Search Results (8,263)

Background/Objectives: Physical inactivity is a significant public health challenge among children and young people (CYP), particularly within clinical populations. Whilst healthcare professionals (HCPs) are uniquely positioned to implement behaviour change strategies, there is little evidence of implementation in practice. This study examined the practices of, as well as barriers and facilitators experienced by, HCPs in South Wales, United Kingdom (UK), when promoting physical activity (PA) and reducing sedentary behaviour (SED) in clinical paediatric populations, together with their perceptions and proficiencies in delivering this support. Methods: A 32-item questionnaire was completed by 41 HCPs, recruited through professional and clinical networks to generate an opportunistic sample from physiotherapists (n = 22), doctors (n = 7), occupational therapists (n = 4), therapy technical instructors (n = 2), and others (n = 1 each). Quantitative responses were analysed using descriptive statistics; free-text responses underwent qualitative content analysis. Results: The findings revealed that 95% of HCPs discussed PA at some or all appointments, with similar figures reported for SED (90%) and exercise (88%). However, only 63% of participants felt PA was adequately addressed within their services. Barriers included time constraints, resource limitations, and knowledge gaps. Key facilitators included training, toolkit availability, and multidisciplinary collaboration. Conclusions: This study highlights the need for system-level changes to enable HCPs to deliver consistent, effective messaging that promotes PA and reduces SED, ultimately improving health outcomes for CYP receiving clinical input. Facilitating this approach requires embedding PA promotion into HCP training, expanding referral pathways to CYP, and strengthening multidisciplinary working. Full article

Background/Objectives: Given the growing need for prenatal care, Nordic Walking (NW) is a promising intervention for maintaining maternal physical activity and quality of life (QoL). We aimed to investigate the influence of NW on gait kinematics, pelvic girdle pain, low back pain (LBP), and QoL during pregnancy. Methods: This is a single-blind randomized controlled trial. A total of 44 pregnant women aged 20 to 40 years with 13–28 weeks of gestation and mild to moderate musculoskeletal pain were included. Participants were randomly assigned to either the study (NW) group or the control group. The study group received the NW program for 12 weeks, three sessions per week, each lasting 45 min. The control group received standard prenatal care plus 30 min of moderate walking three days a week. The GAITRite system was used to measure gait kinematics, and the Visual Analog Scale (VAS) for pain and the SF-36 for QoL were administered at baseline, the fourth week, and the twelfth week. Results: NW significantly improved gait kinematics and reduced musculoskeletal pain (p < 0.001) with improvements in pain and gait speed exceeding the previous reported MCID thresholds. QoL improved across all SF-36 domains in the NW group (p < 0.001) compared with the control group, with large effect sizes observed for the primary outcomes. Conversely, the control group experienced declines in several QoL domains, including energy/fatigue and emotional well-being, despite moderate walking exercise and standard prenatal care over 12 weeks. Conclusions: NW may represent an effective prenatal exercise regimen associated with improved gait, reduced pain, and better overall QoL compared with moderate exercise, consistent with standard prenatal care. Full article

Background: Acute dehydration impairs performance, but its effects on resting neuromuscular and tissue mechanics are unclear. We tested whether baseline hydration status and exercise-induced sweat loss alter the resting neuromechanical phenotype of the rectus femoris (RF) as well as skin, subcutaneous tissue (subQ), and fascia overlying the RF. Methods: Thirty physically active men were randomized to hydration guidance (EXP) or habitual intake (CON). Hydration was verified weekly using first-morning urine specific gravity (USG), with targets of USG < 1.018 (EXP) and USG > 1.018 (CON). Participants performed continuous cycling at 50% maximal power output (Wmax) until ~3% body mass loss. Shear-wave elastography quantified tissue shear modulus (kPa), and tensiomyography assessed RF twitch-derived contractile properties (Dm, Tc, Tr) before and immediately after exercise. SWE data were analyzed using mixed design repeated-measures ANOVA; TMG outcomes were analyzed using non-parametric tests. Results: Baseline measures did not differ between groups. No significant group, time, or interaction effects were observed for RF muscle, skin, or subQ shear modulus. In contrast, fascia shear modulus showed a significant time effect, while TMG outcomes did not change significantly from pre- to post-exercise (all p > 0.05). Deep fascia showed a significant main effect of time, with decreased shear modulus post-exercise (F(1, 21) = 5.06, p = 0.035, η²p = 0.194; Δ = 1.25 kPa; d = 0.41; 95% CI [0.04, 0.78]), independent of hydration group. Conclusions: Under moderate-intensity cycling with approximately 3% body mass loss, we did not detect significant hydration-group differences or significant pre–post changes in resting RF twitch-derived contractile properties or in RF muscle, skin, and subQ shear modulus. Fascia shear modulus decreased after exercise irrespective of hydration group. These findings should be interpreted cautiously: the study was underpowered to detect small effects, and the fascial finding emerged from an exploratory, layer-specific analysis without correction for multiple comparisons. It should therefore be regarded as preliminary and hypothesis-generating, requiring confirmation in adequately powered, pre-registered studies. Full article

Background/Objectives: Vitamin D has been implicated in lipid metabolism, but data regarding its association with atherogenic lipoproteins in elite athletes remain limited. Elite athletes represent a unique research model to investigate these associations with reduced confounding from obesity, chronic disease, smoking, and physical inactivity. Methods: This cross-sectional study included 773 male professional athletes from mixed sports disciplines (mean age 25.5 ± 5.0 years). Serum 25-hydroxyvitamin D [25(OH)D] concentrations and lipid parameters, including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and lipoprotein(a) [Lp(a)], were assessed. Associations were analyzed using correlation analyses, subgroup comparisons according to predefined 25(OH)D categories (<30, 30–50, and >50 ng/mL), and multivariable linear regression models adjusted for age, body mass index, season, and training-related variables. Results: Higher serum 25(OH)D concentrations were independently associated with lower LDL-C (p = 0.028), triglyceride (p = 0.002), and Lp(a) concentrations (p = 0.036), whereas no independent association was observed with HDL-C (p = 0.559). Athletes with 25(OH)D concentrations ≥30 ng/mL demonstrated lower LDL-C, triglyceride, and Lp(a) levels compared with athletes below this threshold (all p < 0.05). Higher vitamin D status was additionally associated with greater peak exercise performance (4.29 ± 1.15 vs. 3.36 ± 0.68 W/kg; p < 0.001). Conclusions: Higher 25(OH)D concentrations were independently associated with a more favorable lipid profile in elite athletes, including lower LDL-C, triglyceride, and Lp(a) concentrations. Prospective studies are warranted to further investigate the relationship between vitamin D status and lipid metabolism in athletic populations. Full article

Background/Objectives: Promoting postural health in children requires not only adequate knowledge but also the implementation of health-promoting behaviors in the school environment. Teachers play a key role in this process; however, the extent to which their knowledge is reflected in everyday practice remains unclear. The study aimed to analyze and compare the levels of knowledge among preschool, early school, and physical education teachers regarding postural health in children and adolescents, including postural abnormalities, ergonomics, the selection of corrective exercises, and behaviors that promote correct body posture. Methods: A cross-sectional study was conducted on a sample of 153 teachers in Poland: 24 preschool (P), 53 early school education (EE), and 76 physical education (PE) teachers. The self-report Teachers’ Body Posture Literacy Questionnaire (TBPLQ) was used to assess knowledge regarding postural abnormalities. Results: PE achieved the highest TBPLQ scores, with significant differences observed mainly in comparison with EE (r = 0.30–0.50, p < 0.001). Across all groups, teachers performed best in recognizing postural abnormalities and worst in selecting appropriate corrective exercises. Although knowledge levels were relatively high, only weak correlations were found between knowledge and postural hygiene-promoting behaviors. The largest behavioral differences concerned the use of appropriate sportswear during physical education classes (η² > 0.14). Conclusions: Teachers demonstrated relatively high levels of knowledge regarding posture health. However, a clear knowledge–behavior gap was identified. Knowledge was only partially translated into proactive health-promoting actions, particularly regarding corrective interventions and communication with parents. The results suggest the need for educational initiatives for teachers focusing on proactive health-promoting and postural hygiene behaviors. Full article

Background: Lepidium meyenii Walp (L. meyenii), traditionally known as maca, is widely recognized for its health-promoting properties, including potential protection against exercise-induced muscle damage (EIMD). However, its precise effect on post-exercise blood biomarkers remains unclear. Objective: This study aimed to qualitatively review research published until April 2026 examining L. meyenii supplementation to reduce blood markers of muscle damage and protein degradation post-exertion in animal studies. Specifically, the effect size (ES) of L. meyenii supplementation on post-exercise levels of creatine kinase (CK), lactate dehydrogenase (LDH), and blood urea nitrogen (BUN) was estimated. Methods: This systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. The certainty of the evidence was assessed using the GRADE framework. Relevant studies were identified through Web of Science, Scopus, SPORTDiscus, PubMed, and MEDLINE. Eligible studies included in vivo experiments in animals with controlled designs and pre-/post-intervention assessments. Methodological quality and risk of bias were evaluated using the CAMARADES tool. Statistical analysis involved standardized mean differences (SMD) using Hedges’ g with 95% confidence intervals. Results: 15 studies were included in the systematic review, and 14 studies in animals in the meta-analysis. The CAMARADES scores ranged from 5 to 7 points, indicating moderate methodological quality. Supplementation with L. meyenii was not associated with statistically significant changes in LDH (SMD = −1.37; 95% CI −3.34 to 0.59), BUN (SMD = −0.37; 95% CI −2.16 to 1.42) nor CK (SMD = 0.29; 95% CI −5.45 to 6.03), with very high heterogeneity (I² > 97%). Exploratory subgroup analyses and meta-regression analyses by formulation type and dose did not identify any moderators that could robustly explain this heterogeneity. Conclusions: The available evidence does not support a robust overall effect of L. meyenii supplementation on blood biomarkers of muscle damage or protein catabolism in animals subjected to physical stress. The high degree of heterogeneity could not be robustly explained by either the type of formulation or the dose. These findings, which are exploratory and hypothesis-generating in nature, highlight the need for standardized, well-characterized formulations and trials with adequate statistical power. Full article

Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable driver of muscle deterioration in COPD. Nutritional deficits impair anabolic signaling, exacerbate proteolysis, worsen mitochondrial dysfunction, and contribute to frailty progression. Methods: This narrative review synthesizes evidence from PubMed, Embase, Scopus, and Web of Science up to 2025, integrating mechanistic, metabolic, nutritional, and biomarker-related pathways underlying muscle dysfunction in COPD. Studies examining inflammation, hypoxemia, oxidative stress, hormonal imbalance, nutrition, and emerging biomarkers were included. Results: COPD-related sarcopenia results from converging inflammatory (TNF-α, IL-6), catabolic (FOXO, UPS), metabolic, and vascular mechanisms, compounded by energy deficiency, protein insufficiency, and micronutrient deficits. Inadequate intake of protein, vitamin D, antioxidants, and omega-3 fatty acids increase anabolic resistance, enhance muscle catabolism, and worsen frailty. Nutritional interventions, particularly high-protein supplementation, leucine-enriched formulas, vitamin D repletion, omega-3 fatty acids, and multimodal nutrition–exercise programs, demonstrate benefits in muscle mass, strength, and physical performance. Biomarkers such as GDF-15, CAF22, and specific microRNAs reflect nutritional status and correlate with muscle health in COPD. Conclusions: Sarcopenia and frailty in COPD arise from a complex interplay of inflammatory, metabolic, nutritional, and lifestyle-related factors. Integrating nutritional assessment and targeted dietary interventions with exercise and pulmonary rehabilitation is essential to counteract anabolic resistance and improve functional outcomes. Advances in biomarker research may support earlier diagnosis and personalized nutrition-based therapeutic strategies. Full article

This study aims to empirically analyze the patterns, intensity, and perceived barriers to physical activity among Polish university students during the COVID-19 pandemic. The research utilized a diagnostic survey method, employing a questionnaire. The online survey was conducted from December 2020 to May 2022 via the Webankieta.pl platform. The minimum sample size, calculated using the standard formula for estimating a proportion in a large population, was set at 1100 participants and was exceeded, with 1260 students providing valid responses. The results show that over half (55.8%, mainly women) of the respondents did not participate in regular physical activity during the pandemic. Participants cited lack of desire, fatigue, and low motivation—not pandemic restrictions—as primary reasons. Conversely, 44.2% of respondents, mostly men, reported engaging in regular physical activity. Most engaged in moderate-intensity activities two to five times a week, with vigorous activities performed slightly less often. Women were more likely to do both types, while men favored strength training. The most common activities included walking (61.6%), simple gymnastic exercises (43.1%), strength training with equipment (35.0%), cycling (34.5%), and calisthenics (30.2%). The majority (81.3%) exercised at home or nearby (33.4%). Reported barriers, especially among those who exercised regularly, were pandemic-related, such as limited or closed access to gyms, fitness centers, and pools (59.1%), along with time constraints (44.7%) and low motivation or determination (32.0%). The findings emphasize the importance of targeted interventions to boost physical activity among university students, particularly women and those with fewer financial resources. Universities should consider implementing programs that promote accessible, regular activity and initiatives to enhance motivation and foster long-term, health-promoting habits. Full article

Cognitive frailty, characterized by the coexistence of physical frailty and cognitive impairment, has emerged as a major challenge in aging populations and is closely linked to sarcopenia, neurodegeneration, and chronic inflammation. Increasing evidence suggests that the gut microbiota acts as a central regulator of neuromuscular and neurocognitive aging through the integrated gut–brain–muscle axis. This review highlights how microbial dysbiosis, reduced short-chain fatty acid (SCFA) production, systemic endotoxemia, and altered microbial metabolites contribute to mitochondrial dysfunction, neuroinflammation, anabolic resistance, and impaired neuroplasticity. Key signaling mediators, including SCFAs, bile acids, tryptophan-derived metabolites, cytokines, and myokines such as irisin, brain-derived neurotrophic factor (BDNF), and cathepsin B, orchestrate bidirectional communication among the gut, skeletal muscle, and brain. We further discuss the role of exercise-induced microbiota remodeling and muscle endocrine signaling in promoting mitochondrial biogenesis and cognitive resilience. In addition, emerging translational strategies including probiotics, prebiotics, postbiotics, polyphenol-rich functional foods, marine bioactives, and precision nutrition are explored as potential interventions targeting this axis. Collectively, the gut–brain–muscle axis provides a novel systems biology framework for understanding cognitive frailty and developing integrated therapeutic strategies for healthy longevity. Full article

Background/Objectives: Frailty and sarcopenia are common among hospitalized patients and are associated with poor clinical outcomes. Nutritional and exercise interventions are widely used to prevent muscle loss and functional decline; however, their independent and incremental effects remain unclear. This scoping review aimed to systematically map the characteristics and reported effects of these interventions during hospitalization. Methods: This scoping review followed the Joanna Briggs Institute methodology and the PRISMA-ScR guidelines. A comprehensive literature search was conducted in PubMed/MEDLINE, EMBASE, CENTRAL, and PEDro. Eligible studies included adult hospitalized patients receiving nutritional interventions, exercise interventions, or both. Interventions were categorized into four groups: no intervention, nutrition alone, exercise alone, and combined interventions. Data regarding study characteristics, intervention details, and clinical outcomes were extracted and descriptively summarized. Results: Thirty-three studies were included. Considerable heterogeneity was observed in patient populations, intervention characteristics, and outcome measures. Most studies evaluated configurations including an exercise component (exercise alone or combined nutrition–exercise), whereas studies isolating nutrition or providing direct head-to-head comparisons between combined and single-component configurations were limited. Intervention dose and reporting were highly variable across studies. Conclusions: Current evidence on the effects of nutritional and exercise interventions during hospitalization remains heterogeneous and limited. Future studies should adopt standardized intervention reporting and directly compare combined and single-component strategies to determine additive and synergistic effects in patients with frailty or sarcopenia. Full article

Background/Objectives: Curcumin has been proposed as a nutritional strategy to support exercise recovery through antioxidant and anti-inflammatory actions. However, trials differ in sport context, training status, supplementation timing, dose, formulation, and methodological control. This systematic review evaluated its effects on recovery outcomes in active individuals and athletes, with particular attention to the applicability of the evidence to real-world sport settings. Methods: PubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library/CENTRAL were searched from 2012 to June 2026. Randomized double-blind placebo-controlled trials were eligible when they evaluated oral curcumin, curcuminoids, Curcuma-derived preparations with a specified curcumin dose, or curcumin combined only with bioavailability enhancers. Studies using artificial muscle-damage protocols, clinical populations, non-randomized designs, or combined bioactive interventions were excluded. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale, supplemented by a Cochrane Risk of Bias 2 (RoB 2) assessment and a Grading of Recommendations Assessment, Development and Evaluation (GRADE) certainty-of-evidence evaluation. Owing to heterogeneity, findings were synthesized narratively by outcome domain, supplementation timing, formulation type, exercise context, and training status. Results: Fifteen trials were included. Favorable effects were reported in 6/7 studies assessing oxidative stress, 4/6 assessing muscle damage, 3/8 assessing inflammation, 3/7 assessing subjective recovery, soreness, or fatigue, and 4/8 assessing physical or athletic performance. However, effects varied substantially according to population, exercise context, biomarker selection, timing of assessment, and formulation type. The certainty of evidence was low for oxidative stress and very low for muscle damage, inflammation, subjective recovery/soreness/fatigue, and performance. Conclusions: Curcumin supplementation may support selected aspects of exercise recovery, particularly oxidative stress responses. However, these findings should be interpreted cautiously because the evidence derives mostly from small trials with heterogeneous populations, exercise protocols, supplementation regimens, formulations, biomarkers, and assessment time points. Evidence for muscle damage, inflammation, subjective recovery, fatigue, and performance remains inconsistent, and further well-controlled trials in trained and high-performance athletes are needed before practical recommendations can be established. Full article

Declines of skeletal muscle mass and functions are implicated in the progression of various clinical conditions such as cancers, obesity, insulin resistance, diabetes, and osteoporosis. While no effective and safe drugs against muscle wasting, such as sarcopenia and disease-associated cachexia, have been discovered, it is well documented that dietary essential amino acids (EAAs) or high-quality protein work synergistically to enhance the anabolic effect of resistance exercise training (RT), leading to gains in muscle mass, strength, and muscle quality. Dietary EAAs serve as precursors and signaling molecules for the synthesis of new muscle proteins (both contractile and mitochondrial) and stimulate neuromuscular junction remodeling. Furthermore, EAAs consumed in the post-absorptive state improve endurance capacity via stimulation of mitochondrial biogenesis (independent of PGC1-α) and mitochondrial dynamics (mitochondrial protein synthesis and fission). Here, we discuss (1) traditional molecular mechanisms regulating the muscle proteome through constant turnover (synthesis and breakdown), (2) novel mechanisms by which dietary supplementation of EAAs during RT simultaneously improves muscle strength and endurance, (3) stable isotope tracer methodologies that enable understanding of the dynamic muscle proteome and accurate assessment of functional muscle mass, and finally, (4) clinical implications of combined EAA and RT interventions in the context of muscle and metabolic dysfunction, including sarcopenia, cachexia, obesity, and chronic disease. Collectively, current evidence underscores the potential of balanced EAAs, particularly when combined with resistance training, as a safe, effective, and translationally relevant nutritional strategy to preserve and enhance muscle and metabolic health across healthy and clinical populations. Full article

(1) Background: Physical fatigue, either in short anaerobic exercises or in aerobic ones, affects locomotion patterns. Those effects, if consistently observed, may function as fatigue proxies. The present study focuses on the regularity of the pseudo-periodic acceleration patterns measured by a wearable sensor. Studies during laboratory anaerobic tasks on healthy subjects and on persons with multiple sclerosis during 6 min walking tests demonstrated that regularity decreases with fatigue. This study’s objective is to verify if the gait regularity during an unsupervised endurance aerobic walking task progressively decreases in healthy subjects. (2) Methods: Ten healthy male adults, not competitive recreational athletes, equipped with an accelerometer, participated in a non-competitive 100 km walk in about 24 h. (3) Results: Eight participants took from about 22 to 25 h to complete the task. Two did not finish. The trend of locomotion regularity (on average −6.3%, p < 0.001, effect size 1.41) was negative for all the participants. The gait speed decrease, in all the participants, explained less than 20% of the regularity decrease. Other outcome indices, such as that related to cadence, did not provide unique trends. (4) Conclusions: Regularity decrease is associated with fatigue in submaximal locomotor efforts; due to the experimental group limitations in size and composition, further studies should extend regularity assessments to women, and to persons with neuromuscular disabilities or attending walking rehabilitation. Full article

Adults with type 1 diabetes mellitus (T1DM) face elevated cardiovascular risk, and regular exercise is a key non-pharmacological mitigation strategy. However, safe prescription requires cardiovascular and glycemic monitoring, often unfeasible in real-world gyms. Low-cost psychophysiological tools (ratings of perceived exertion—RPE and enjoyment) may offer practical alternatives. This exploratory randomized crossover trial examined whether post-session RPE and enjoyment are associated with acute heart rate (HR) and capillary blood glucose (BG) responses to gym-based aerobic and resistance training. Twelve adults with T1DM (29.8 ± 7.8 years; HbA1c 7.7 ± 1.6%; LDL-c 119.5 ± 24.4 mg/dL) completed three ~30 min sessions: aerobic interval training (AE) and two resistance protocols (STA, STB). HR and BG were measured pre-, immediately post-, and 20 min post-exercise; RPE and enjoyment, post-session. Multiple linear regression, controlling for exercise session type, examined associations of RPE and enjoyment with resting HR, BG, and percentage of heart rate reserve (%HR). RPE was higher after STA and STB than AE (p < 0.001; η²p = 0.529), while enjoyment and %HR were similar across sessions. Neither variable was associated with resting HR or BG (all adjusted R² < 0; all p > 0.05). Controlling for exercise session type, RPE was a significant positive predictor of %HR (β = 0.44, p = 0.044), whereas enjoyment was not (β = −0.06, p = 0.719); however, the overall %HR model did not reach statistical significance (adjusted R² =0.119; F(4,31) = 2.183; p = 0.094). These exploratory findings suggest that RPE, but not enjoyment, may serve as a low-cost adjunct intensity marker to inform exercise prescription in adults with T1DM at elevated cardiovascular risk; however, replication in larger samples is needed before clinical recommendations can be drawn. Direct BG monitoring remains essential for safety. Full article

Objectives/Background: Regular physical activity is a key health behavior associated with physical and mental well-being. However, sustaining physical activity remains challenging among adults, and the psychological mechanisms that support continued engagement require further clarification. Grounded in Self-Determination Theory, this study examined the roles of autonomous motivation and controlled regulation in health behavior engagement, focusing on the mediating role of physical activity self-regulation strategies. Methods: A cross-sectional study was conducted with 468 Korean adults. Autonomous motivation and controlled regulation were assessed using the Behavioral Regulation in Exercise Questionnaire-3, and physical activity self-regulation strategies were measured using the Physical Activity Self-Regulation Scale. Health behavior engagement was assessed using a single-item measure based on the stages of change for exercise. Structural equation modeling with bootstrapping was used to examine direct and indirect relationships among the study variables. Results: Both autonomous motivation (β = 0.649, p < 0.001) and controlled regulation (β = 0.153, p < 0.001) were positively associated positive with self-regulation strategies. Self-regulation strategies were positively associated with health behavior engagement (β = 0.336, p < 0.001). Autonomous motivation showed both a significant direct effect (β = 0.131, p = 0.018) and a significant indirect effects through self-regulation strategies (bias-corrected 95% confidence interval [CI] [0.206, 0.420]) on health behavior engagement, indicating partial mediation. In contrast, controlled regulation showed no significant direct effect (β = −0.062, p = 0.144) but had a significant indirect effect through self-regulation strategies (bias-corrected 95% CI [0.043, 0.131]). Conclusions: Autonomous motivation appears to be a stronger predictor of health behavior engagement than controlled regulation, both directly and indirectly through self-regulation strategies. These findings highlight the importance of motivational quality and suggest that self-regulation strategies are a key mechanism through which motivation is translated into physical activity engagement among adults. Interventions should therefore combine autonomy-supportive approaches alongside the development of practical self-regulatory skills to promote sustained physical activity. Full article