in lipid management. The questionnaire evaluated the use of Systematic Coronary Risk Evaluation 2 (SCORE2)-based risk assessment, familiarity with LDL-C targets, treatment intensification strategies, awareness and use of apolipoprotein B (apoB) and lipoprotein(a) [Lp(a)], perceived barriers to LDL-C goal attainment, and responses to a standardized clinical vignette. Descriptive analyses and chi-square testing were conducted. Results: Ninety-five physicians completed the survey, the majority practicing in Europe (92.7%), including 83.2% from Portugal (41.1% general practice/family medicine; 14.7% cardiology; 14.7% internal medicine/geriatrics; 14.7% vascular surgery; 9.5% endocrinology). SCORE2 calculators were used “often” or “always” by 52.6%, with significant inter-specialty variation (p < 0.001). Familiarity with LDL-C targets was high (76.8%), and 89.4% reported frequent therapy intensification when goals were not achieved; however, consistent escalation (“always”) differed markedly across specialties (p < 0.001). Although 69.5% were aware of recommendations for lifetime assessment of apoB/non–HDL-C/Lp(a), only 17.9% implemented them routinely. Most clinicians reported never or rarely using advanced biomarkers for residual risk assessment, and in a clinical vignette only 12.6% would consistently intensify therapy despite elevated Lp(a) and apoB (p = 0.004). Patient non-adherence (86.3%) was the most frequently perceived barrier. Conclusions: Despite the widespread awareness of LDL-C targets, important gaps persist in the consistent application of guideline-directed therapy and in the use of advanced biomarkers. The underutilization of apoB and Lp(a), together with therapeutic inertia and structural barriers, limits effective residual risk management. Bridging this gap will require coordinated efforts focused on implementation, access, and multidisciplinary care. Full article

Background: While Toxoplasma gondii infection poses a significant health threat, its impact on the localized intestinal lipid metabolism remains unclear. Methods: Thus, this study established an acute infection model in BALB/cJ mice and analyzed the colonic contents collected 10 days post-infection via untargeted lipidomics. The lipid profiles of the two groups diverged substantially, with a clear separation evident between infection and control conditions. Results: We identified 65 upregulated and 87 downregulated differential lipids, primarily falling into the glycerophospholipids and sphingolipids categories. Pathway enrichment analysis revealed that the choline metabolism in cancer and glycerophospholipid metabolism pathways was pinpointed as being among the most perturbed following infection. Correlation and network analyses further suggested that key molecules, such as LPC (20:4) and LPA (18:0), may mediate these metabolic pathway abnormalities by regulating related enzymatic activities. Conclusions: This systematic characterization of the intestinal lipid metabolic landscape in mice during acute T. gondii infection revealed the host intestinal lipid metabolic reprogramming induced by T. gondii infection. The findings offer a novel metabolic perspective for understanding T. gondii pathogenesis and host–parasite interactions. Full article

Atherosclerosis, manifesting as acute myocardial infarction, stroke and peripheral artery disease, is the main cause of death worldwide. Conventional risk factors contributing to the development and progression of atherosclerosis are well established, including diabetes mellitus, hypertension, hypercholesterolemia, smoking and obesity. In recent decades, other lipid molecules have been identified as risk factors for atherosclerosis and arterial calcification, including lipoprotein (a) and apolipoproteins. Despite the available evidence for the association between those biomarkers and atherosclerosis in the general population, their impact on diabetic patients is incompletely characterized. This review aims to summarize the current evidence on the relationship between lipoprotein (a), apolipoproteins and atherosclerotic cardiovascular disease in diabetic patients. By integrating genetic, epidemiological, and mechanistic data, this review highlights the dual and context-dependent associations of lipoprotein (a) with incident type 2 diabetes and atherosclerotic cardiovascular risk, supporting more nuanced interpretation of Lp(a) in diabetes-related risk assessment. Full article

Trauma and substance use disorders commonly co-occur, are clinically complex, and are associated with poorer outcomes. This study applies mixture modeling methods in a co-occurring model to examine group membership patterns across trauma and substance use to identify differences in treatment outcomes. Using the constructs of trauma and substance use, a co-occurring model was conducted to examine group membership patterns at intake and identify differences in outcomes among court-mandated participants in a trauma-informed substance abuse treatment program. This approach uses a joint/cross-classification of two independent Latent Profile Analyses (LPAs) to examine patterns. Findings from the LPA identified three trauma and four substance use profiles. Classes from each LPA were regressed in the co-occurring model, resulting in 12 unique pattern combinations, which were then compared to examine the differences in graduate rates. The results demonstrated that those in the Minimal Trauma/Alcohol Use group were more likely to complete treatment than other higher drug-using populations. Given the complexity of the clinical treatment and the prevalence of co-occurring disorders, the application of this approach can provide a means to examine different grouping patterns across two diagnostic criteria that can guide and tailor treatment efforts. Full article

Objectives: This study aims to examine Internet addiction profiles, their associations with comorbid anxiety and depression, and characterize network architectures of anxiety and depression across profiles. Methods: From November 2022 to November 2023, we conducted a short-term cohort study including 2503 students. Latent profile analysis (LPA) and multinomial logistic regression analysis were employed to investigate the association between Internet addiction and comorbidity of anxiety and depression, and network analysis was used to characterize anxiety–depression network structure within each profile. Results: LPA identified three profiles of Internet addiction, which were labeled: “regular” (66.60%) profile, “risk” profile (23.09%), and “addiction” profile (10.31%). The incidence of comorbid anxiety and depression was 10.67%. Both the “risk” (adjusted OR = 1.76, 95% CI: 1.27–2.44) and “addiction” (adjusted OR = 2.12, 95% CI: 1.39–3.24) profiles were significantly associated with increased comorbidity risk. The “dass13” (“Downhearted and blue”) emerged as a core symptom, and “dass15” (“Close to panic”) was identified as a key bridge symptom across three network models. The edge weight for the dass05–dass21 (Lack of motivation–Meaninglessness of life) was higher in the “risk” profile than in the “addiction” profile. Conclusions: Children and adolescents in the “risk” and “addiction” profiles were significantly more likely to experience comorbid anxiety and depression. “dass13” (“Downhearted and blue”) and “dass15” (“Close to panic”) can be used as the key target during intervention. Targeted interventions can be implemented for children and adolescents in the “risk” and “addiction” profiles. Full article

Background: Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular disease (ASCVD). Proteomic studies suggest that Lp(a)-associated proteins mediate inflammation, thrombosis, and vascular calcification, but methodological variability may influence proteome definition. Methods: Lp(a) was immunoprecipitated from human plasma using an apo(a)-specific monoclonal antibody and analyzed by mass spectrometry following either in-gel digestion or automated in-solution proteolysis. Proteins identified by ≥3 unique peptides and consistently detected across all samples by both methods were considered high confidence. Functional enrichment and interaction networks were assessed using STRING. Results: In-solution proteolysis identified 92 proteins and in-gel digestion identified 55 proteins, with 34 proteins shared between methods. These high-confidence proteins were enriched for pathways involved in lipoprotein remodeling, coagulation regulation, vesicle-mediated transport, lipid binding, and extracellular matrix organization, providing biological insight into mechanisms linking Lp(a) to inflammation, thrombosis, and calcification. Conclusions: Proteome composition of Lp(a) is method-dependent; however, a rigorously defined core proteome of 34 proteins was consistently identified across analytical approaches, highlighting biologically relevant pathways that may underlie Lp(a)-mediated ASCVD risk. Full article

Social identity approaches suggest that people favour ingroup members, yet ingroup favouritism does not necessarily translate into outgroup derogation. Using a sample of Croatian majority-group youth from a nationally and religiously homogeneous pre-COVID context, we examined whether personal values moderate the relationship between national identification and attitudes towards minorities. We conducted a latent profile analysis (LPA) on higher-order values among young Croatian Catholics who did not belong to minority groups (N = 994) and identified five value profiles that varied primarily in the prioritisation of openness to change versus conservation. Profiles differed in minority attitudes and national identification. Crucially, the association between national identification and minority attitudes varied across profiles: it was unrelated in the profile prioritising openness over conservation, whereas in the remaining profiles it tended to be negative and was most consistently negative in the profile prioritising conservation over openness. Taken together, the findings highlight the role of values in the relationship between group identification and attitudes towards outgroups, confirming their relevance for social cohesion and potential for the development of deradicalisation interventions. Full article

Through their influence on various inner-school factors, school leaders can be considered relevant with regard to how tracking policies are enacted at the school level. However, research on attitudes of school leaders vis-à-vis school tracking is sparse. We examine profiles of tracking-related attitudes and predictors of profile membership at the individual (i.e., gender, age, work experience, self-efficacy beliefs, leadership competencies) and contextual level (i.e., school size, school level, social context, size of municipality). Data were collected from 1162 school leaders of pre-primary, primary, and lower secondary schools in Switzerland. Using Latent Profile Analysis (LPA), three profiles were identified: inclusion, tracking-separation, and average. School leaders in the inclusion profile showed positive attitudes towards inclusive education and the abolition of grades, a disapproval of early tracking, and negative attitudes towards tracking and its transparency. Leaders in the tracking-separation profile showed negative attitudes towards inclusive education and the abolition of grades, an approval of early tracking, and positive attitudes towards tracking and its transparency. Most school leaders were in the average profile, with neither especially favorable nor especially critical attitudes. While gender, school level, and the size of a municipality were found to be predictors of profile membership, other variables were not. The results give indications as to what factors are relevant in predicting certain attitudes towards tracking. This knowledge can be used for further research as well as for designing targeted interventions. Full article

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 (M = 20.01; SD = 2.48), 62% were male, 53% lived in Poland, and 58% studied Sports Sciences vs. 42% Physical Education. The Mini-International Personality Item Pool (Mini-IPIP) was used to assess the Big Five personality traits, and grade point average (GPA) was used to measure students’ academic achievements in the last semester. The LPA identified four personality profiles: (1) Restrained Neurotic (Profile 1, 32%), Open Extravert (Profile 2, 42%), Competitive Neurotic (Profile 3, 17%), and Cooperative Perfectionist (Profile 4, 8%). Profiles 1, 3, and 4 showed similarly low levels of emotional stability, extraversion, and intellect but differed significantly in agreeableness and conscientiousness. Gender and country differences across athletes representing specific profiles were also noted. Profile 2 showed the strongest link with academic achievement. Hierarchical multiple linear regression showed that LPA profiles explained only 2% of GPA variance, compared to Big Five personality traits (9%) and demographic variables, such as sex, country, and study major (8%), which were also included in the following steps in the regression model, explaining only 9% and 8%, respectively. Most student athletes (52%) with personality profiles 1 (Restrained Neurotic), 3 (Competitive Neurotic), and 4 (Cooperative Perfectionist) may require psychological training to better cope with negative emotions and stress arising in competitive and academic settings. Profile 2 (Open Extravert) seems to be the most adaptive and potentially successful personality type. Personality types are, at least to some extent, related to gender and country of residence. More cross-cultural research is required to further verify the types of athletic personalities. Full article

For decades, the pharmacological identity of Panax ginseng has been primarily attributed to triterpenoid saponins known as ginsenosides. However, accumulating evidence indicates that ginseng also contains a structurally distinct lipid–protein complex, termed gintonin, enriched in lysophosphatidic acid (LPA) species. Unlike ginsenosides, which predominantly exert modulatory effects on membrane dynamics and intracellular kinase pathways, gintonin directly activates LPA G protein-coupled receptors (GPCRs), thereby inducing rapid phospholipase C (PLC) activation and intracellular Ca²⁺ mobilization. Biochemical analyses have identified major LPA species within the gintonin fraction, including C16:0, C18:0, and C18:1, stabilized within a proteinaceous matrix that may influence receptor engagement kinetics. Pharmacological studies demonstrate that gintonin preferentially activates LPA₁ and LPA₃ receptor subtypes, triggering downstream signaling cascades involving MAPK, PI3K/Akt, and Rho pathways. These receptor-mediated effects occur on a rapid temporal scale, distinguishing gintonin from the slower transcriptional and kinase-modulating actions of ginsenosides. In this review, we synthesize current evidence regarding the chemical architecture, receptor pharmacology, and signaling dynamics of gintonin and propose a dual signaling framework in which steroid-like saponins and lipid GPCR ligands represent complementary molecular axes within P. ginseng. Recognition of this layered signaling organization refines the molecular understanding of ginseng biology and highlights gintonin as a unique plant-derived GPCR ligand system. Full article