Search Results (251)

Background: High-intensity interval training (HIIT) is effective for improving body composition and cardiorespiratory fitness, but individual variability in responsiveness remains a challenge. This study examined the dose–response effects of three HIIT session durations (6, 8, and 10 min) and whether previously non-responsive adolescents could benefit from a modified program. Methods: A total of 137 adolescents completed one of three school-based HIIT interventions. Body fat percentage (BF%), systolic and diastolic blood pressure, and maximal oxygen uptake (VO₂max) were assessed before and after the intervention. Responders and non-responders were classified using a Bayesian approach. Statistical analyses included ANOVA, McNemar’s test, logistic regression, and generalized estimating equations. Results: All protocols improved outcomes, with the 10 min sessions producing the most consistent VO₂max gains. No significant differences were observed for BF% or blood pressure. Individual analysis showed that more than half of the participants responded positively to training, depending on the outcome. Among prior non-responders, 70–100% showed improvements after the modified intervention. The number of previously non-responsive outcomes strongly predicted improvement (Odds Ratio > 2.4, p < 0.01). Conclusions: School-based HIIT can induce meaningful adaptations even in previously non-responsive adolescents. Individualized monitoring and adjustment of training dose may optimize responsiveness and support health promotion in youth. Full article

Background/Objectives: Cardiac autonomic neuropathy (CAN) is a common but also underdiagnosed complication of diabetes mellitus (DM), associated with high cardiovascular risk and mortality. Sudomotor dysfunction can serve as an early indicator of autonomic dysfunction. This study evaluated the association between sudomotor dysfunction and the severity of CAN in patients with type 2 diabetes (T2D). Methods: In this cross-sectional study, 109 patients with T2D were evaluated for diabetic peripheral neuropathy, cardiovascular autonomic dysfunction, and sudomotor dysfunction. Additionally, clinical and biochemical data were collected from patients’ medical records. Results: Sudomotor dysfunction (SUDO+) was present in 59.6% of patients. The presence of SUDO+ was associated with a higher age, longer duration of diabetes, lower eGFR (estimated glomerular filtration rate) values, and more severe signs of peripheral neuropathy. SUDO+ patients showed significantly greater orthostatic systolic and diastolic BP (blood pressure) changes, lower RR interval ratios, and lower feet ESC (electrochemical skin conductance) values. ROC (receiver operating characteristic) analysis for feet ESC in identifying pathological RR ratio showed an AUC of 0.689 (95% CI: 0.593–0.774, p = 0.0022), with a sensitivity of 46.7% and a specificity of 94.7% at a cutoff of ≤68 µS. For orthostatic hypotension and QTc prolongation, the ESC values had limited discriminative power. Chi-squared analysis showed a significant association between feet sudomotor impairment and pathological RR ratio (χ² = 6.521, p = 0.0107). Conclusions: Sudomotor dysfunction is associated with indicators of CAN. SUDOSCAN can be used as a complementary tool for early CAN detection in clinical practice. Full article

Objectives: To compare the acute effects of upper cervical manipulation (CM) and manual massage (MM) to simulated CM (Sham) and Control conditions (Control) on heart rate variability (HRV) and blood pressure (BP) responses in women with non-elevated BP. Methods: A single-blind, four-arm, parallel-group, randomized, crossover, placebo-controlled trial recruited 15 apparently healthy women with non-elevated BP who visited the lab on four occasions with 48 h intervals to ensure adequate washout between interventions. A Latin square randomization approach was employed to assign participants to one of four experimental conditions: (1) Control: Rest without intervention; (2) CM: Bilateral high-velocity, low-amplitude manipulation of the upper cervical spine (C0–C2); (3) MM: A single 120 s session of MM release applied unilaterally to the anterior and posterior thigh, posterior lower leg, and lumbar musculature; or (4) Sham: Mimicking the positioning used in CM without the application of thrust manipulation. In each experiment, HRV, systolic and diastolic BP were measured at rest (Baseline) and every 15 min for 60 min after each intervention. All procedures were performed in the morning to avoid any confounding circadian rhythm effect on HRV and BP. Results: We found significant increases within conditions for RMSSDms (Control: Post-0 (p = 0.032), Post-15 (p = 0.023); Sham: Post-15 (p = 0.014); CM: Post-15 (p = 0.027)); SDNNms (Control: Post-45 (p = 0.037); CM: Post-45 (p = 0.014) and Post-60 (p = 0.019)); PNN50% (CM: Post-0 (p = 0.044), Post-15 (p = 0.044) and Post-45 (p = 0.019)); LF Power (ms2) (CM: Post-60 (p = 0.001)), and LF/HF ratio (MM: Post-60 (p = 0.022). Conclusions: Although no statistically significant between-condition differences were detected, within-condition changes with moderate-to-large effect sizes suggest potential clinical relevance of CM and MM. These preliminary findings emphasize the importance of effect sizes and may indicate greater translational significance in populations with non-elevated cardiovascular risk. Full article

Aims: The present study evaluated the acute morning effect of melatonin supplementation (5 mg) on cardiometabolic responses. Methods: For this purpose, 12 physically active men (22.1 ± 1.3 years; 1.7 ± 01 m; 74.7 ± 12.1 kg; 24.3 ± 2.7 m/kg²; VO₂max: 46.9 ± 2.3 mL/kg/min; 17.3 ± 5.2%F) were measured in a double-blind crossover protocol, where participants were measured before, during, and after a high-intensity interval exercise (HIIE) protocol [4 × 4 min at 95% of maximum heart rate (HRmax) with a 3 min interval at 60–70% of HRmax] followed by 30 min of recovery. At rest, the following variables were measured: HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), lactate, and maximum oxygen consumption (VO₂max). At the end of each stage and interval, VO₂, respiratory exchange ratio (RER), and HR were measured. During recovery, VO₂, VCO₂, RER, SBP, DBP, and HR were measured. Results: Melatonin significantly enhanced recovery metabolism, as evidenced by increased VO₂ at Interval 3 (+2.2 mL/kg/min, p = 0.03, d = 0.69) and 5 min postexercise (+2.4 mL/kg/min, p = 0.02, d = 0.81). The RER was higher during Sprint 4 (+0.08, p = 0.01, d = 0.84), indicating greater carbohydrate reliance. Cardiovascular recovery was also improved, with a reduced HR at 30 min (−5 bpm, p = 0.04, d = 0.66) and lower SBP at 15 min (−8 mmHg, p = 0.02, d = 0.75). Lactate concentration at 30 min was lower with melatonin (−0.7 mmol/L, p = 0.03, d = 0.72). No significant effects were observed at rest or during early exercise. Conclusions: Acute morning melatonin intake may amplify metabolic responses to HIIE while facilitating cardiometabolic recovery. This dual-phase action may benefit athletes aiming to optimize energy expenditure, fat metabolism, and recovery during early-day training. Full article

Background: The training impulse (TRIMP) method integrates exercise duration and intensity, yet its application in school-based health programs is limited. This study examined dose–response relationships between TRIMP and changes in body fat percentage (%BF), blood pressure, and cardiorespiratory fitness (CRF) in adolescents. Methods: 145 adolescents (69 males, 76 females; aged 15.01 ± 0.54 years) completed eight-week interval-based physical education programs: high-intensity interval training (HIIT) or high-intensity plyometric training (HIPT). Heart rate was continuously monitored, and TRIMP values were calculated across 16 sessions. Outcomes included %BF, systolic (SBP) and diastolic blood pressure (DBP), and maximal oxygen consumption (VO_2max), assessed pre- and post-intervention. Results: HIIT elicited higher TRIMP than HIPT in females (η²p = 0.043). Linear dose–response patterns were identified (r = 0.18–0.36) (e.g., SBP in males, r = −0.38, p = 0.001; %BF in males, r = −0.36, p = 0.002). In males, one TRIMP unit reduced SBP by 1.8 mmHg (HIIT) and DBP by 1.6 mmHg (HIPT). In females, HIPT-derived TRIMP predicted reductions of ~0.6% in %BF and~0.9 mmHg in DBP. No significant associations were found for VO_2max. Conclusions: TRIMP provides a feasible and sensitive tool for quantifying internal training load in adolescent interventions, linking exercise dose to measurable health benefits and supporting its application in preventive contexts. Full article

Background and Objectives: Circadian fluctuations in blood pressure, particularly the non-dipping pattern characterized by the absence of a nocturnal decline, are associated with an increased risk of microvascular complications. The retina, as a highly sensitive microvascular tissue, offers a valuable window into systemic hemodynamic alterations. However, the literature lacks detailed structural analyses that evaluate all retinal regions by segmenting nighttime into specific time intervals. Notably, the early morning period (04:00–08:00), during which stress hormones such as cortisol and catecholamines rise physiologically, leads to increased blood pressure that may significantly affect retinal microcirculation. This prospective study aims to assess retinal microvascular structures in dipper and non-dipper individuals using structural optical coherence tomography and to investigate their relationship with blood pressure parameters by dividing nighttime into distinct time segments. Materials and Methods: A total of 60 participants were classified as dipper (n = 26) or non-dipper (n = 34) based on 24 h ambulatory blood pressure monitoring results. Structural optical coherence tomography was used to evaluate superficial and deep capillary plexus densities in the foveal, parafoveal, and perifoveal regions, along with the area and perimeter of the foveal avascular zone (FAZ) and flow density (FD). Blood pressure values, including systolic, diastolic, mean arterial, and pulse pressure, were recorded during two nighttime intervals (00:00–04:00 and 04:00–08:00), and correlations with retinal parameters were analyzed. Results: No significant differences were observed in retinal microvascular parameters between the dipper and non-dipper groups. Deep capillary densities, particularly in the parafoveal and perifoveal regions, showed significant positive correlations with serum total protein, albumin, and very low-density lipoprotein (VLDL) levels. Furthermore, systolic and mean arterial pressures measured during the 04:00–08:00 interval demonstrated significant positive correlations with deep retinal vascular densities. The FAZ perimeter was negatively correlated with pulse pressure variability, while FD showed a negative correlation with mean arterial pressure variability. Conclusions: This prospective study is among the first to investigate the effects of circadian blood pressure patterns on retinal microvascular structures by segmenting nighttime into specific intervals and employing comprehensive structural optical coherence tomography across the entire retina. The findings suggest that retinal microvascular structure may be associated with fluctuations in blood pressure. Analyses of blood pressure measurements between 04:00 and 08:00 may offer supplementary insights into the evaluation of retinal microvascular structure. Full article

Metabolic syndrome (MetS) is a global public health challenge, characterized by the coexistence of cardiometabolic risk factors such as abdominal obesity, dyslipidaemia, hypertension, and insulin resistance. Non-pharmacological strategies, including the Mediterranean diet (MD) and physical activity (PA), have been widely studied for their potential to prevent and manage MetS. This systematic review aimed to synthesize the evidence on the combined effect of MD and PA on MetS components in adults, based on randomized controlled trials (RCTs). Twenty-two RCTs published between 2018 and 2024 were included, involving 11,478 participants. The interventions ranged from 8 weeks to 3 years and combined adapted or hypocaloric MDs with moderate-to-high-intensity PA, typically including walking, aerobic exercise, or high-intensity interval training (HIIT), performed 3 to 7 times per week. The combined interventions resulted in reductions in body weight (−2.5 to −7.2 kg), body mass index (−0.7 to −2.2 kg/m²), waist circumference (−5.1 to −7.8 cm), and blood pressure (up to −9.0 mmHg systolic and −6.7 mmHg diastolic). Improvements in HDL cholesterol, triglyceride levels, and insulin sensitivity were also observed. These findings suggest that integrated interventions based on the Mediterranean lifestyle are effective in reducing MetS components and may support future public health strategies. Full article

Background/Objectives: In Japan, evidence on catecholamine syringe exchange methods is limited, with practices varying across facilities and individuals. In this study, we aimed to determine the effect of the catecholamine syringe exchange method on blood pressure variability in intensive care unit patients. Methods: We retrospectively analyzed 119 patients (308 syringe exchanges) who underwent catecholamine syringe exchange between 1 April 2020 and 31 March 2022. Patient characteristics for the double-pumping changeover (DPC) and quick syringe changeover (QC) groups were matched and compared using propensity scores. A sub-analysis focused on patients with severe shock with systolic blood pressures ≤ 90 mmHg. Logistic regression analysis was used to examine factors influencing blood pressure variability during the catecholamine syringe changeover. Results: Neither propensity score matching nor the sub-analysis for patients with shock revealed significant differences in the coefficient of variation or absolute systolic/diastolic/mean blood pressure within 15 min of syringe exchange in the two groups. Logistic regression revealed that age was the sole risk factor affecting blood pressure variability during syringe changeover (odds ratio: 1.018, 95% confidence interval: 1.001–1.036), while syringe changeover methods did not contribute to circulating variability (odds ratio: 1.186, 95% confidence interval: 0.672–2.092). Conclusions: Differences between the DPC and QC methods did not significantly affect blood pressure variability during catecholamine syringe changeovers. However, in older adult patients, catecholamine syringe changeover may be more likely to cause blood pressure variability. Full article

Background: Arm swing exercise (ASE) is a simple and accessible form of physical activity that has been reported to reduce disease risk and enhance overall health across various populations. In alignment with the World Health Organization’s recommendations for promoting physical activity, ASE requires no specialized equipment or professional supervision. However, systematic evidence on its health benefits remains limited. Objective: This systematic review and meta-analysis aimed to assess the effects of ASE on body composition, glycemic control, cardiovascular health, and musculoskeletal outcomes. Methods: A comprehensive systematic search was conducted in four major databases, including PubMed, Embase, Scopus, and the Thai-Journal Citation Index Center, covering studies published from inception to October 2024. Articles published in both English and Thai were included. Two independent reviewers screened and selected eligible randomized controlled trials and quasi-experimental studies. Methodological quality was assessed using the JBI critical appraisal tool, and meta-analyses were performed using Stata software (version 18), presenting mean differences (MD) with 95% confidence intervals (CI). Results: Thirteen studies were included, comprising eight randomized controlled trials and five quasi-experimental studies, with intervention durations ranging from 5 to 24 weeks. The ASE significantly reduced waist circumference (MD = −4.76; 95% CI: −8.36 to −1.17; and p < 0.05), hemoglobin A1C (MD= −0.80%; 95% CI: −1.19 to −0.40; and p < 0.001), fasting blood glucose (MD = −17.62 mg/dL; 95% CI: −25.93 to −9.32; and p < 0.05), and diastolic blood pressure (MD = −9.74 mmHg; 95% CI: −17.84 to −1.65; and p < 0.05). The ASE showed a non-significant reduction in systolic blood pressure (MD = −3.65 mmHg; 95% CI: −10.37 to 3.08; and p = 0.29). Additionally, the ASE significantly increased high-density lipoprotein cholesterol (HDL-C) levels (MD = 6.96 mg/dL; 95% CI: 2.20 to 11.71; and p < 0.05). Conclusions: This study, representing the first systematic review and meta-analysis focusing on ASE, demonstrates that ASE is an effective intervention for improving body composition, glycemic control, and cardiovascular health. Given its simplicity, low cost, and broad applicability, ASE could serve as a practical public health strategy to promote health and prevent chronic diseases across diverse populations. Full article

Background: High-intensity interval training (HIIT) is a time-efficient approach that has been recognized to enhance cardiometabolic health and aerobic capacity in adolescents. The purpose of this study was to investigate the effects of various HIIT durations on cardiometabolic health and aerobic ability in adolescent women aged 17 to 19 years. Methods: Participants were separated into two intervention groups: HIIT 1 (6 weeks) and HIIT 2 (8 weeks), along with a control group. Both HIIT regimens included two weekly sessions: warm-up (jogging, accelerated running, and dynamic stretching), major sets (2 × 6–9 bouts of 30 s training at 90–95% HR_max with active recovery), and cooldown. Pre- and post-intervention measurements included body mass, BMI, body fat percentage, lipid profile, blood pressure, fasting glucose, and VO_2max. Results: Both HIIT programs resulted in significant reductions in body weight, BMI, and body fat percentage (all p < 0.001), as well as improvements in total cholesterol, triglycerides, LDL cholesterol, and systolic and diastolic blood pressure (all p < 0.001), compared to the control group. The changes in glycemia (p = 0.078) and HDL cholesterol (p = 0.825) were not statistically significant. Both HIIT groups showed significantly higher VO_2max (p < 0.001). Conclusions: Adolescent women’s cardiometabolic health and aerobic capacity increased considerably following 6- and 8-week HIIT training. These findings emphasize HIIT as a practical and time-saving strategy for this population, highlighting its effectiveness in improving key health parameters within a relatively short period. Full article

Vital sign monitoring is fundamental to patient care. Although traditional intermittent systems are flawed, barriers to implementing continuous monitoring systems remain. The SMART MAT is a novel continuous monitoring device that detects vital signs remotely via fibre optic technology. The study aims to validate the SMART MAT and its paired devices against gold/clinical standard measurements for measuring heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and oxygen saturation (SpO2). Healthy adults aged 21 to 80 were recruited for this cross-sectional study. Participants rested supine on a standardised mattress with the SMART MAT below. Vital signs were recorded over three five-minute intervals. Statistical analysis included descriptive statistics, two-way ANOVA, Mean Absolute Percentage Error (MAPE), and Bland–Altman plots. Among 321 participants recruited, HR and most RR measurements saw non-statistically significant differences (p > 0.05). Statistically significant differences were observed for SBP, SpO2, and most DBP measurements (p < 0.05). Only SBP measurements exceeded the acceptable limits of differences. Effect sizes were small to negligible (n² < 0.04) and MAPE values were <20%. The SMART MAT has demonstrated reasonable accuracy and validity in monitoring vital signs in healthy adults. Alternative paired BP devices are recommended to enhance SBP measurement accuracy. Full article

Continuous cardiovascular monitoring is essential for the early detection of cardiac events, but conventional electrode-based ECG systems cause skin irritation and are unsuitable for long-term wear. We propose an electrode-free ECG monitoring approach that leverages synchronized phonocardiogram (PCG) and seismocardiogram (SCG) signals captured by wireless mechano-acoustic sensors. PCG provides precise valvular event timings, while SCG provides mechanical context, enabling the robust identification of systolic/diastolic intervals and pathological patterns. A deep learning model reconstructs ECG waveforms by intelligently combining mechano-acoustic sensor data. Its architecture leverages specialized neural network components to identify and correlate key cardiac signatures from multimodal inputs. Experimental validation on an IoT sensor dataset yields a mean Pearson correlation of 0.96 and an RMSE of 0.49 mV compared to clinical ECGs. By eliminating skin-contact electrodes through PCG–SCG fusion, this system enables robust IoT-compatible daily-life cardiac monitoring. Full article

Background: This network meta-analysis aimed to assess the relative efficacy of macronutrient dietary groups with varying carbohydrate, fat, and protein ratios on weight control and cardiovascular risk factors improvement in adults. Methods: We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Web of Science Core Collection, and ClinicalTrials.gov from inception to 30 November 2024, as well as reference lists of related systematic reviews. Eligible randomized controlled trials (RCTs) were included. Literature screening, data extraction, and risk of bias assessment were conducted independently by two reviewers. The changes in body weight, blood glucose, systolic blood pressure, diastolic blood pressure, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, and total cholesterol were the study outcomes. Utilizing a Bayesian framework, a series of random-effects network meta-analyses were conducted to estimate mean difference (MD) with 95% credible interval (CrI) and determine the relative effectiveness of the macronutrient dietary groups. The quality of evidence for each pair of dietary groups was assessed based on the online tool called confidence in network meta-analysis (CINeMA). Results: This study initially identified 14,988 studies and ultimately included 66 eligible RCTs involving 4301 participants in the analysis. The very low carbohydrate–low protein (VLCLP, MD −4.10 kg, 95% CrI −6.70 to −1.54), the moderate carbohydrate–high protein (MCHP, MD −1.51 kg, 95% CrI −2.90 to −0.20), the very low carbohydrate–high protein (VLCHP, MD −1.35 kg, 95% CrI −2.52 to −0.26) dietary groups might lead to weight loss compared with the moderate fat–low protein (MFLP) dietary group. Among the dietary groups relative to the MFLP dietary group, the moderate carbohydrate–low protein (MCLP, MD 0.09 mmol/L, 95% CrI 0.02 to 0.16) and VLCHP (MD 0.16 mmol/L, 95% CrI 0.08 to 0.24) dietary groups were less effective in lowering HDL cholesterol, and the VLCHP (MD 0.50 mmol/L, 95% CrI 0.26 to 0.75) dietary group was less effective in lowering LDL cholesterol. In terms of triglyceride reduction, the MCLP (MD −0.33 mmol/L, 95% CrI −0.44 to −0.22), VLCHP (MD −0.31 mmol/L, 95% CrI −0.42 to −0.18), VLCLP (MD −0.14 mmol/L, 95% CrI −0.25 to −0.02), and moderate fat–high protein (MFHP, MD −0.13 mmol/L, 95% CrI −0.21 to −0.06) dietary groups were more efficacious than the MFLP dietary group, while any pair of dietary group interventions showed minimal to no difference in the effects on blood glucose, blood pressure, and total cholesterol. Conclusions: High or moderate certainty evidence reveals that the VLCLP dietary group is the most appropriate for weight loss, while the MCLP dietary group is best for reducing triglycerides. For control of blood glucose, blood pressure, and cholesterol levels, there is little to no difference between macronutrient dietary groups. Additionally, future studies in normal-weight populations are needed to verify the applicability of our findings. Full article

Objective: This study systematically examined the effects of recreational football on body composition and cardiometabolic health in overweight or obese individuals via subgroup analyses of potential moderators. Methods: A systematic search was conducted across six databases (PubMed, Web of Science, the Cochrane Library, CNKI, VIP, and Wanfang Data) in May and July 2025 to identify controlled trials evaluating recreational football among overweight or obese individuals. A meta-analysis was performed to pool the effect estimates, reported as standardized mean differences (SMDs), with heterogeneity explored through subgroup analyses. Results: Recreational football interventions across 32 studies (1126 participants, aged 11–68) led to significant improvements in body composition and cardiometabolic health. The training programs ranged from 4 to 48 weeks, with sessions lasting 4 to 30 min. Key body composition outcomes included reductions in body weight (SMD = −0.51), body mass index (SMD = −0.41), body fat percentage (SMD = −0.53), fat mass (SMD = −0.40), and waist circumference (SMD = −1.43), along with increases in lean body mass (SMD = 0.18). The effects were more pronounced in females and younger participants (≤18 years). Cardiometabolic benefits included reductions in systolic blood pressure (SMD = −0.59), diastolic blood pressure (SMD = −0.75), and mean arterial pressure (SMD = −0.91), as well as resting heart rates (SMD = −0.85), especially among females, obese males, and those subject to shorter rest intervals. Participants’ peak oxygen uptake also improved (SMD = 0.81). Concerning lipid metabolism, participants’ total cholesterol, low-density lipoprotein cholesterol, and triglycerides decreased significantly, particularly in females, younger and obese individuals, and those who trained more than twice per week. High-density lipoprotein cholesterol increased significantly only in females and those involved in frequent training. In regard to glucose metabolism, participants’ fasting insulin declined (SMD = −0.47), especially in regard to programs exceeding 12 weeks, whereas no significant changes were observed in fasting blood glucose, glycated hemoglobin, or the homeostatic model assessment of insulin resistance. According to the GRADE assessments, the certainty of the evidence ranged from very low to moderate across these outcomes. Conclusions: Recreational football improves the body composition and cardiometabolic health in overweight or obese individuals, resulting in reductions in adiposity, blood pressure, lipids, and insulin, with greater benefits observed in females, younger individuals, and those engaging in more frequent training. These findings support its potential as a practical intervention for weight and cardiometabolic risk management, in both clinical and community settings. Full article

This research aims to offer a deep learning-based diagnostic approach for hemorrhagic complications linked to patent ductus arteriosus (PDA) in preterm infants. Utilizing the You Only Look Once (YOLO) algorithm, this research analyzed five key cardiac parameters derived from echocardiographic ultrasonic waves: the left ventricular ejection time (LVET), left ventricular internal dimension at diastole (LVIDd), left ventricular internal dimension at systole (LVIDs), posterior wall thickness at end-systole (HES), and RR interval between two successive R-waves. The proposed ensemble model achieved best-in-class detection accuracies for each parameter, with rates of 97.56% (LVET), 88.69% (LVIDd), 99.50% (LVIDs), 82.29% (HES), and 81.15% (RR interval). Furthermore, assessment of cardiac function using derived indices—end-systolic wall stress (ESWS) and rate-corrected mean velocity of circumferential fiber shortening (mVcfc)—achieved mean accuracy rates of 82.33% and 90.16%, respectively. This approach enables physicians to accurately evaluate cardiac function in preterm infants and facilitates the diagnosis of PDA-related hemorrhagic complications. Full article