Search Results (449)

Background/Objectives: Prediabetes markedly increases the risk of progression to type 2 diabetes. While exercise and dietary polyphenols independently enhance metabolic health, their combined and synergistic effects remain unclear. This randomized, single-blind, placebo-controlled trial investigated the synergistic effects of concurrent training and a microencapsulated persimmon–karonda polyphenol formulation on glycemic control and inflammatory outcomes in adults with prediabetes and who are overweight/obese. Methods: Forty-three participants completed the intervention and were assigned to placebo, concurrent training (CBT), supplementation (EATME), or the combined intervention (CBT + EATME) for 8 weeks. Primary outcomes included fasting blood glucose (FBG), glycated hemoglobin (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), adiponectin, physical fitness, and quality of life (QoL). Results: All intervention groups (CBT, EATME, and CBT + EATME) showed improvements in glycemic indices, with the greatest reductions in FBG (p < 0.01), HbA1c (p < 0.05), and HOMA-IR (p < 0.01) observed in the CBT + EATME group compared with placebo. All interventions significantly reduced hs-CRP (p < 0.01) and IL-6 (p < 0.01), accompanied by marked increases in adiponectin (p < 0.01), compared with placebo. In the CBT + EATME group, reductions in hs-CRP were positively correlated with improvements in HOMA-IR (r = 0.627, p < 0.05). Both CBT and CBT + EATME improved muscular strength and maximal oxygen consumption (V̇O₂max), with the combined intervention producing greater gains in upper- and lower-body strength (p < 0.05), V̇O₂max (p < 0.05), and the psychological well-being domain of QoL (p < 0.05) compared with placebo. Conclusions: These findings highlight that combining concurrent training with microencapsulated polyphenol supplementation produced the most consistent improvements across metabolic, inflammatory, and fitness outcomes, supporting this combined approach as an integrated and synergistic strategy to reduce diabetes risk and promote overall health in at-risk adults. The trial was registered at the Thai Clinical Trials Registry (TCTR20250512003). Full article

Individuals often lack field-based tools to monitor exercise effectiveness. New sensing methods may allow for an improved measurement of the individualized response to exercise by monitoring oxygen kinetics directly in muscle tissue. This study aimed to validate a non-invasive wearable sensor capable of measuring muscle oxygen saturation (SmO₂) using continuous-wave near-infrared spectroscopy (CW-NIRS) against a laboratory-validated frequency-domain NIRS (FDNIRS) device. Ten physically fit adults performed an incremental cycling test until voluntary exhaustion. Devices were placed on contralateral rectus femoris muscles. SmO₂ was simultaneously measured continuously for the duration of the protocol. Time series alignment was performed using linear interpolation to enable direct comparison between devices at matched time points. Z-score normalization accounted for inter-individual differences in a group-level analysis. Individual subject validation showed strong correlations between the two devices (r = 0.792, range: 0.69–0.88, p < 0.001) with an RMSD < 5% for most subjects, a mean bias of 0.005 and low proportional bias (−0.199) between all paired measurements. Group-level analysis demonstrated a correlation of r = 0.788. Bland–Altman analysis revealed that 95% of all measurements fell between −8.1% and 7.6% SmO₂. The CW-NIRS device delivered reliable performance compared to the FDNIRS device, offering potential applications for real-time physiological monitoring during exercise and performance assessment. Full article

The escalating frequency and complexity of cyber threats have made cybersecurity education a national priority, yet a practical gap persists between theoretical instruction and workforce readiness. This study presents a comprehensive, modular framework for designing and implementing cybersecurity laboratories in academic institutions, environments that foster hands-on learning, skill mastery, and curricular innovation. Using a mixed-methods, multi-stage case study approach, the research combined qualitative analysis of institutional practices and instructional methods with quantitative evaluation of learning outcomes to comprehensively examine technical and pedagogical considerations impacting lab development. Data sources included literature analysis, direct observation, document review, and semi-structured interviews. The study synthesized best practices across these domains into a scalable lab design model grounded in experiential learning theory. Results demonstrate that the framework supports enhanced student performance, instructional adaptability, and simulation fidelity. Case study data revealed measurable gains in participant competency, with all participants achieving at least a 20% improvement in post-training test scores, high engagement levels demonstrated through consistent session attendance and active participation in hands-on exercises, and successful adaptation to logistical and technological barriers, including facility relocations and system downtime incidents. The lab’s modularity enabled curricular alignment, resource efficiency, and expansion to serve workforce training initiatives beyond the classroom. By integrating pedagogical (structured, teacher-guided instructional approaches) and andragogical (adult learning) design with technological scalability, this research contributes an actionable roadmap for institutions seeking to modernize cybersecurity education and respond effectively to evolving digital threats. The findings offer broad implications for future curriculum development, facilitator training, and sustainable program implementation. Full article

Background/Objectives: Self-perceptions in childhood shape motivation, behavior, and well-being; however, their relationship to motor competence and physical fitness remains unclear. We tested whether physical fitness mediates the association between motor competence and domain-specific self-perceptions in middle childhood. Methods: In a school-based sample of 100 ten-year-olds (59 girls, 41 boys; 3 exclusions ≤ 5th MABC-2 percentile), children completed MABC-2 (motor competence), EUROFIT (physical fitness), and SPPC (self-perceptions). Principal component analysis of the nine EUROFIT tests yielded two factors: Motor Fitness (agility/endurance/flexibility/muscular endurance) and Strength/Size (handgrip and BMI). Parallel mediation models (MABC-2 → [Motor Fitness, Strength/Size] → SPPC) were estimated with maximum likelihood and 5000 bias-corrected bootstrap resamples. Benjamini–Hochberg FDR (q = 0.05) was applied within each path family across the six SPPC domains. Results: In baseline models (no covariates), Motor Fitness → Athletic Competence was significant after FDR (β = 0.263, p = 0.003, FDR p = 0.018). Associations with Scholastic (β = 0.217, p = 0.039, FDR p = 0.090) and Social (β = 0.212, p = 0.046, FDR p = 0.090) were positive but did not meet the FDR threshold. Strength/Size showed no associations with any SPPC domain. Direct effects from MABC-2 to SPPC were non-significant. Indirect effects via Motor Fitness were minor and not supported after FDR (e.g., Athletic: β = 0.067, p = 0.106, 95% CI [0.007, 0.174], FDR p = 0.251). In BMIz-adjusted sensitivity models, Motor Fitness remained significantly related to Athletic (β = 0.285, p = 0.008, FDR p = 0.035), Scholastic (β = 0.252, p = 0.018, FDR p = 0.035), and Social (β = 0.257, p = 0.015, FDR p = 0.035); MABC-2 → Motor Fitness was β = 0.235, p = 0.020. Some paths reached unadjusted significance but were not significant after FDR correction (all FDR p-values = 0.120 for indirect effects). Conclusions: Functional Motor Fitness, but not Strength/Size, showed small-to-moderate, domain-specific links with children’s Athletic (and, when adjusting for adiposity, Scholastic/Social) self-perceptions; mediated effects were small and not FDR-supported. Findings highlight the salience of visible, functional performances (e.g., agility/endurance tasks) for children’s self-views and support PE approaches that foster diverse motor skills and motor fitness. Because the study is cross-sectional and BMI-adjusted analyses are presented as robustness checks, caution should be exercised when interpreting the results causally. Full article

Background: Menopause is often accompanied by menopausal symptoms and reduced quality of life. Studies on the combined effects of time-restricted eating and exercise in this population are lacking. This approach may provide additive preventive benefits by aligning nutritional timing with exercise to improve health and well-being in menopausal women. We aimed to assess whether a combined intervention is more effective than exercise alone in reducing menopausal symptoms and improving quality of life. Methods: This study examined the effects of a time-restricted eating protocol (16:8) combined with a resistance and endurance circuit training program in menopausal women. Symptoms were assessed using the Menopause Rating Scale (MRS), and quality of life was evaluated with the Menopause-Specific Quality of Life Questionnaire (MENQOL). Participants (n = 54) were quasi-randomly assigned to a combination group (exercise + time-restricted eating; n = 24) or an exercise group (exercise only; n = 30), with allocation influenced by participant preference. Results: The reduction in the total MRS score, as well as in the psychological and somatic MRS subdomains, was significantly greater in the combination group than in the exercise group (p = 0.008, p = 0.009, p = 0.007, respectively). No significant difference was observed in the urogenital domain. For MENQOL, post-intervention scores in the physical and psychosocial subdomains were significantly lower in the combination group compared with the exercise group (p = 0.013, p = 0.002, respectively), while no significant differences were found in the vasomotor and sexual subdomains. Conclusions: These findings suggest that integrating time-restricted eating with exercise results in greater alleviation of menopausal symptoms and improvements in quality of life compared to exercise alone in menopausal women. Full article

Background: Emotion regulation (ER) difficulties are closely linked to maladaptive coping strategies, including impulsive and emotional eating, which undermine health and well-being in young adults. Technical university students are particularly vulnerable due to factors such as a high academic workload, sedentary behavior, and performance-related stress. This study evaluated the effects of a four-week structured physical activity intervention on ER and eating behaviors among engineering students. Methods: Seventy first- and second-year computer science and engineering students (40 males and 30 females, aged 19–25 years) from Politehnica University of Bucharest participated in the study. The intervention included three weekly supervised training sessions and a daily step count requirement (≥6000 steps), verified via weekly smartphone submissions. Pre- and post-intervention assessments employed the Difficulties in Emotion Regulation Scale (DERS-36) and the Adult Eating Behavior Questionnaire (AEBQ-35). Data were analyzed using Kolmogorov–Smirnov tests, Wilcoxon signed-rank tests, and paired-sample t-tests. Results: Significant improvements were observed in five ER domains—non-acceptance of emotional responses, goal-directed behavior, impulse control, access to regulation strategies, and emotional clarity (all p < 0.01). No change occurred in emotional awareness (p > 0.05). Eating behaviors (restrained, emotional, and external eating) showed no significant differences pre- and post-intervention (all p > 0.05). Conclusions: A short-term, structured physical activity program enhanced emotion regulation capacities but did not alter eating behaviors in the short run. These findings highlight the feasibility of embedding low-cost, exercise-based modules into higher education to strengthen students’ psychological resilience. Longer and multimodal interventions may be required to produce measurable changes in eating behaviors. Full article

Background: Early childhood is crucial for motor and cognitive development, with physical activity playing a key role. Mini-trampoline exercises may offer an effective approach to enhance these domains. Methods: This study assessed the effects of a mini-trampoline program on executive functions and motor skills in Tunisian preschoolers. Fifty-four children (age 3.87 ± 0.47 years) participated in a 12-week intervention, divided into a control group (n = 27), following standard activities, and an experimental group (n = 27), engaging in mini-trampoline exercises. Pre- and post-tests measured motor skills like postural steadiness, balance, and coordination, as well as cognitive functions, including working memory (WM) and inhibition. Results: Significant improvements were observed in the experimental group for functional mobility, postural steadiness, lower body strength, and inhibition (p < 0.001), whereas the control group showed minimal changes. ANOVA revealed no significant group × time effects, except for a trend in postural steadiness (p = 0.062), suggesting a potential benefit of the intervention. Conclusions: These findings highlight the potential of mini-trampoline exercises to enhance motor skills and specific executive functions in preschoolers, supporting their overall development. Full article

Aging contributes to neurodegeneration, predominantly characterized by increased oxidative stress, which leads to neurodegenerative changes and cognitive decline. This cognitive impairment is often associated with neuroinflammation, oxidative stress, and neuronal damage. Exercise is widely recognized for its capacity to elevate levels of irisin, a hormone derived from the cleavage of fibronectin type III domain-containing protein 5 (FNDC5). FNDC5/irisin acts as a myokine that mediates numerous beneficial effects of physical activity on metabolic health. It has also been recognized for its neuroprotective roles, suggesting its potential to mitigate neurodegenerative processes by promoting neuronal survival, reducing oxidative stress, and enhancing synaptic plasticity. However, the specific impact of exercise on the FNDC5/irisin pathway and antioxidant mechanisms in the aged brain remains insufficiently explored. In this study, we aimed to validate the neuroprotective role of exercise-induced FNDC5/irisin against aging-related oxidative stress, glial activation, neuronal damage, and cognitive impairment in 20-month-old mice. The exercise group underwent treadmill running for 60 min daily over an 8-week period. Our findings indicated that aging mice exhibited cognitive impairment, as evidenced by the Y-maze test; however, treadmill exercise effectively alleviated this impairment. Aged mice showed the activation of microglia and astrocytes in the hippocampus, which was notably reduced by exercise. Moreover, exercise improved the levels of calbindin and irisin, which were diminished due to aging. Our study demonstrated that aging led to a decrease in the antioxidant response element system and FNDC5/irisin pathway. However, exercise effectively activated Nrf2 and FNDC5/irisin expression, subsequently enhancing levels of SOD1, GSTO1/2, Sirt1, PGC-1α, BDNF, IGF-1, and IGF-2 in the hippocampus. The exercise-induced activation of Nrf2 signaling and FNDC5/irisin has emerged as a potent mechanism for alleviating oxidative stress and neuroinflammation associated with aging. In conclusion, our findings suggest that regular exercise has the potential to alleviate cognitive impairment through the activation of PGC-1α-FNDC5/irisin signaling, the Nrf2 ARE system, and neurotrophic factors in aged mice. Full article

(1) Background: The global increase in life expectancy has generated growing interest in strategies that support functional independence and quality of life among older adults. Functional fitness—including strength, mobility, flexibility, and aerobic endurance—is essential for preserving autonomy during aging. In this context, physical exercise, particularly High-Intensity Interval Training (HIIT), has gained attention for its time efficiency and physiological benefits. This randomized controlled trial aimed to evaluate the effects of a group-based HIIT program on functional fitness in older adults; (2) Methods: Functional outcomes were assessed before, during, and after a 65-week intervention using standardized field tests, including measures of upper and lower body strength, flexibility, aerobic endurance, and agility. This study was prospectively registered at ClinicalTrials.gov (NCT07170579); (3) Results: Significant improvements were observed in the HIIT group across multiple domains of functional fitness compared to the control group, notably in upper body strength, lower limb flexibility, cardiorespiratory endurance, and mobility; (4) Conclusions: These results suggest that HIIT is an effective and adaptable strategy for improving functional fitness in older adults, with the potential to enhance performance in daily activities and support healthy aging in community settings. Full article

Background/Objectives: Systemic lupus erythematosus (SLE) is associated with impaired functional capacity, persistent fatigue, and poor health-related quality of life despite advances in pharmacological therapy. Exercise training has been proposed as a non-pharmacological intervention, but its efficacy and safety remain incompletely defined. This systematic review aimed to evaluate the effects of exercise training on functional aerobic capacity and quality of life in adults with SLE. Methods: A comprehensive search of PubMed, EMBASE, Cochrane Library, and PEDro was conducted to identify randomized controlled trials published up to October 2022, in accordance with the PRISMA guidelines. Results: Twelve randomized controlled trials involving 619 participants were included. Exercise interventions were heterogeneous and comprised aerobics, resistance, combined programs, vibration training, home-based protocols, and counseling strategies, with durations ranging from 6 weeks to 12 months. Supervised aerobic and combined interventions consistently improved functional aerobic capacity, while quality of life benefits were reported across several domains, particularly physical health, vitality, and fatigue. Additional positive effects were observed on fatigue, depression, pain, sleep, insulin sensitivity, and self-care ability, without evidence of increased disease activity. Conclusions: Structured exercise is safe and can meaningfully enhance functional capacity and quality of life in patients with SLE, supporting its incorporation into multidisciplinary clinical management. Full article

Background/Objectives: Beetroot supplementation is a rich source of inorganic nitrate and has been proposed to enhance nitric oxide bioavailability and support cardiovascular recovery after exercise. This study aimed to evaluate the effects of beetroot supplementation on post-exercise cardiovascular and autonomic recovery in postmenopausal women. Methods: A systematic review and meta-analysis were conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Searches were performed in PubMed, Scopus, and Web of Science databases from inception to July 2025. Ten trials involving postmenopausal women were included. Outcomes assessed included cardiovascular measures (blood pressure and vascular function), autonomic parameters derived from heart rate variability (HRV)—specifically the root mean square of successive differences (RMSSD), the standard deviation of normal-to-normal intervals (SDNN), and high-frequency power (HF)—as well as physical performance (peak oxygen uptake [VO_2peak or VO_2max] and functional fitness tests). Four independent reviewers extracted data, assessed risk of bias, and evaluated the certainty of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Results: Pooled analyses from two trials (n = 54) revealed a statistically significant improvement in RMSSD with beetroot supplementation (mean difference: 6.68 ms; 95% CI: 0.86 to 12.50; p = 0.02), suggesting enhanced parasympathetic reactivation after exercise. No significant effects were detected for HF (mean difference: 61.75 ms²; 95% CI: −70.92 to 194.43; p = 0.36) or SDNN (mean difference: 6.20 ms; 95% CI: −9.69 to 22.09; p = 0.44). Substantial to considerable heterogeneity was identified across outcomes (I² = 73–86%). Certainty of evidence was rated moderate for RMSSD, low for SDNN, and very low for HF. Conclusions: Beetroot supplementation may enhance post-exercise autonomic recovery in postmenopausal women, primarily through improvements in RMSSD. However, further trials with standardized protocols, larger samples, and longer intervention durations are required to clarify its impact on broader HRV domains, cardiovascular function, and clinical outcomes. Full article

Fuzzing has established itself as a cornerstone technique for uncovering defects in both stand-alone executables and software libraries. In the domain of library testing, prior research has predominantly concentrated on the automated generation of fuzz drivers-code harnesses that invoke individual Application Programming Interfaces (APIs) under test. While these approaches successfully orchestrate API calls in the correct sequence, they often neglect a critical factor: the semantic relevance and structural validity of the input data supplied to each API parameter. Unlike monolithic programs, where inputs are typically drawn from well-defined file or network formats, API parameters may span a broad spectrum of primitive and composite data types-ranging from integers and floating-point values to strings, containers, and user-defined aggregates—each of which demands tailored mutation strategies to exercise deep code paths and trigger latent faults. To address this gap, we introduce PointFuzz, a novel fuzzing framework that integrates type-aware input generation into existing harness generation pipelines. PointFuzz begins by statically analyzing the API’s function signatures and associated type definitions to accurately identify the data type of every parameter. It then applies a suite of specialized mutation operators. This data-type-guided mutation maximizes the likelihood of traversing previously untested execution branches. Moreover, PointFuzz incorporates an innovative feedback mechanism that dynamically adjusts mutation priorities based on real-time coverage gains. By assigning quantitative scores to parameter-specific operators, our system continuously learns which strategies yield the most valuable inputs, and reallocates computational effort accordingly. Empirical evaluation across multiple widely used C/C++ libraries demonstrates that PointFuzz achieves superior API coverage compared to generic, agnostic-type fuzzers. These results validate the efficacy of combining type-aware mutation with adaptive feedback to advance the state of library API fuzzing. Full article

Background/Objectives: As global aging accelerates, there is a pressing and empirically substantiated demand for integrated and sustainable strategies, as evidenced by the rising prevalence rates of chronic conditions, social isolation, and digital exclusion among older adults worldwide. These factors underscore the urgent need for multidimensional interventions that simultaneously target physical, psychological, and social well-being. The HOPE-FIT (Hybrid Outreach Program for Exercise and Follow-up Integrated Training) model and the SAGE (Senior Active Guided Exercise) program were designed to address this need through a hybrid framework. These programs foster inclusive aging by explicitly bridging digitally underserved groups and mobility-restricted populations into mainstream health promotion systems through tailored exercise, psychosocial support, and smart-home technologies, thereby functioning as a scalable meta-model across healthcare, community, and policy domains. Methods: HOPE-FIT was developed through a formative, multi-phase process grounded in the RE-AIM framework and a Hybrid Type II effectiveness–implementation design. The program combines professional health coaching, home-based and digital exercise routines, Acceptance and Commitment Performance Training (ACPT)-based psychological strategies, and smart-home monitoring technologies. Empirical data from pilot studies, large-scale surveys (N = 1000), and in-depth user evaluations were incorporated to strengthen validity and contextual adaptation. Culturally tailored content and participatory feedback from older adults further informed ecological validity and program refinement. Implementation Strategy/Framework: The theoretical foundation integrates implementation science with behavioral and digital health. The RE-AIM framework guided reach, fidelity, and maintenance planning, while the Hybrid E–I design enabled the concurrent evaluation of effectiveness outcomes and contextual implementation strategies. Institutional partnerships with community centers, public health organizations, and welfare agencies further facilitated the translation of the model into real-world aging contexts. Dissemination Plan: The multi-pronged dissemination strategy includes international symposia, interdisciplinary academic networks, policy briefs, localized community deployment, and secure, authenticated data sharing for reproducibility. This design facilitates evidence-informed policy, empowers practitioners, and advances digital health equity. Ultimately, HOPE-FIT constitutes a scalable and inclusive model that concretely addresses health disparities and promotes active, dignified aging across systems and disciplines. Full article

Background: Multiple sclerosis (MS) is the most prevalent neurological disorder in young adults, characterised by physical, psychological and cognitive dysfunction. Exercise training is a safe management strategy. Healthcare providers (HCPs) acknowledge deficiencies in awareness, counselling strategies, and resources that prevent them from promoting and prescribing this effective treatment. We implemented an online evidence-based educational programme and evaluated the effect, acceptability, appropriateness, and feasibility of the programme in improving HCP confidence, knowledge, and attitudes towards remote exercise prescription to persons with MS. Methods: Physiotherapists and exercise physiologists were recruited and received the educational programme (online theory and 16-week experience of prescribing to persons with MS). Participants’ confidence, knowledge and attitudes towards exercise prescription, as well as their professional quality of life, were our primary outcomes—baseline (T1), immediately post-online theoretical learning (T2), post-application with clients (T3; approximately 16 weeks after T2), and at 12-month follow-up (T4). We gathered participants’ acceptability, appropriateness, and feasibility evaluation at T2, T3 and T4. We analysed the effect on primary outcomes using generalised linear mixed models, with secondary and evaluative outcomes analysed as counts and qualitative themes. Results: Of 40 participants who provided baseline data, 24 completed the theoretical programme, and 16 completed the experiential programme. Self-confidence improved significantly (|βs| ≥ 1.27, SEs ≤ 0.31, |zs| ≥ 5.28, ps < 0.001), with large effect sizes (percentage change: 256.8–479.4%). Some theoretical domains framework-based domains have improved, such as beliefs about skills to prescribe evidence-based principles. Participants expressed high satisfaction with the programme and showed increased delivery of implementation behaviour change strategies. Conclusions: An online evidence-based education programme for MS care improved HCPs’ self-confidence, perceived skills and delivery of evidence-based exercise behaviour-based prescription. Full article

Background/Objectives: Lack of objective evidence exists regarding changes in physical function and impact on daily functioning in paediatric post-COVID-19 condition (PPCC). This study aimed to assess exercise capacity, fatigue, and peripheral and respiratory muscle strength in PPCC patients compared with healthy controls. Additionally, the impact of PPCC on domains of daily life was evaluated. Methods: A cross-sectional study was performed. Study variables: exercise capacity (6 min walk test, 6MWT), inspiratory muscle strength (maximal inspiratory pressure, PImax), handgrip strength (handheld dynamometer, HHD), quadriceps femoris muscle thickness (QF MT), rectus femoris muscle thickness (RF MT), rectus femoris cross-sectional area (RF CSA), rectus femoris echo-intensity (RF EI), fatigue (Paediatric Functional Assessment of Chronic Illness Therapy-Fatigue, pedsFACIT-F), and physical activity (Assessment of Physical Activity Levels Questionnaire, APALQ). Results: A total of 115 PPCC patients and 227 healthy controls were included. The PPCC group had lower 6MWT (509.00 ± 86.12, p < 0.001), PImax (68.71 ± 26.23, p < 0.001), HHD (82.84 ± 29.09, p < 0.001), APALQ (7.94 ± 3.14, p < 0.001), pedsFACIT-F (24.51 ± 11.01, p < 0.001), QF MT mid-thigh (33.21 ± 7.99, p = 0.011), and higher RF EI (p < 0.001) vs. controls. Only 37.63% of the PPCC group resumed previous sports, 43.48% were unable to attend school full-time and 28.7% could not participate in after-school activities. Conclusions: Paediatric post-COVID-19 condition patients exhibited significant impairments in terms of physical function, with a high impact on daily functioning. This knowledge is necessary to provide targeted therapeutic interventions. Full article