Counselor value guidance and lower psychological crisis vulnerability: dual meaning-and-resilience pathways in cross-sectional and cluster-randomized evidence from Chinese universities.

In this exploratory case-control study, PAPP-A showed performance comparable to β-HCG as a candidate biomarker for early detection of ectopic pregnancy. These preliminary findings are hypothesis-generating and require assessment in broader, prospective cohorts before any clinical application can be considered. Ectopic pregnancy (EP) is a frequent condition in obstetrics and gynecology that occurs when a fertilized egg implants outside the uterus. There are several types of EPs, including fallopian tube, ovarian, abdominal, broad ligament, and cervical pregnancies. Fallopian tube pregnancies are the most prevalent among EPs. EP is a leading cause of acute abdominal issues in gynecology, accounting for over 80% of such cases (). In cases of EP, particularly in tubal pregnancies, the embryo's development may be unsustainable, potentially causing a rupture that leads to bleeding and delays treatment. Without prompt resuscitation, this can result in shock, fainting, or death. In Europe and the United States, EPs occur in about 1%–2% of pregnancies and account for nearly 75% of early-pregnancy maternal deaths (, ). The number of EP cases in U.S. hospitals increased from 17,800 cases in 1970 to 88,400 in 1989. The incidence rate is 11.5/1,000 in the United Kingdom and about 10/1,000 in China (–). EP is typically diagnosed using ultrasound, serum β-HCG, laparoscopy, curettage, and aspiration of the posterior vaginal fornix. While cases with clear symptoms are easily diagnosed, atypical cases pose a significant clinical challenge. Improving early detection rates is a pressing issue for obstetricians and gynecologists, which highlights the need for new non-invasive candidate markers (–).