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Search Results (10,001)

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16 pages, 673 KB  
Article
Associations Between the Food Environment and Food Insecurity on Fruit, Vegetable, and Nutrient Intake, and Body Mass Index, Among Urban-Dwelling Latina Breast Cancer Survivors Participating in the ¡Mi Vida Saludable! Trial
by Zachary O. Kadro, Eileen Rillamas-Sun, Blake O. Langley, Allison Meisner, Isobel Contento, Pamela A. Koch, Ann Ogden Gaffney, Dawn L. Hershman and Heather Greenlee
Nutrients 2025, 17(24), 3950; https://doi.org/10.3390/nu17243950 (registering DOI) - 17 Dec 2025
Abstract
Background: Socioeconomic disparities may drive cancer inequities in Hispanic/Latino populations. We examined associations of perceived access to healthy foods (AHF) and food insecurity (FI) with diet and body mass index (BMI) changes in Latina breast cancer (BC) survivors. Methods: Latina BC [...] Read more.
Background: Socioeconomic disparities may drive cancer inequities in Hispanic/Latino populations. We examined associations of perceived access to healthy foods (AHF) and food insecurity (FI) with diet and body mass index (BMI) changes in Latina breast cancer (BC) survivors. Methods: Latina BC survivors in a 12-month intervention trial aiming to increase fruit/vegetable intake and physical activity were analyzed. AHF was from a modified, validated neighborhood environment scale and dichotomized (low–medium vs. high). FI was defined as eating less and/or going hungry due to a lack of money. AHF and FI surveys were self-reported. Outcomes included dietary intake, diet quality, and BMI. Fruit/vegetable intake was log-transformed. Relationships between AHF and FI and changes in diet and BMI were evaluated using generalized estimating equations. Results: Of women with AHF data (n = 86), 58% reported low–medium access and 42% reported high access. Fruit/vegetable (FV) intake declined overall from baseline to 12 months, with greater reductions among low–medium AHF women (−32%, 95% CI: −51%, −7%) compared with high AHF women (−17%, CI: −40%, +13%). Statistically significant 12-month decreases in total calories, carbohydrates, sugars, and fat occurred in low–medium AHF women but not high AHF women, and changes in total energy density, carbohydrates, sugars, and BMI at 12 months were statistically significantly different between women with low–medium AHF and women with high AHF, p ≤ 0.05. Among 157 women, 23% reported FI. Reductions in fruit/vegetable intake were larger in women with FI (−39%, CI: −57%, −14%) than in women without FI (−10% reductions, CI: −25%, +8%) and between-group differences were significant at both 6 and 12 months, p ≤ 0.05. Most diet measures decreased for both FI and non-FI women, with greater decreases among those with FI. Conclusions: Latina BC survivors with FI or perceived limited AHF experienced greater declines in indicators of healthy diets including FV intake. Future interventions should integrate strategies to measure AHF and FI to address disparate access to healthy food options. Full article
(This article belongs to the Special Issue Food Security, Food Insecurity, and Nutritional Health)
17 pages, 976 KB  
Systematic Review
Effectiveness of the Internet of Things for Improving Health of Non-Pregnant Women Living in High-Income Countries: A Systematic Review
by Olukunmi Omobolanle Balogun, Etsuko Nishimura, Noyuri Yamaji, Kiriko Sasayama, Md. Obaidur Rahman, Katharina da Silva Lopes, Citra Gabriella Mamahit, Mika Ninohei, Phyu Phyu Tun, Rina Shoki, Daichi Suzuki, Aya Nitamizu, Windy Mariane Virenia Wariki, Daisuke Yoneoka, Eiko Saito and Erika Ota
Healthcare 2025, 13(24), 3310; https://doi.org/10.3390/healthcare13243310 - 17 Dec 2025
Abstract
Background/Objectives: There is increased advocacy for the potential for digital applications (apps) and the Internet of Things (IoT) to improve women’s health. We conducted a systematic review to assess and synthesise the role of Apps and the IoT in improving the health [...] Read more.
Background/Objectives: There is increased advocacy for the potential for digital applications (apps) and the Internet of Things (IoT) to improve women’s health. We conducted a systematic review to assess and synthesise the role of Apps and the IoT in improving the health of non-pregnant women. Methods: Six databases were searched from inception to 13 February 2023. We included randomised controlled trials that assessed the effects of various Apps and the IoT with regard to improving the health of non-pregnant women in high-income countries. Our primary outcomes were health status and well-being or quality of life, and we assessed behaviour change as the secondary outcome. Screening, data extraction, and quality assessment were performed in duplicate. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool. Narrative methods were used to synthesise study outcomes. Results: The search retrieved 18,433 publications and seven publications from six studies met the inclusion criteria. Participants included overweight or obese women, postmenopausal women, or women with stage I–III breast cancer. Intervention types varied across included studies but broadly included wearable or sensor-based personal health tracking digital technologies. The most commonly assessed intervention effect was on behaviour change outcomes related to promoting physical activity. Interventions administered yielded positive effects on health outcomes and well-being or quality of life in one study each, while three of the four studies that assessed behaviour change reported significant positive effects. Most included studies had methodological concerns, while study designs and methodologies lacked comparability. Conclusions: Based on our findings, the use of apps and the IoT may be promising for facilitating behaviour change to promote physical activity. However, more evidence is needed to assess the effectiveness of the IoT for improving health status, well-being and quality of life among non-pregnant women. Full article
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13 pages, 849 KB  
Article
Effects of Lee Silverman Voice Treatment® BIG on At-Home Physical Activity in Individuals with Parkinson’s Disease: A Preliminary Retrospective Observational Study
by Yuichi Hirakawa, Hiroaki Sakurai, Soichiro Koyama, Kazuya Takeda, Masanobu Iwai, Ikuo Motoya, Yoshikiyo Kanada, Nobutoshi Kawamura, Mami Kawamura and Shigeo Tanabe
Appl. Sci. 2025, 15(24), 13235; https://doi.org/10.3390/app152413235 - 17 Dec 2025
Abstract
In individuals with Parkinson’s disease (PD), bradykinesia severity is related to physical activity (PA) inside homes. We aimed to investigate the effectiveness of the Lee Silverman Voice Treatment (LSVT)® BIG intervention in increasing at-home PA in individuals with PD. To evaluate the [...] Read more.
In individuals with Parkinson’s disease (PD), bradykinesia severity is related to physical activity (PA) inside homes. We aimed to investigate the effectiveness of the Lee Silverman Voice Treatment (LSVT)® BIG intervention in increasing at-home PA in individuals with PD. To evaluate the effect of the intervention, we compared pre- and post-intervention scores on the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Parts 3 and 2, as well as the time spent at home in three categories of PA intensity. For statistical testing, paired t-tests were used when the data met the assumptions of normality, and the Wilcoxon signed-rank test was applied otherwise. Differences were considered statistically significant at p < 0.05. This preliminary retrospective observational study included 10 eligible individuals with PD (4 males). The participants’ mean age was 71.0 ± 10.8 years, with median Hoehn and Yahr stage 3 [interquartile range: 1 to 4]. The MDS-UPDRS Part 3 score, bradykinesia score calculated from a part of that score, and the MDS-UPDRS Part 2 score significantly improved after the intervention (Wilcoxon signed-rank test, p < 0.05). The time spent in sedentary behavior (SB) significantly decreased from 516.4 ± 72.6 to 484.0 ± 70.0 min, whereas that spent in light PA (LPA) significantly increased from 137.8 ± 46.2 to 169.5 ± 32.1 min (paired t-test, p < 0.05). The time spent on moderate-to-vigorous PA (MVPA) did not change significantly (paired t-test, p = 0.533). The results suggested that LSVT® BIG is an effective intervention for increasing at-home PA in individuals with PD. In addition, regarding the specific details of the increase, the time spent on MVPA may not change, and the increase may be mainly attributed to increased LPA and reduced sedentary time. Full article
(This article belongs to the Special Issue Current Advances in Rehabilitation Technology)
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14 pages, 502 KB  
Article
Stride Mechanics and Strength Analysis of Lower Limbs in Runners with Medial Tibial Stress Syndrome vs. Asymptomatic Runners
by Estélio Henrique Martin Dantas, Ronald Bispo Barreto, Miguel Angel Narvaez Silva, Marcos Antonio Almeida-Santos, Guido Belli and Luca Russo
Biomechanics 2025, 5(4), 106; https://doi.org/10.3390/biomechanics5040106 - 17 Dec 2025
Abstract
Background: Street running has seen rapid growth due to its health benefits and accessibility, leading to a simultaneous rise in running-related injuries, particularly among recreational and professional street runners. Medial Tibial Stress Syndrome (MTSS) is a common injury affecting up to 15% of [...] Read more.
Background: Street running has seen rapid growth due to its health benefits and accessibility, leading to a simultaneous rise in running-related injuries, particularly among recreational and professional street runners. Medial Tibial Stress Syndrome (MTSS) is a common injury affecting up to 15% of athletes and posing significant risks to runners of all levels of participation. Objective: This study aimed to investigate the strength and kinematic differences in the lower limbs of runners diagnosed with MTSS compared to asymptomatic runners. Methods: A total of 56 participants were divided into an MTSS group (27 runners) and a healthy control group (29 runners). Participants were evaluated for demographics, physical activity level, pain threshold using algometry, and running kinematics obtained through high-resolution 2D video analysis with Kinovea software. Lower-limb muscle strength was measured using an isometric Lafayette® digital dynamometer. Results: Although there were no significant differences in age or anthropometric measures, MTSS runners exhibited lower initial (∆% = 10.6%, p = 0.002) and intermediate (∆% = 8.7%, p = 0.026) running speeds. Pain assessment revealed significant lower pain thresholds in the MTSS group. Kinematic analysis identified greater foot-strike angles (left foot: ∆% = 31.9%, p = 0.004; right foot: ∆% = 25.9%, p = 0.0049) at initial speeds in MTSS runners, while other parameters like medial calcaneus rotation, push-off angles, and support time did not differ significantly. Additionally, MTSS runners demonstrated reduced strength in the quadriceps femoris (QF—Left QF: ∆% = −28.5%, p = 0.0049; Right QF: ∆% = −28.2%, p = 0.003). Conclusions: MTSS appears to affect female and male runners. MTSS may be attributed to a weaker quadriceps strength, higher heel contact angles during foot strike, or both, suggesting that interventions focusing on the improvement of these factors may be beneficial in preventing and treating MTSS. Full article
(This article belongs to the Section Gait and Posture Biomechanics)
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33 pages, 824 KB  
Review
Lifestyle-Based Approaches to Cancer Prevention and Treatment: Diet, Physical Activity, and Integrative Strategies
by Gianpiero Greco, Alessandro Petrelli, Francesco Fischetti and Stefania Cataldi
Pathophysiology 2025, 32(4), 70; https://doi.org/10.3390/pathophysiology32040070 - 17 Dec 2025
Abstract
Cancer remains a leading global cause of morbidity and mortality. Modifiable lifestyle factors, including avoidance of tobacco use and excessive ultraviolet radiation, healthy dietary patterns, regular physical activity, and weight management, play key roles in prevention and care. This narrative review synthesizes evidence [...] Read more.
Cancer remains a leading global cause of morbidity and mortality. Modifiable lifestyle factors, including avoidance of tobacco use and excessive ultraviolet radiation, healthy dietary patterns, regular physical activity, and weight management, play key roles in prevention and care. This narrative review synthesizes evidence on lifestyle-based interventions influencing cancer risk, treatment tolerance, and survivorship. A literature search was conducted in PubMed and Scopus, supplemented by manual screening via Google Scholar. The time frame (2001–2025) was selected to reflect evidence produced within the modern era of molecular oncology and contemporary lifestyle medicine research. Eligible publications addressed carcinogen exposure (tobacco, alcohol, ultraviolet radiation), diet and nutritional strategies, physical activity, sedentary behavior, obesity, metabolic health, complementary therapies, and cancer outcomes. Evidence indicates that reducing exposure to tobacco and ultraviolet radiation remains central to cancer prevention. Adherence to predominantly plant-based diets, regular physical activity, and maintenance of healthy body weight are consistently associated with lower incidence of several cancers, including breast, colorectal, and liver cancer. Nutritional strategies such as caloric restriction, ketogenic diets, and fasting-mimicking diets show promise in improving treatment efficacy and quality of life. Complementary and mind–body therapies may alleviate treatment-related symptoms, although high-quality evidence on long-term safety and effectiveness is limited. Integrating lifestyle medicine into oncology offers a cost-effective, sustainable strategy to reduce cancer burden and enhance survivorship. Comprehensive programs combining carcinogen avoidance, dietary regulation, structured exercise, and effective radiation risk mitigation may extend healthspan, improve treatment tolerance, and help prevent recurrence. Full article
(This article belongs to the Topic Overview of Cancer Metabolism)
20 pages, 291 KB  
Article
Gender-Based Violence Prevalence, Psychosocial Effects, and Coping Mechanisms Among Refugee Women in Kebribeyah Camp, Ethiopia: Baseline for Interventions to Prevent Psychosocial Challenges
by Fikadu Tafesse Lakew, Getachew Abeshu Disassa and Kassim Kimo Kebelo
Soc. Sci. 2025, 14(12), 721; https://doi.org/10.3390/socsci14120721 - 17 Dec 2025
Abstract
The study investigated the prevalence of gender-based violence, its psychological effects, and coping mechanisms among refugees in Ethiopia’s Kebribeyah Camp, which is believed to be the least recognized issue for female refugees. Owing to the loss of a social network and power, refugee [...] Read more.
The study investigated the prevalence of gender-based violence, its psychological effects, and coping mechanisms among refugees in Ethiopia’s Kebribeyah Camp, which is believed to be the least recognized issue for female refugees. Owing to the loss of a social network and power, refugee women are the most vulnerable to different forms of gender-based violence and psychosocial challenges. The data collection and analysis were performed using a cross-sectional explanatory, quantitative design. The study involved 357 women refugees who were eligible for the study and found that there was a prevalence of 10.98% for GBV. In this study, it was determined that the most prevalent forms of GBV are psychological, physical, and sexual forms, respectively, which require immediate interventions. Irrational verbal and physical violence against women by men is identified as a signal for sexual violence. The mediation analysis examines the relationship between GBV acts, psychosocial challenges, and survivors’ coping strategies. GBV was found to be a significant predictor of both psychological and social difficulties, accounting for a significant variance in psychological difficulties (71%) and phobias (59%), and a substantial portion of social challenges (35%). GBV accounts for 82% of the variance in coping strategies. The study deduces the multidimensional pathway of the adverse effects of GBV among survivors, and suggests a combination of interventions to address GBV acts, psychological challenges, social challenges, and psychological phobias through an intersectional approach. Full article
(This article belongs to the Section Gender Studies)
30 pages, 3827 KB  
Review
A Review of Anticoagulant Surface Modification Strategies for Blood-Contacting Materials: From Inertness to Bioinspired and Biointegration
by Shuguang Zhang, Zhixiang Deng, Yuhe Wang and Chao Zhao
Coatings 2025, 15(12), 1486; https://doi.org/10.3390/coatings15121486 - 16 Dec 2025
Abstract
The coagulation cascade triggered by the contact between blood and the surface of implantable/interventional devices can lead to thrombosis, severely compromising the long-term safety and efficacy of medical devices. As an alternative to systemic anticoagulants, surface anticoagulant modification technology can achieve safer hemocompatibility [...] Read more.
The coagulation cascade triggered by the contact between blood and the surface of implantable/interventional devices can lead to thrombosis, severely compromising the long-term safety and efficacy of medical devices. As an alternative to systemic anticoagulants, surface anticoagulant modification technology can achieve safer hemocompatibility on the device surface, holding significant potential for clinical application. This article systematically elaborates on the latest research progress in the surface anticoagulant modification of blood-contacting materials. It analyzes and discusses the main strategies and their evolution, spanning from physically inert carbon-based coatings and heparin-based drug-functionalized surfaces to hydrophilic/hydrophobic dynamic physical barriers, biologically signaling regulatory coatings, and bio-integrative/regenerative endothelium-mimicking surfaces. The advantages and limitations of the respective methods are outlined, and the potential for synergistic application of multiple strategies is explored. A special emphasis is placed on current research hotspots regarding novel anticoagulant surface technologies, such as hydrogel coatings, liquid-infused surfaces, and 3D-printed endothelialization, aiming to provide insights and references for developing long-term, safe, and hemocompatible cardiovascular implantable devices. Full article
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19 pages, 961 KB  
Review
Exercise-Induced Molecular Adaptations in Chronic Non-Communicable Diseases—Narrative Review
by Héctor Fuentes-Barría, Raúl Aguilera-Eguía, Miguel Alarcón-Rivera, Olga López-Soto, Juan Alberto Aristizabal-Hoyos, Ángel Roco-Videla, Marcela Caviedes-Olmos and Diana Rojas-Gómez
Int. J. Mol. Sci. 2025, 26(24), 12096; https://doi.org/10.3390/ijms262412096 - 16 Dec 2025
Abstract
Physical exercise is a potent non-pharmacological strategy for the prevention and management of chronic non-communicable diseases (NCDs), including type 2 diabetes, cardiovascular diseases, obesity, and certain cancers. Growing evidence demonstrates that the benefits of exercise extend beyond its physiological effects and are largely [...] Read more.
Physical exercise is a potent non-pharmacological strategy for the prevention and management of chronic non-communicable diseases (NCDs), including type 2 diabetes, cardiovascular diseases, obesity, and certain cancers. Growing evidence demonstrates that the benefits of exercise extend beyond its physiological effects and are largely mediated by coordinated molecular and cellular adaptations. This review synthesizes current knowledge on the key mechanisms through which exercise modulates metabolic health, emphasizing intracellular signaling pathways, epigenetic regulation, and myokine-driven inter-organ communication. Exercise induces acute and chronic activation of pathways such as AMPK, PGC-1α, mTOR, MAPKs, and NF-κB, leading to enhanced mitochondrial biogenesis, improved oxidative capacity, refined energy sensing, and reduced inflammation. Additionally, repeated muscle contraction stimulates the release of myokines—including IL-6, irisin, BDNF, FGF21, apelin, and others—that act through endocrine and paracrine routes to regulate glucose and lipid metabolism, insulin secretion, adipose tissue remodeling, neuroplasticity, and systemic inflammatory tone. Epigenetic modifications and exercise-responsive microRNAs further contribute to long-term metabolic reprogramming. Collectively, these molecular adaptations establish exercise as a systemic biological stimulus capable of restoring metabolic homeostasis and counteracting the pathophysiological processes underlying NCDs. Understanding these mechanisms provides a foundation for developing targeted, personalized exercise-based interventions in preventive and therapeutic medicine. Full article
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38 pages, 2283 KB  
Review
Memory Under Stress: How Post Traumatic Stress Disorder Affects Working Memory in Adults: A Scoping Review
by Olga Ganis, Anna Tsiakiri, Foteini Christidi, Magdalini Katsikidou, Aikaterini Arvaniti and Maria Samakouri
Int. J. Cogn. Sci. 2025, 1(1), 4; https://doi.org/10.3390/ijcs1010004 - 16 Dec 2025
Abstract
Post-Traumatic Stress Disorder (PTSD) is consistently linked to multidimensional working memory (WM) impairments, encompassing deficits in sustained attention, verbal and visuospatial processing, and executive control, with inhibitory dysfunction emerging as a key feature. This scoping review synthesizes evidence from 39 studies examining neurobiological [...] Read more.
Post-Traumatic Stress Disorder (PTSD) is consistently linked to multidimensional working memory (WM) impairments, encompassing deficits in sustained attention, verbal and visuospatial processing, and executive control, with inhibitory dysfunction emerging as a key feature. This scoping review synthesizes evidence from 39 studies examining neurobiological mechanisms, trauma-related factors, genetic and hormonal influences, gender differences, and task-specific variability. Findings indicated that PTSD is associated with altered activation and connectivity in the prefrontal cortex, hippocampus, and related neural networks, often resulting in compensatory but inefficient recruitment patterns. Emotional distraction and comorbidities such as depression, alcohol use, and traumatic brain injury can exacerbate cognitive deficits. Performance impairments are evident across both emotional and neutral WM tasks, with visuospatial and updating processes being particularly vulnerable. Risk factors include chronic trauma exposure, older age, APOE ε4 allele, and the BDNF Val66Met (rs6265) polymorphism, while modulators such as oxytocin, cortisol, and physical activity show potential cognitive benefits under specific conditions. Methodological heterogeneity and limited longitudinal data restrict generalizability. These findings underscore the importance of early screening, targeted cognitive interventions, and inclusion of underrepresented populations to refine prevention and treatment strategies for PTSD-related WM deficits. Full article
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14 pages, 1236 KB  
Article
From Altered Metabolic and Anthropometric Parameters to Metabolic Syndrome: A Cross-Sectional Survey on the Effectiveness and Safety of Neo-Policaptil® Gel Retard
by Elena Gabriele, Roberto Cioeta, Paola Muti, Marta Rigoni, Roberta La Salvia, Andrea Cossu and Emiliano Giovagnoni
Healthcare 2025, 13(24), 3293; https://doi.org/10.3390/healthcare13243293 - 15 Dec 2025
Abstract
Background/Objectives: Metabolic syndrome (MetS) and even closely related metabolic and anthropometric alterations require timely intervention to reduce associated risks. Neo-Policaptil® Gel Retard has shown potential in managing both established MetS and early imbalances. To further characterize its real-world impact, a large [...] Read more.
Background/Objectives: Metabolic syndrome (MetS) and even closely related metabolic and anthropometric alterations require timely intervention to reduce associated risks. Neo-Policaptil® Gel Retard has shown potential in managing both established MetS and early imbalances. To further characterize its real-world impact, a large post-marketing survey was conducted to assess perceived effectiveness, safety, quality of life (QoL), and patterns of use. Methods: Between December 2021 and May 2025, patients/child caregivers, pharmacists, and physicians completed online questionnaires via a dedicated web platform. Patients reported their direct experience, while healthcare professionals (HCPs) provided observations on patient use. Results: The survey included 2204 patients, 57 child caregivers, 455 physicians, and 387 pharmacists. Overall, 97.7% of patients reported an improvement in their condition. Most physicians (94.3%) and pharmacists (89.1%) rated the overall effectiveness of the product as “good” or “excellent”. The safety profile was judged “good” or “excellent” by 84.4% of patients and by over 93% of HCPs. The product was mainly used as monotherapy or in combination with dietary measures and/or physical exercise. Conclusions: These findings underscore the product’s effectiveness, safety, tolerability, and positive influence on QoL in both adults and children affected by MetS or by related metabolic and anthropometric imbalances. Full article
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16 pages, 374 KB  
Article
Trajectories of Adherence to Study-Prescribed Physical Activity Goals in a mHealth Weight Loss Intervention
by Zhadyra Bizhanova, Lora E. Burke, Maria M. Brooks, Bonny Rockette-Wagner, Jacob K. Kariuki and Susan M. Sereika
Sensors 2025, 25(24), 7595; https://doi.org/10.3390/s25247595 - 15 Dec 2025
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Abstract
Introduction: Engaging in ≥300 min/week of moderate-to-vigorous physical activity (MVPA) is recommended for weight management. This study identified MVPA goal-adherence trajectories and associated predictors and weight outcomes in a 12-month mHealth weight-loss trial. Materials and Methods: This was a secondary analysis [...] Read more.
Introduction: Engaging in ≥300 min/week of moderate-to-vigorous physical activity (MVPA) is recommended for weight management. This study identified MVPA goal-adherence trajectories and associated predictors and weight outcomes in a 12-month mHealth weight-loss trial. Materials and Methods: This was a secondary analysis of valid PA data (≥4 days/week with ≥500 steps/day) from participants (age ≥ 18 years, BMI 27–43 kg/m2) randomized 1:1 to self-monitoring with tailored feedback or self-monitoring only. Both groups received Fitbit trackers. Group-based trajectory modeling identified adherence trajectories and baseline predictors. Analysis of variance was used to estimate associations between trajectory group membership and 12-month weight change. Results: Among 502 participants (79% female, 82% White, mean age of 45.0 ±14.4 years), four MVPA goal-adherence trajectories were identified: lower stable (34.5%), moderate (39.8%), increasing (19.3%), and high (6.4%). A graded association was observed with better adherence trajectories being associated with greater 12-month weight loss (p < 0.0001). Older age, male sex, being unpartnered, and higher first-week MVPA predicted membership in higher adherence trajectory groups (p < 0.05). Conclusions: Higher MVPA goal-adherence was related to greater weight loss. Early MVPA levels predicted long-term adherence, supporting the importance of personalized, technology-supported strategies to promote long-term PA adherence and inform targeted interventions to prevent chronic diseases. Full article
(This article belongs to the Special Issue Sensors for Physiological Monitoring and Digital Health: 2nd Edition)
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14 pages, 624 KB  
Article
Health-Related Quality of Life and Symptom Burden in Patients with Diffuse Large B-Cell Lymphoma Before Treatment with Tafasitamab and Lenalidomide: An Ad Hoc Analysis of Italian Real-World Data from the PRO-MIND Study
by Pier Luigi Zinzani, Nicola Battaglia, Mario Lapecorella, Guido Gini, Maria Cristina Cox, Stefan Hohaus and Antonio Pinto
Diseases 2025, 13(12), 399; https://doi.org/10.3390/diseases13120399 - 15 Dec 2025
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Abstract
Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) exhibits substantial clinical heterogeneity and poor prognosis in relapsed/refractory (R/R) settings. PRO-MIND is a prospective, multicenter real-world study evaluating tafasitamab–lenalidomide followed by tafasitamab monotherapy in patients with transplant-ineligible R/R DLBCL in Italy. This ad hoc, cross-sectional, [...] Read more.
Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) exhibits substantial clinical heterogeneity and poor prognosis in relapsed/refractory (R/R) settings. PRO-MIND is a prospective, multicenter real-world study evaluating tafasitamab–lenalidomide followed by tafasitamab monotherapy in patients with transplant-ineligible R/R DLBCL in Italy. This ad hoc, cross-sectional, baseline analysis aimed to characterize health-related quality of life (HRQoL) and symptom burden before tafasitamab–lenalidomide initiation in the PRO-MIND cohort. Methods: Thirty-eight patients across 30 centers completed the EORTC QLQ-C30 and QLQ-NHL-HG29 questionnaires at pretreatment baseline, prior to starting tafasitamab–lenalidomide. EORTC QLQ-C30 scores (0–100) were compared with age-specific normative values for the Italian general population using Welch’s t-test. Differences of ≥5 points were considered clinically meaningful and ≥10 points clearly clinically important. Effect sizes (Cohen’s d) were calculated to complement p-values for between-group comparisons. Results: Compared with normative data, the PRO-MIND cohort had significantly lower EORTC QLQ-C30 functioning scores for physical (Δ 12.7, p = 0.0135), role (Δ 16.1, p = 0.0168), social (Δ 15.2, p = 0.0019), and cognitive (Δ 8.5, p = 0.0460) functioning. Symptom scales revealed worse fatigue (Δ 14.8, p = 0.0097), insomnia (Δ 13.9, p = 0.0291), appetite loss (Δ 9.4, p = 0.0435), and pain (Δ 8.7, p = 0.0430) in the PRO-MIND cohort versus normative data, with effect sizes in the small-to-moderate range. EORTC QLQ-NHL-HG29 scores indicated a high prevalence of concerns about future health (84.2%), disease recurrence (81.6%), and dependency (78.9%), as well as physical symptoms, including lack of energy (71.1%), sleep difficulties (63.2%), and pain or discomfort (60.5%). Conclusions: This cross-sectional, baseline-only analysis of the PRO-MIND real-world cohort showed that patients with transplant-ineligible R/R DLBCL scheduled to receive tafasitamab–lenalidomide already had pronounced impairments in physical, role, social, and cognitive functioning, along with substantial fatigue, insomnia, pain, appetite loss, and psychological concerns. These baseline benchmarks underscore the importance of systematic HRQoL assessment and targeted supportive interventions focusing on these domains before and during treatment. Future longitudinal PRO-MIND analyses will complement these findings by describing how HRQoL evolves after tafasitamab–lenalidomide initiation. Full article
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10 pages, 223 KB  
Article
Promoting Sustainable Social Inclusion in Physical Education: A Follow-Up Study of a Workshop Intervention on Students’ Perceptions Toward Inclusion in Israel
by Mahmood Sindiani and Yeshayahu Hutzler
Sustainability 2025, 17(24), 11208; https://doi.org/10.3390/su172411208 - 15 Dec 2025
Viewed by 53
Abstract
Children and adolescents with disabilities (CAWD) face barriers that limit participation in physical activity, contributing to health and inclusion disparities. This study examined the impact of a short-term inclusive physical education workshop on students’ perceptions toward the inclusion of peers with disabilities. Seventy-six [...] Read more.
Children and adolescents with disabilities (CAWD) face barriers that limit participation in physical activity, contributing to health and inclusion disparities. This study examined the impact of a short-term inclusive physical education workshop on students’ perceptions toward the inclusion of peers with disabilities. Seventy-six students (ages 11–15) from four Hebrew-speaking schools in Israel attended a two-and-a-half-hour workshop combining disability awareness with experiential Paralympic sports activities. Perceptions were assessed using a structured questionnaire at three time points: pre-intervention, post-intervention, and three-month follow-up. The results showed a significant improvement in perceptions immediately after the workshop, with most gains sustained at follow-up. These findings suggest that brief, experiential interventions can foster lasting perceptual change, supporting inclusive education and advancing social dimensions of sustainability. This study offers practical implications for designing policies and programs that promote equity and inclusion in physical education, aligned with UN Sustainable Development Goals (3, 4, and 10). Full article
(This article belongs to the Section Sustainable Education and Approaches)
41 pages, 2101 KB  
Review
The Significant Role of Physical Activity and Exercise in Health and Metabolic Diseases
by George D. Dimitriadis, Costas Chryssanthopoulos, Anastassios Philippou and Michael Koutsilieris
Physiologia 2025, 5(4), 57; https://doi.org/10.3390/physiologia5040057 - 15 Dec 2025
Viewed by 54
Abstract
Physical inactivity, which currently dominates the lifestyles of most people, is linked to chronic metabolic diseases such as obesity, type 2 diabetes (T2D), hypertension, metabolic syndrome, and cardiovascular disease, all of which share insulin resistance as a common pathogenic mechanism. Both epidemiological and [...] Read more.
Physical inactivity, which currently dominates the lifestyles of most people, is linked to chronic metabolic diseases such as obesity, type 2 diabetes (T2D), hypertension, metabolic syndrome, and cardiovascular disease, all of which share insulin resistance as a common pathogenic mechanism. Both epidemiological and experimental intervention studies have consistently shown that physical activity and exercise can reduce the incidence of these diseases and significantly improve their clinical outcomes, resulting in enhanced quality of life and well-being. This approach includes various forms of aerobic and anaerobic/resistance training, either individually or in combination, leading to reduced insulin resistance and visceral fat, regardless of the weight loss achieved through diet. It also lowers inflammatory responses and oxidative stress, a harmful mechanism that leads to cellular damage, and positively impacts immunological regulation. Regarding timing, physical activity/exercise appears to produce better outcomes for metabolic control, particularly in individuals with T2D, when performed after dinner compared to other times of the day. In addition to organized physical activity/exercise sessions, practices such as interrupting prolonged sitting with frequent breaks every 30 min that involve muscular contractions and increased energy expenditure may also benefit metabolic health. Minimizing physical inactivity, prolonged sitting at work or during leisure time, can decrease the frequency of metabolic illness, enhance health and quality of life, and avert premature death. However, intense exercise may not always be the most beneficial option for health, and the relationship between adverse events and the intensity of physical activity or exercise resembles a U-shaped or J-shaped curve. Physical activity/exercise should be performed at a suitable intensity that aligns with personal capability. In this primarily clinically focused review, we discuss the effects of insulin on target tissues, the significance of insulin sensitivity in metabolic regulation, how physical inactivity contributes to insulin resistance, the different types of exercise and their impact on insulin effectiveness, and the importance of physical activity and exercise in managing metabolic diseases. Full article
(This article belongs to the Special Issue Exercise Physiology and Biochemistry: 2nd Edition)
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Review
What to Know About Falls in Older Adults? Risk Factors, Predictors, and Therapeutic Interventions
by Fernanda Bueno Pilastri, Julia Fantim Lopez, Eric Nkansah Boateng and Nise Ribeiro Marques
Int. J. Environ. Res. Public Health 2025, 22(12), 1863; https://doi.org/10.3390/ijerph22121863 - 14 Dec 2025
Viewed by 152
Abstract
Background: Approximately one quarter of community-dwelling older adults experience at least one fall each year. Falls can result in soft tissue injuries, fractures, or even death. Given this high prevalence, it is essential to identify fall-related risk factors, develop predictive models, and prescribe [...] Read more.
Background: Approximately one quarter of community-dwelling older adults experience at least one fall each year. Falls can result in soft tissue injuries, fractures, or even death. Given this high prevalence, it is essential to identify fall-related risk factors, develop predictive models, and prescribe effective exercise-based interventions to prevent falls. Objective: To analyze risk factors, predictors, and therapeutic interventions for falls in older adults. Methods: A literature search was conducted in SCIELO, PUBMED, and PEDro databases between 15–20 October 2025. Inclusion criteria comprised peer-reviewed, open-access studies in English published from 2020 onward. Findings were categorized into three domains: (1) fall risk factors, (2) predictive models, and (3) exercise-based interventions. Twenty studies met the inclusion criteria. Results: Falls among older adults arise from multifactorial interactions involving physical, clinical, cognitive, and social factors such as impaired mobility, comorbidities, polypharmacy, and cognitive decline. Lower-limb strength and functional performance are key determinants of fall risk. Current predictive models show limited accuracy, with fall history as the strongest predictor. Exercise-based interventions, particularly multicomponent and home-based programs, improve balance, strength, and mobility but show variable effects on fall rates. The absence of standardized parameters for exercise prescription limits the development of evidence-based guidelines. Conclusions: Falls in older adults are multifactorial events influenced by physical and cognitive decline. Predictive models remain imprecise, and although exercise interventions improve functional outcomes, their impact on reducing falls is inconsistent. Standardized exercise protocols are needed to optimize fall prevention strategies. Full article
(This article belongs to the Special Issue Achieving Effective Fall Prevention and Intervention for Older Adults)
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