Search Results (555)

Governments worldwide are mandating e-invoicing and real-time VAT reporting, yet many cash-intensive service SMEs continue to under-report VAT, eroding fiscal revenues. This study investigates whether financial technology (FinTech) adoption can reduce this under-reporting among tourism SMEs in Greece—an economy with high seasonal spending and a persistent shadow economy. This is the first micro-level empirical study to examine how FinTech tools affect VAT compliance in this sector, offering novel insights into how technology interacts with behavioral factors to influence fiscal behavior. Drawing on the Technology Acceptance Model, deterrence theory, and behavioral tax compliance frameworks, we surveyed 214 hotels, guesthouses, and tour operators across Greece’s main tourism regions. A structured questionnaire measured five constructs: FinTech adoption, VAT compliance behavior, tax morale, perceived audit probability, and financial performance. Using Partial Least Squares Structural Equation Modeling and bootstrapped moderation–mediation analysis, we find that FinTech adoption significantly improves declared VAT, with compliance fully mediating its impact on financial outcomes. The effect is especially strong among businesses led by owners with high tax morale or strong perceptions of audit risk. These findings suggest that FinTech tools function both as efficiency enablers and behavioral nudges. The results support targeted policy actions such as subsidies for e-invoicing, tax compliance training, and transparent audit communication. By integrating technological and psychological dimensions, the study contributes new evidence to the digital fiscal governance literature and offers a practical framework for narrowing the VAT gap in tourism-driven economies. Full article

Background: Pain is a problem faced by critically ill surgical patients and has a major impact on their outcomes. Pain assessment is therefore essential for effective pain management, with a combination of pharmacological and non-pharmacological treatment. Clinical supervision, supported by models such as SafeCare, can improve professional development, safety and the quality of care in intensive care units. Objectives: This study aimed to: (1) assess current pain assessment practices in a polyvalent Intensive Care Unit (ICU) in the Porto district; (2) identify nurses’ training needs regarding the Clinical Supervision-Sensitive Indicator—Pain; and (3) evaluate the impact of clinical supervision sessions on pain assessment practices. Methods: A quantitative, quasi-experimental, cross-sectional study with a pre- and post-intervention design was conducted. Based on the SafeCare model, it included a situational diagnosis, 6 clinical supervision sessions (February 2023), and outcome evaluation via nursing record audits (November 2022 and May 2023) in 31 total critical ill patients. Pain was assessed using standardised tools, in line with institutional protocols. Data was analysed using Software Statistical Package for the Social Sciences v25.0. Results: Pain was highly prevalent in the first 24 h, decreasing during hospitalisation. Generalised acute abdominal pain predominated, with mild to moderate intensity, and was exacerbated by wound care and mobilisation/positioning. Pain management combined pharmacological and non-pharmacological treatment. There was an improvement in all the parameters of the pain indicator post-intervention. Conclusions: Despite routine assessments, gaps remained in reassessing pain post-analgesia and during invasive procedures. Targeted clinical supervision and ongoing training proved effective in improving compliance with protocols and supporting safer, more consistent pain management. Full article

The highway and bridge industry is facing persistent challenges related to the high turnover of technical personnel, which poses risks to the continuity and sustainability of infrastructure development. Although Geographic Information System (GIS) training has increasingly been advocated as a strategy to stabilize the workforce, its practical application remains relatively limited across China. Drawing on the Conservation of Resources (COR) theory, this study examines whether GIS training is associated with lower turnover intention among technical staff, potentially through enhanced perceptions of career growth and reduced work-related anxiety. Based on 412 valid responses—primarily from technical personnel employed by major infrastructure enterprises such as regional subsidiaries of the China Communications Construction Group (CCCG) and China State Construction Engineering Corporation (CSCEC)—the study employs Partial Least Squares Structural Equation Modeling (PLS-SEM) to assess the proposed relationships. The findings indicate that GIS training is negatively associated with turnover intention, with career growth partially mediating this association. Additionally, work anxiety moderates the relationship, such that the link between GIS training and turnover intention appears weaker under higher levels of anxiety. This research contributes to bridging the gap between training practices and theoretical understanding, offering insights to inform workforce retention strategies in technology-intensive industries. Full article

Background: Few studies have examined exercise-based treatments for migraine and tension-type headache (TTH), and even fewer have focused on strength training and chronic headache, as these present greater challenges. Objectives: This study aimed to evaluate the effectiveness of a group-based neck and shoulder strength training intervention combined with postural correction for patients with chronic headache. Methods: This prospective, single-arm, uncontrolled pilot study with a pre–post design included patients with chronic migraine (n = 10) and TTH (n = 12) who participated in an 8-week group-based program consisting of neck and shoulder strength training three times per week, along with instructions for postural correction. The primary outcome was change in headache frequency. Secondary outcomes included changes in the intensity and duration of headache, number of days of analgesic use, and functionality. Results: In total, 22 patients completed the intervention and were included in the analysis. Headache frequency decreased at follow-up for the overall group (r = 0.531; p = 0.014). In-depth analysis showed that 45% of participants experienced an average reduction of 38% in headache frequency. Additionally, large to moderate effect sizes were observed for the secondary outcomes. Conclusions: This is the first study to introduce a group-based exercise program targeting the neck and shoulder muscles, combined with postural correction and standard pharmacological treatment, for patients with chronic primary headache. It was found to be a safe, well-tolerated, useful, and promising intervention for improving headache frequency, duration, and functionality. Full article

This study aimed to describe the training leading to the Zwift Academy (ZA) Finals of a world-class road cyclist who earned a professional contract after winning the contest. Four years of daily power meter data were analyzed (male, 25 years old, 68 kg, VO₂max: 85 mL·min⁻¹·kg⁻¹, and 20-min power: 6.37 W·kg⁻¹), focusing on load, volume, intensity, and strategies. Early training alternated between long, moderate-intensity sessions and shorter high-intensity sessions, with easy days in between. Gradually, the structure was progressively modified by increasing the duration of moderate-intensity (MIT) and high-intensity (HIT) and, subsequently, moving them to “high-volume days”, creating a sort of “all-in days” with low-intensity (LIT), MIT, and HIT. Moderate use of indoor training and a few double low-volume, low-intensity sessions were noted. These data provide a deep view of a 4-year preparation period of ZA, providing suggestions for talent identification and training, thereby highlighting the importance of gradual progression in MIT and HIT. Full article

Water scarcity, exacerbated by climate change, population growth, and competing sectoral demands, poses a major threat to agricultural sustainability, particularly in irrigated regions such as the Nile Delta in Egypt. Addressing this challenge requires innovative approaches to evaluate irrigation performance despite the limitations in ground data availability. Traditional assessment methods are often costly, labor-intensive, and reliant on field data, limiting their scalability, especially in data-scarce regions. This paper addresses this gap by presenting a comprehensive and scalable framework that employs publicly accessible satellite data to map crop types and subsequently assess irrigation performance without the need for ground truthing. The framework consists of two parts: First, crop mapping, which was conducted seasonally between 2015 and 2020 for the four primary crops in the Nile Delta (rice, maize, wheat, and clover). The WaPOR v2 Land Cover Classification layer was used as a substitute for ground truth data to label the Landsat-8 images for training the random forest algorithm. The crop maps generated at 30 m resolution had moderate to high accuracy, with overall accuracy ranging from 0.77 to 0.80 in summer and 0.87–0.95 in winter. The estimated crop areas aligned well with national agricultural statistics. Second, based on the mapped crops, three irrigation performance indicators—adequacy, reliability, and equity—were calculated and compared with their established standards. The results reveal a good level of equity, with values consistently below 10%, and a relatively reliable water supply, as indicated by the reliability indicator (0.02–0.08). Average summer adequacy ranged from 0.4 to 0.63, indicating insufficient supply, whereas winter values (1.3 to 1.7) reflected a surplus. A noticeable improvement gradient was observed for all indicators toward the north of the delta, while areas located in the delta’s new lands consistently displayed unfavorable conditions in all indicators. This approach facilitates the identification of regions where agricultural performance falls short of its potential, thereby offering valuable insights into where and how irrigation systems can be strategically improved to enhance overall performance sustainably. Full article

Background: Pre-season training is pivotal for optimizing athletic performance in collegiate basketball, yet the effectiveness of such programs in improving body composition (BC) under NCAA-mandated hourly restrictions remains underexplored. The aim of this study was to evaluate the impact of a four-week, NCAA Division II-compliant strength and conditioning (SC) program on BC in women’s basketball. Methods: Sixteen student athletes (20.6 ± 1.8 y; 173.9 ± 6.5 cm; 76.2 ± 20.2 kg) completed an eight-hour-per-week micro-cycle incorporating functional conditioning, Olympic-lift-centric resistance, and on-court skill development. Lean body mass (LBM) and body-fat percentage (BF%) were assessed using multi-frequency bioelectrical impedance on Day 1 and Day 28. Linear mixed-effects models were used to evaluate the fixed effect of Time (Pre, Post), including random intercepts for each athlete and covariate adjustment for age and height (α = 0.05). Results The LBM significantly increased by 1.49 kg (β = +1.49 ± 0.23 kg, t = 6.52, p < 0.001; 95% CI [1.02, 1.96]; R² semi-partial = 0.55), while BF% decreased by 1.27 percentage points (β = −1.27 ± 0.58%, t = −2.20, p = 0.044; 95% CI [−2.45, −0.08]; R² = 0.24). Height positively predicted LBM (β = +1.02 kg/cm, p < 0.001), whereas age showed no association (p > 0.64). Conclusions: A time-constrained, NCAA-compliant SC program meaningfully enhances lean mass and moderately reduces adiposity in collegiate women’s basketball athletes. These findings advocate for structured, high-intensity, mixed-modality training to maximize physiological readiness within existing regulatory frameworks. Future research should validate these results in larger cohorts and integrate performance metrics to further elucidate functional outcomes. Full article

While the interest and participation in general endurance training and recreational sports competitions have continuously increased in recent decades, the number of recreational master-level endurance athletes has additionally multiplied. Athletes, active men and women older than 40 years of age, who participate in competitive athletics are usually referred to by the term master athletes (MAs). Previous research revealed the significant benefits of regular moderate physical activity, i.e., its positive influence on cardiovascular risk factors and cardiovascular health; however, recent data have raised concerns that long-term endurance exercise participation is associated with cardiac remodeling and potential adverse cardiovascular outcomes. Previous research also indicated potential structural, functional, and electrical remodeling in MAs due to prolonged and repeated exposure to high-intensity endurance exercise—a condition known as athlete’s heart. In this review, we focus on the association between extreme levels of endurance exercise and potential cardiovascular controversies, such as arrhythmogenesis due to new-onset atrial fibrillation, accelerated coronary artery atherosclerosis, and exercise-induced cardiac remodeling. Additionally, the exercise-dependent modulation of immunological response, such as proteomic response and cytokine alterations, is discussed. Furthermore, we discuss the impact of nutritional supplements in MAs and their potential benefits and harmful interactions. We aim to provide sports medicine practitioners with knowledge of these contemporary longevity controversies in sports cardiology and to highlight the importance of shared decision making in situations of clinical uncertainty. Full article

Background: Emerging evidence highlights the role of physical exercise as a non-pharmacological intervention for reducing symptoms of anxiety and depression. While most research has focused on aerobic modalities and chronic training programs, the acute psychological impact of resistance training (RT)—particularly in healthy, active individuals—remains underexplored. This study addresses this gap by evaluating the immediate effects of a single RT session on anxiety and depression in healthy, active individuals. Methods: Fifty-six healthy, physically active participants (43 males, 13 females; M age = 24.41 ± 4.41 years) were randomly assigned to an experimental group (RT, n = 30) or a control group (stretching/mobility, n = 26). The RT session included multi-joint exercises performed at 70–75% 1RM, while the control session consisted of non-load-based mobility and flexibility exercises. Psychological responses were measured immediately before and five minutes after the session using the Hospital Anxiety and Depression Scale (HADS), which includes subscales for anxiety (HADS-A) and depression (HADS-D). Results: Non-parametric within-group analysis (Wilcoxon Signed-Rank Test) revealed a significant reduction in anxiety scores in the RT group (Z = −3.3, p < 0.001, r = −0.7), and a moderate but significant decrease in depression (Z = −2.8, p = 0.005, r = −0.6). No significant changes were observed in the control group for either variable. Between-group comparisons (Mann–Whitney U) showed significantly greater reductions in anxiety in the RT group (p = 0.021), while differences in depression deltas were not significant. A Quade ANCOVA confirmed that group assignment is significantly predictive for post-intervention anxiety levels (F(1, 54) = 8.46, p = 0.005), controlling for baseline values. Conclusions: A single session of moderate-to-high-intensity resistance training can acutely reduce anxiety symptoms in healthy physically active individuals. The effect on depressive symptoms appears more modest and variable, suggesting differential sensitivity to acute exercise stimuli. These findings support the use of RT not only for long-term psychological health but also as a feasible short-term intervention for emotional regulation in healthy active populations. Full article

Limited data exist on the underlying physiological phenomena of aerobic training; the impulse oscillometry method, allowing the assessment of small airways and lung periphery in addition to standard lung function testing, might be a useful addition to rehabilitation programs. Background/Objectives: This study aimed to determine the immediate effect of a structured low-intensity aerobic training program on small airway function in healthy volunteers to explore potential implications for long-term COPD care. Methods: Thirty-six healthy volunteers were recruited between May 2024 and January 2025; each participant underwent a lung function testing session, followed by low/moderate-intensity aerobic exercise, and, after 15 min, by a second impulse oscillometry assessment. Results: There was a statistically significant reduction in airway resistance following the physical exertion for the whole group (mean difference 0.03 kPa/L/s, 95%CI 0–0.6 kPa/L/s); significantly lower values were recorded for the reactance component X5 (0.02 kPa/L/s, 95%CI 0–0.4 kPa/L/s) for the normal weight subgoup (n = 24). These results, corroborated with literature data, suggest optimization of the distribution of the airflow and possibly alteration of the elastic properties of the thoracic structures following even low-intensity effort. Conclusions: Low-intensity upper body strength and aerobic training seem to have an immediate respiratory beneficial effect on healthy volunteers manifested as a reduction in airway resistance. The underlying mechanism might be related to improved contractility of respiratory muscles, but changes in lung parenchyma elasticity may also be involved, possibly reflecting modifications of ventilation heterogeneity. Impulse oscillometry may be superior to spirometry in monitoring the effects of aerobic training, considering the additional data it provides, and could be used to optimize and personalize rehabilitation protocols. Full article

The benefits of regular physical exercise, primarily moderate-intensity exercise, are widely known, recognized, and acclaimed. As an important lifestyle modification, regular training activities are gaining increasing popularity in the general population. Apart from the obvious benefits, physical exercise may carry the risk of trauma, cardiovascular events, and exercise-induced asthma and bronchoconstriction, to name just a few well-known clinical situations reported in athletes, both recreational and competitive. In susceptible individuals, acute bouts of exercise may lead to the appearance of urticaria, angioedema, and anaphylaxis. Among these three clinical phenomena, angioedema is the least addressed and recognized, often being considered an accompanying clinical feature of urticaria or a hallmark of imminent anaphylactic reaction. To fill this knowledge gap, in this review, we focus on exercise-associated angioedema symptoms and highlight their most important features, both as isolated phenomena and in association with urticaria or anaphylaxis. Full article

Type 2 diabetes (T2D) is a major global health issue, influenced by sedentary behavior and obesity. Emerging evidence implicates the gut microbiota in T2D pathophysiology through effects on glucose metabolism, inflammation, and insulin sensitivity. This systematic review included eleven studies, six observational and five interventional, examining the relationship between physical activity, exercise, and gut microbiota in individuals with or at risk of T2D. Observational studies associated low physical activity and high sedentary time with reduced α-diversity and increased abundance of potentially harmful bacteria. Interventional studies showed that structured exercise, including moderate-intensity and sprint interval training, increased beneficial bacteria such as Faecalibacterium, Veillonella, Lachnospira, and Bifidobacterium, linked to anti-inflammatory effects and improved metabolic profiles. However, overall microbial diversity often remained unchanged unless combined with dietary modifications. Exercise also reduced levels of trimethylamine N-oxide, a metabolite linked to cardiovascular risk. Despite increases in butyrate-producing taxa, most studies did not report significant short-term changes in short-chain fatty acid levels, highlighting the complex interaction between microbiota and host metabolism. These findings support physical activity and exercise as modifiable factors that can influence gut microbiota composition, potentially contributing to improved metabolic regulation and better management of T2D. Full article

Background/Objectives: High-intensity interval training (HIIT) can optimize recovery by complementing the low cardiovascular fitness intensities typically achieved in stroke rehabilitation programs. Skating exercise is an HIIT workout developed based on ice skating movements, and we investigated the effects of this exercise on the cardiorespiratory fitness of elderly patients with minor stroke. Methods: Participants aged 65 or older with a National Institutes of Health Stroke Scale score of 3 or lower were recruited. This study was designed as a randomized controlled trial, in which the intervention group engaged in skating exercises following HIIT, while the control group underwent moderate-intensity continuous training (MICT). Both groups of participants performed either HIIT or MICT for 20 min per day, four times a week, over three months. Results: A total of 34 elderly patients with minor stroke were recruited, with an average age of 70.7 years. For three months, no fall-down injuries or adverse cardiovascular or cerebrovascular events were reported among patients undergoing HIIT or MICT. Both the intervention and control groups showed significant increases in the measures of aerobic capacity after the intervention. However, the patients in the intervention group exhibited significantly greater improvements in peak oxygen uptake, ventilatory threshold, and peak MET (p = 0.005, p = 0.002, and p = 0.024, respectively). Additionally, the Berg Balance Scale (BBS) scores and the skeletal muscle mass index showed significantly greater enhancements in the intervention group compared to the control group (p = 0.032 and p = 0.032). Conclusions: In conclusion, skating exercise could be a safe and effective HIIT protocol for elderly people who have experienced a minor stroke. Full article

Background/Objectives: Physical activity is generally recommended, but youth with disabilities present increased sedentary behaviors. This is often due to limited or inaccessible exercise options. The aim of this systematic review was to report on the state of knowledge about the role of adapted physical activity (APA) in improving gross motor performance (query 1), participation and QoL (query 2) of children and adolescents with neurological motor disability. Methods: Pubmed, Scopus and Cinahl databases were enquired in October 2023 and updated in May 2025. Inclusion criteria were the following: any type of physical activity; pediatric subjects with any neuromotor disease; and any type of outcome measure regarding gross motor performance, participation or QoL. The risk of bias (RoB) was assessed by means of ROB 2, Robins-I and JBI tools. Results were synthetized focusing on the outcome measures and the type of activity proposed. Results: Thirteen and seven studies were included relative to queries 1 and 2, respectively. They all were RCTs, and some presented randomization RoB. Several types of APA (e.g., resistance, high-intensity circuit, running, cycling, aquatic and dance training) and of outcome measures were enquired, mostly focusing on subjects with cerebral palsy or Down syndrome. An increased time of moderate-to-vigorous physical activity, improvement in timed functional tests, muscle strength and stability were observed. Conclusions: APA may improve functioning, social participation and promote active lifestyle in pediatric persons with neuromotor disabilities, without adverse effects. In the future, more specific indications based on the functioning profile are advisable to orient professionals to define individualized safe training programs. Full article

Introduction: The purpose of this study was to evaluate effects of post-exercise protein supplementation with combined resistance and interval training on total insulin-like growth factor-1 (IGF-1) concentration, strength (3RM), and body composition (DXA) in untrained pre-menopausal women. Methods: Twenty-seven women (33.6 ± 9.2 years, 69.4 ± 12.4 kg, 25.5 ± 3.7 kg/m²) were randomised into a control (CON) or moderate protein group (PRO) (3 g, 24 g, resp.) and completed twelve weeks of upper-body resistance (2×/week) and high-intensity interval cycle training (3×/week). Linear mixed-effects model analyses were conducted. Results: PRO had a greater daily protein intake (5.0 ± 16.6 g, 20.5 ± 13.9 g, CON, PRO, resp., p = 0.025), with no change in IGF-1 (−6.0 ± 27.7 µg/L, −2.1 ± 27.8 µg/L, CON, PRO, resp., p = 0.920). Total lean mass increased (0.84 ± 0.80 kg, 0.56 ± 1.4 kg, CON, PRO, resp., p = 0.009), and all strength measures increased in both groups (19–113%, p < 0.05). Conclusions: Untrained women can increase strength and lean mass over twelve weeks of combined resistance and interval training. Post-exercise protein supplementation had little effect, despite increasing protein intake by ~20 g/day in the PRO group. IGF-1 was not associated with any outcome measure. Full article