Search Results (187)

Background/Objectives: Biofeedback interventions are increasingly utilized in pediatric and adult care, with evidence in treating specific medical conditions and specific symptoms. However, evidence supporting their efficacy among children and adolescents and young adults (AYAs, aged 15–39) with cancer is limited. The aims of this systematic review are to present, assess, and synthesize the existing research on biofeedback in pediatric and AYA oncology, identify gaps in biofeedback research within this population, and provide recommendations for future research and clinical implications. Methods: A systematic search for articles was conducted using six bibliographic databases—PubMed/MEDLINE (NLM), EMBASE (Elsevier), CINAHL (EBSCO), SPORTDiscus (EBSCO), PsycINFO (OVID), and PEDro (NeuRA)—with an update on 5/7/2025. Included were studies involving pediatric/AYA oncology participants (0–39 years old) and those receiving at least one biofeedback modality. The methodological quality and risk of bias among included articles were assessed using the Cochrane Risk of Bias (ROB) Tool (modified version for non-randomized studies). A narrative synthesis of included studies examined the type of cancer studied, type of biofeedback used, study designs and methodological quality, and key outcomes evaluated. Results: While the literature suggests that biofeedback may offer beneficial outcomes for managing various pediatric/AYA oncology-related symptoms, such as pain, anxiety, and fatigue, only 8 studies out of 1013 screened (<1%) met inclusion criteria. Limitations included low study quality (small sample sizes, lack of control groups, and methodological inconsistencies). Conclusions: While biofeedback shows promise as a feasible and effective intervention, there is a call to action for well-designed, methodologically rigorous studies to substantiate its effectiveness and inform evidence-based practice specifically for pediatric/AYA oncology patients and clinicians. Full article

Background: Breast and prostate cancer represent a significant global public health burden. Among the adverse effects of oncological treatments, fatigue is one of the most prevalent, persistent, and disabling symptoms. Therapeutic exercise has been shown to be effective for its management, with supervision identified as a key factor that may enhance adherence, safety, and intensity control. This systematic review and meta-analysis aimed to compare the effects of supervised exercise programs versus usual care on cancer-related fatigue in patients with breast or prostate cancer. Methods: A systematic search (September–December 2024) was conducted in six databases (PubMed, Web of Science, Scopus, Cochrane, PEDro, Scielo), selecting RCTs from the past 10 years in English or Spanish. Studies compared supervised exercise with unsupervised exercise or usual care in stage I–III breast or prostate cancer patients within five years post-treatment. Methodological quality was assessed with the PEDro scale and risk of bias with Cochrane’s RoB 2.0. A random-effects model was used to calculate pooled effect sizes (ES, 95% CI), with heterogeneity (I²), sensitivity, subgroup, and publication bias analyses. Results: A total of 25 interventions from 19 randomized controlled trials involving over 2200 participants were included. Supervised exercise significantly reduced cancer-related fatigue compared to usual care (effect size = 0.34; 95% CI: 0.22–0.47; p < 0.001; I² = 56%). Sensitivity analyses supported the robustness of the findings. Subgroup analyses revealed greater effects in combined exercise programs, in men, and in patients with prostate cancer. No evidence of publication bias was observed. While 73.7% of studies were rated as having good methodological quality, the risk of bias was often unclear or high. Conclusions: Supervised therapeutic exercise programs are effective and safe for reducing fatigue in breast and prostate cancer survivors. These interventions should be incorporated into comprehensive care plans, with individualization based on patients’ clinical and demographic characteristics. Further research is needed to identify the most effective and sustainable strategies for different patient subgroups. Full article

Background/Objectives: Given the heterogeneous nature of long COVID, its treatment and management remain challenging. This study aimed to investigate whether poor pre-pandemic sleep quality, its deterioration during the peak of the pandemic, and circadian preference increase the risk of long COVID symptoms. Methods: An online survey was conducted between 9 October and 12 December 2022, with 384 participants who had recovered from COVID-19 at least three months prior to data collection. Participants were categorized based on the presence of at least one long COVID symptom. Logistic regression models assessed associations between sleep-related variables and long COVID symptoms. Results: Participants with long COVID symptoms reported significantly poorer sleep quality, higher perceived stress, greater somatic and cognitive pre-sleep arousal, and elevated levels of post-traumatic stress symptoms, anxiety, depression, and aggression. Fatigue (39.8%) and memory problems (37.0%) were the most common long COVID symptoms. Sleep deterioration during the pandemic peak was reported by 34.6% of respondents. Pre-pandemic poor sleep quality, its deterioration during the pandemic, and poor sleep at the time of the survey were all significantly associated with long COVID. An extreme morning chronotype consistently predicted long COVID symptoms across all models, while an extreme evening chronotype was predictive only when accounting for sleep quality changes during the pandemic. COVID-19 frequency, severity, financial impact, and somatic pre-sleep arousal were significant predictors in all models. Conclusions: Poor sleep quality before the pandemic and its worsening during the pandemic peak are associated with a higher likelihood of long COVID symptoms. These findings underscore the need to monitor sleep health during pandemics and similar global events to help identify at-risk individuals and mitigate long-term health consequences, with important clinical and societal implications. Full article

Background and Aims: The majority of individuals with COVID-19 developed acute symptoms. Post-COVID-19 syndrome refers to the signs and symptoms of COVID-19 that persist for more than 12 weeks. The present study was conducted to estimate the prevalence and risk factors for post-COVID-19 syndrome in the Omani population. Methods: This is a cross-sectional study that was conducted at the University Hospital Center (UHC). All patients diagnosed with COVID-19 (through polymerase chain reaction PCR testing) between March 2020 and March 2022 were included. Eligible participants were interviewed through a phone call, informed about the study procedure, and invited to participate in the study. Results: The study enrolled 265 COVID-19 patients, of whom 156 (59.2%) were females and 204 (77.3%) had been vaccinated. The overall prevalence of post-COVID-19 syndrome was 48.5%. The most common symptom was fatigue (71, 26.9%), followed by joint pain (44, 16.7%). The other symptoms included loss of taste/smell (34, 12.9%), cough (32, 12.1%), palpitation (25, 9.5%), and hair loss (27, 10.2%). Unvaccinated patients showed a higher incidence of fatigue (p = 0.03) and loss of smell/taste (p = 0.01) on univariate analysis. Females were at high risk for the development of various symptoms, including fatigue, muscular pain, breathing difficulty, cough, chest pain, palpitation, headache, and hair loss. Multivariate analysis showed that female gender is a significant independent predictor (odds ratio: 3.1; p = 0.00) for the development of post-COVID-19 syndrome. Conclusions: The prevalence of post-COVID-19 syndrome among the Omani population was high, highlighting the need for targeted interventions to manage long-term symptoms in vulnerable groups. Full article

A psoriasis vulgaris flare is characterized by a rapid intensification of symptoms, which is often triggered by various factors that can worsen the condition. The risk factors for these exacerbations are numerous and include obesity, antihypertensive drugs, and psychological stress. Moreover, links have been documented between type II diabetes, hypertension, and psoriasis vulgaris. The present case report describes a 52-year-old female patient who presented at the clinic with disseminated erythematous-squamous plaques and patches covered by thick, white-pearly, easily detachable scales, along with stress, fatigue, anxiety, severe pruritus, irritability, insomnia, and decreased self-esteem. Her past medical regimen included various conventional topical options, including calcipotriol combined with betamethasone, clobetasol, betamethasone combined with salicylic acid, and betamethasone combined with gentamicin, yet the condition remained refractory, with periodic flare-ups. The integrated and personalized therapeutic approach aimed to target both the dermatological issues and the associated systemic and psychological factors contributing to the condition. The therapeutic strategy implemented in this case combined psychological counseling sessions, a very low-calorie ketogenic diet, oral supplementation with anti-inflammatory and antioxidant vitamins and minerals, topical treatments utilizing urea and Dead Sea-mineral-based formulations, and rosemary extract-based scalp care, without requiring additional conventional treatment. This comprehensive approach led to significant improvement, ultimately achieving complete remission of the patient’s psoriasis. The associated comorbidities were well controlled with the specified medication, without any further complications. Thus, the importance of alternative options was emphasized, particularly in the context of an incurable disease, along with the need for continued research to improve the ongoing therapeutic management of psoriasis vulgaris. Such approaches are essential to reducing the risk of flare-ups and to achieving better management of associated risk factors. Full article

Background/Objectives: “Ozempic face” is an aesthetic side effect associated with the use of the antidiabetic agent Ozempic (semaglutide), characterized by a prematurely aged and fatigued facial appearance due to rapid weight loss. Currently, treatment options for this condition are limited. In this study, we present our clinical experience with the BodyTite device, provided by InMode Italy S.r.l. (Rome, Italy). Materials and Methods: We report a case series involving 24 patients (19 women and 5 men, aged 27–65 years), treated with subdermal bipolar radiofrequency (Endotissutal Bipolar Radiofrequency) between 2023 and 2024. All patients underwent a minimum follow-up of 12 months. At the end of the follow-up period, patients rated their satisfaction on a from 0 to 10 scale, and an independent expert assessed the stability of clinical outcomes. Results: The majority of patients reported high satisfaction levels (≥8), which correlated with the independent expert’s evaluation of treatment efficacy and result stability. The only observed adverse event was transient cutaneous erythema. Conclusions: “Ozempic face” is an increasingly common side effect associated with newer classes of antidiabetic medications. Although these drugs offer significant metabolic benefits, the accompanying facial volume loss and aging are often poorly tolerated by patients. Our findings suggest that subdermal bipolar radiofrequency represents a safe, low-risk, and cost-effective therapeutic option for the aesthetic management of Ozempic face. Full article

Myeloproliferative neoplasms (MPNs) are chronic blood cancers characterized by overproduction of blood cells, leading to increased thrombotic and ischemic risk. Patients frequently experience symptoms including fatigue, abdominal discomfort, and complications from thrombotic events, which significantly impact the quality of life (QoL). Many patients inquire about complementary and integrative medicine (CIM) approaches, including nutritional interventions and supplements, creating opportunities for healthcare providers to engage in meaningful discussions guided by the principle of safety. This review examines the current evidence for integrative approaches in MPN management, focusing on nutrition, microbiota, supplements, mind–body techniques, and acupuncture. We analyze the available data on anti-inflammatory interventions, QoL improvement strategies, and treatment tolerance enhancement. The review provides clinicians with evidence-based guidance for safely integrating complementary therapeutic approaches with conventional MPN treatment. This integrative approach represents an opportunity to develop more comprehensive and personalized therapeutic paradigms in hematology while ensuring that complementary interventions serve as adjuncts to evidence-based medical treatment. Full article

The assessment of player well-being through questionnaires is vital for managing training and match demands in soccer, aiming to mitigate injury and overtraining risks. This study investigates the impact of Four-Match Congestion on the well-being of under-16 male soccer players. An observational study design was implemented, focusing on the well-being of eighteen male soccer players throughout a championship. Players were monitored daily for indicators such as muscle soreness, stress levels, mood, fatigue, sleep quality, and an overall well-being index. Data collection was conducted by research team staff without interfering with established training plans. Preliminary findings indicate significant fluctuations in well-being indicators throughout the championship, with lower well-being scores correlating with higher match intensity. Specifically, it was indicated that the athletes’ fatigue increased, while their stress levels gradually decreased (p < 0.05). Furthermore, muscle soreness, mood, and sleep quality metrics fluctuated throughout the study, with significant differences found between matches 1 and 3. These results highlight the importance of monitoring well-being to inform coaches about necessary adjustments in training loads during congested match schedules. Understanding the relationship between match demands and player well-being can lead to effective recovery strategies, enhancing performance and reducing injury risks. Future research should explore the long-term impacts of well-being monitoring and its integration into training regimens to optimize athlete management in competitive settings. Full article

Background and Objectives: Myasthenia Gravis (MG) comprises an autoimmune disorder marked by muscle weakness and fatigue. MG has been associated with comorbid conditions, including dyslipidemia (DL), which may exacerbate the clinical burden of MG and impact the overall quality of life. Materials and Methods: This systematic review and meta-analysis aimed to assess the prevalence of DL in patients with MG. Following PRISMA guidelines, a comprehensive search was conducted in the MEDLINE, Scopus, and Google Scholar databases. Primary outcomes included the pooled prevalence of DL in MG patients, and the relative risk of DL compared to healthy controls. Results: Nineteen studies involving 98,947 MG patients were analyzed. The pooled prevalence of DL was 23.64% (95% CI: 17.01–30.98). The relative risk of DL in MG patients versus controls was 1.13 (95% CI: 0.53–2.41), indicating no significant increase. Meta-regression revealed a positive correlation between DL prevalence and MG onset age (β = 0.02, p < 0.001), with a 2% rise in DL prevalence per 1-year increase in onset age. Regional subgroup analysis showed a statistical trend of higher DL prevalence in the USA (33.02%) compared to Asia (19.89%) and Europe (17.5%). Conclusions: This study found that approximately one in four MG patients has comorbid DL, with MG onset age significantly influencing DL prevalence. These findings highlight the need for personalized management strategies and evaluations (e.g., statins, LP(a) levels). Further research is warranted to elucidate the pathophysiological links between MG and DL. Full article

Background/Objectives: Background: Cancer survivors were at higher risk of poor job performance. Objectives: We aimed to identify differences in the relationship between patient activation, cancer-related symptoms, and job performance among young adult cancer survivors with low and high workplace support. Methods: Study Design: Our cross-sectional observational study was conducted using an online survey across Japan in January 2022. Measurement and Statistical Analysis: The survey was designed to assess demographic and clinical characteristics, patient activation, physical fatigue, depression, cognitive impairments, and job performance. Multiple-group structural equation modeling (SEM) was conducted using data from 202 survivors. Results: Of participants, 53% were aged 35–39 years and 78% were female. Patient activation was positively associated with job performance (β = 0.28, p < 0.01) and negatively related to cancer-related symptoms (β = −0.30, p = 0.01), and cancer-related symptoms were negatively associated with job performance (β = −0.29, p = 0.01), only among young adult cancer survivors with low workplace support. On the other hand, in the high support group, the path coefficients from patient activation to cancer-related symptoms (β = −0.06, p = 0.76), cancer-related symptoms to job performance (β = −0.12, p = 0.37), and patient activation to job performance (β = 0.20, p = 0.21) were not significant. Conclusions: Patient activation plays an important role in improving job performance, especially among young adult cancer survivors who lack workplace support. Even if obtaining workplace support is difficult for young adult cancer survivors, activation of self-management can improve their job performance. Full article

Aircraft mechanical maintenance involves high loads, repetitive movements, and awkward postures, significantly increasing the risk of work-related musculoskeletal disorders (WMSDs). Traditional static evaluation methods based on posture analysis fail to capture the complexity and dynamic nature of these tasks, limiting their applicability in maintenance settings. To address this limitation, this study introduces a novel quantitative WMSD risk assessment model that leverages 3D motion data collected through an optical motion capture system. The model evaluates dynamic human postures and employs an inverse trigonometric function algorithm to quantify the loading effects on working joints. Experimental validation was conducted through quasi-real-life scenarios to ensure the model’s reliability and applicability. The findings demonstrate that the proposed methodology provides both innovative and practical advantages, overcoming the constraints of conventional assessment techniques. Specifically, it enables precise quantification of physical task loads and enhances occupational injury risk assessments. The model is particularly valuable in physically demanding industries, such as aircraft maintenance, where accurate workload and fatigue monitoring are essential. By facilitating real-time ergonomic analysis, this approach allows managers to monitor worker health, optimize task schedules, and mitigate excessive fatigue and injury risks, ultimately improving both efficiency and workplace safety. Full article

Background/Objectives: Prostate cancer (PCa) patients frequently experience extended survivorship, highlighting the importance of quality of life (QoL) in cancer care. QoL has been shown to influence survival and PCa progression. For PCa patients, fatigue is a common issue due to cancer itself or its treatments. However, many QoL studies on PCa patients are limited by small sample sizes in clinic settings and often overlook the impact of fatigue and health-related behaviors. To fill this gap, this study aims to evaluate fatigue associated with QoL and related health measures among PCa patients. Methods: This study used the All of Us cohort with 6426 PCa patients. Factors associated with QoL and health outcomes were tested using logistic models. Results: Among PCa patients, 8.8% reported poor QoL, 20.9% reported poor physical health, and 9.0% reported poor mental health. Around 24.5% and 5.0% of PCa patients had a moderate and high fatigue level, respectively. A high fatigue level was significantly associated with poor QoL (OR = 2.33, p < 0.001), poor physical health (OR = 8.20, p < 0.001), and poor mental health (OR = 3.62, p < 0.001), adjusting for other factors. Social function ability also played a critical role in QoL and health outcomes. In addition, PCa therapy was associated with a higher risk of poor physical health (OR = 1.30, p = 0.030) but not associated with QoL and mental health. Conclusions: This study provides valuable insights about fatigue’s important role in QoL, physical health, and mental health for PCa patients. Effective fatigue management is suggested to enhance QoL and overall well-being for PCa patients. Full article

Today, African swine fever (ASF) continues to spread in European wild boar populations, while existing management strategies respond to an animal health emergency. The current disease scenario, characterised by constant re-emergence and persistence of infection, poses a fundamental social problem for the future of ASF policy in the affected regions. A World Café workshop was organised with veterinary epidemiology experts from practice, academia and governance. The aim was to explore the problems caused by ASF in Germany for the various stakeholders and to gather perspectives for the long-term management of ASF. The panel of experts linked the unintended extension of the animal health emergency concept to the tensions between the various stakeholders and the risk of system fatigue. Sustainable management approaches need to balance rapid response to outbreaks with long-term management efforts. The experts emphasised the importance of risk-based strategies, stakeholder involvement and evidence-based policies in ASF management. The expert panel also highlighted the need for transparent communication to increase public trust and acceptance. The need for more flexible approaches requires a more open discussion about the intractable challenges posed by the long-term presence of ASF, the adequacy of existing regulations and possible visions for the future. Full article

Endometriosis is a chronic disease affecting approximately 10% (190 million) of women and girls of reproductive age worldwide. It is associated with a variety of often debilitating symptoms, including severe pelvic pain, pain during intercourse, bowel movements and/or urination, bloating, nausea, fatigue, risk of infertility, as well as depression and anxiety in some cases. This review summarized the pathogenesis of endometriosis and the criteria for clinical diagnosis, proposed a panel of potential biomarkers for predictive molecular diagnosis, as well as choice of treatments for pain and infertility management. Full article

In response to the increasing frequency of maritime traffic accidents along China’s coast, this study develops an accident-cause analysis framework that integrates an optimized Bidirectional Encoder Representations from Transformers (BERT) with a Bidirectional Long Short-Term Memory network (BiLSTM), combined with the Apriori association rule algorithm. Systematic performance comparisons demonstrate that the BERT + BiLSTM architecture achieves superior unstructured-text-processing capability, attaining 89.8% accuracy in accident-cause classification. The hybrid framework enables comprehensive investigation of complex interactions among human factors, vessel characteristics, environmental conditions, and management practices through multidimensional analysis of accident reports. Our findings identify improper operations, fatigue-related issues, illegal modifications, and inadequate management practices as primary high-risk factors while revealing that multi-factor interaction patterns significantly influence accident severity. Compared with traditional single-factor analysis methods, the proposed framework shows marked improvements in Natural Language Processing (NLP) efficiency, classification precision, and systematic interpretation of cross-factor correlations. This integrated approach provides maritime authorities with scientific evidence to develop targeted accident prevention strategies and optimize safety management systems, thereby enhancing maritime safety governance along China’s coastline. Full article