Search Results (9)

Background/Objectives: Breast cancer-related lymphedema (BCRL) is more prevalent and severe in women with overweight or obesity. This study evaluated the effect of a comprehensive lifestyle intervention—comprising supervised exercise, a hypocaloric Mediterranean diet, and optional meal replacement—on lymphedema outcomes in this population. Methods: In this pilot randomized controlled trial, 112 women with BCRL and BMI 25–40 kg/m² were assigned to an intervention group—receiving supervised resistance and aerobic training, dietary counseling, and optional high-protein meal replacement—or to a control group with standard advice. The primary outcome was change in affected limb volume at 3 and 6 months. Secondary outcomes included morphofunctional parameters, muscle strength, dietary intake, and serum levels of cytokines (IL-1β, IL-6, IL-10, and TNF-α). Analyses also explored outcomes according to whether participants achieved ≥ 5% weight loss. Results: Ninety-four participants completed the trial (intervention n = 43, control n = 51). At 6 months, women who achieved ≥5% weight loss had greater reductions in affected limb volume (−664.9 ± 362.1 mL vs. −395.6 ± 596.9 mL). The intervention group showed significantly greater improvements in BMI (−1.14 ± 1.22 kg/m²), waist circumference (−3.59 ± 4.6 cm), triceps skinfold (−4.61 ± 3.02 mm), fat mass (−2.38 ± 2.75 kg), extracellular water (−0.58 ± 0.85 L), and quadriceps strength (+7.1 ± 9.7 kg). No significant changes were observed in circulating cytokines. Conclusions: In this pilot randomized controlled trial, a structured dietary and exercise intervention improved morphofunctional outcomes in overweight women with BCRL. Weight loss of ≥5% emerged as a potentially relevant therapeutic target that may inform the design of future studies aimed at optimizing lymphedema management. Full article

Background/Objectives: Current scientific evidence shows both the relationship between good physical condition and a lower incidence of certain chronic diseases (including smoking), as well as the efficacy of cytisinicline. The aim of this protocol is to evaluate the efficacy of the synergistic effect of the combination of targeted physical exercise, together with brief advice and taking the drug cytisinicline, to achieve smoking cessation. Methods: We propose an experimental, multicentre, randomised, controlled study with two parallel arms to be carried out by a multidisciplinary team in the primary care setting of the Andalusian public health system (APHS) in Spain, with a follow-up of 12 months. The population sample will include people who are aged between 18 and 65 years and meet the criteria to be eligible for treatment with cytisinicline financed by the APHS: smokers of 10 or more cigarettes per day who are in the determination/action phase for smoking cessation of the transtheoretical model of Prochaska and Diclemente, willing to start anti-smoking treatment imminently and confirmed, with high dependence to nicotine (Fagerström’s test ≥ 7), with a motivation to quit smoking according to the Richmond test (≥6), and who have made a previous smoking cessation attempt in the last year. The study consists of two treatment arms. EXPERIMENTAL ARM: Smokers who are going to be prescribed targeted physical exercise and brief advice to stop smoking while receiving cytisinicline treatment (1.5 mg tablets) according to the care process. CONTROL ARM: Smokers will receive a standard leaflet explaining physical exercise to the general population and brief advice on smoking cessation when starting cytisinicline treatment, according to the care process. The calculated sample size is 75 participants per arm. Results: The primary results will allow us to estimate the efficacy of prescribing physical exercise as an adjuvant therapy to classic multicomponent treatment, incorporating it as an additional element to be considered when it is accepted by the smoker. Conclusions: This protocol (NCT06579846) evaluates the efficacy of combining physical exercise, brief advice, and cytisinicline to support smoking cessation, improve fitness, and reduce smoking-related comorbidities Full article

Digital learning environments create a dynamic and engaging learning and teaching context that promotes a deeper understanding of complex concepts, eases the teaching process and fosters a passion for learning. Moreover, integrating interactive materials into pilot courses can assist teachers in better assessing student learning and adjusting their teaching strategies accordingly. The teachers can also receive valuable insights into students’ strengths and weaknesses, allowing them to provide targeted support and intervention when needed. For students from the defence and security fields, digital learning environments can create realistic simulations and virtual training scenarios that allow students to practise their skills in a controlled and safe environment, develop hands-on experience, and enhance their decision-making abilities without the need for real-world training exercises. In this context, the purpose of this paper is to introduce an approach for solving mathematical problems embedded in technical scenarios within the defence and security fields with the aid of digital technology using different software environments such as Python, Matlab, or SolidWorks. In this way, students can visualise abstract concepts, experiment with different scenarios, and receive instant feedback on their understanding. At the same time, the use of didactic and interactive materials can increase the interest among students and teachers for utilising mathematical models and digital technologies in the educational process. This paper also helps to reinforce key concepts and enhance problem-solving skills, sparking curiosity and creativity, and encouraging active participation and collaboration. Throughout the development of this proposal, based on survey analysis, good practices are presented, and advice for improvement is collected while having a wide range of users giving feedback, and participating in discussions and testing (pilot) short-term learning/teaching/training activities. Full article

(1) Background: Cardiac rehabilitation often emphasizes aerobic capacity while overlooking the importance of muscle strength. This study evaluated the impact of an enhanced remote strength training program (RCR-ST) on cardiac rehabilitation. (2) Methods: In this randomized prospective study (RCT registration number SMC-9080-22), 50 patients starting cardiac rehabilitation were assessed for muscle strength, aerobic capacity, and self-reported outcomes at baseline and after 16 weeks. Participants were divided into two groups: the RCR-ST group received a targeted resistance training program via a mobile app and smartwatch, while the control group received standard care with general resistance training advice. (3) Results: The RCR-ST group demonstrated significant improvements in muscle endurance, notably in leg extension and chest press exercises, with increases of 92% compared to 25% and 92% compared to 13% in the control group, respectively. Functional assessments (5-STS and TUG tests) also showed marked improvements in agility, coordination, and balance. Both groups improved in cardiorespiratory fitness, similarly. The RCR-ST group reported enhanced physical health and showed increased engagement, as evidenced by more frequent use of the mobile app and longer participation in the rehabilitation program (p < 0.05). (4) Conclusions: Incorporating a focused strength training regimen in remote cardiac rehabilitation significantly improves muscle endurance and patient engagement. The RCR-ST program presents a promising approach for optimizing patient outcomes by addressing a crucial gap in traditional rehabilitation protocols that primarily focus on aerobic training. Full article

Introduction: Dietary and physical activity interventions have beneficials health effects for people with type 2 diabetes (T2D). Although the effects of such interventions on long-term changes in glucose levels are well studied in a controlled setting, little is known about the acute effects of lifestyle interventions in a real-life setting and on an individual level. Quantifying the effects of lifestyle on metrics of continuously measured glucose and how these differ between individuals may allow for personalized lifestyle advice for people with T2D. Methods: Forty people with T2D were included in this study. Participants wore a continuous glucose monitor (CGM) for 11 periods of 4 days, of which 3 were control periods (habitual everyday life) and 8 were intervention periods (2× low carbohydrate diet, 2× Mediterranean diet, 2× walking after each meal, and 2× hourly exercise bouts of 5 minutes (‘active day’)). The CGM metrics used in the ambulatory glucose profile, an internationally recognized standard for interpreting glucose control, were calculated. We used a random effects model to quantify the effect of the four lifestyle interventions on CGM metrics with the participants as a random effect. Results: On overage, a low carbohydrate diet, walking after a meal, and an active day resulted in improved CGM metrics, including a lower mean glucose (−0.70, −0.34, and −0.25 mmol/L, respectively) and SD (−0.22, −0.05, and −0.02) and higher time in range (6.9, 3.5, and 3.2%, respectively), the latter being the average percentage of time per day spend in the target glucose range (3.9–10.0 mmol/L). Only the low carbohydrate diet had a positive effect on the coefficient of variation (−1.48), a measure of glucose variability. Also, the magnitude of the effects varied between the interventions. Surprisingly, the Mediterranean diet had adverse effects on all the calculated CGM metrics. Our next step is to investigate inter-individual variation in these intervention effects. Discussion: The low carbohydrate diet, walking after a meal, and active day intervention showed positive, but differential, effects on CGM metrics within 4 days, while the Mediterranean diet showed negative effects. Further analysis on inter-individual variation can be used for personalized lifestyle recommendations, for instance targeted at avoiding high glucose peaks, or reducing variability in glucose levels. Full article

As chronic diseases such as cardiovascular diseases are prevalent and progressively more common in young people, more and more college students are paying attention to exercising, even though they are busy studying. However, some college students are unmindful of their physique and their bodies’ targeted exercise. The exercise they do is either extensive but not refined or too homogeneous. We conducted a statistical analysis of 18,101 college students’ physical examination results. We found that students who exercise regularly but still did not achieve satisfactory results in one or more physical examination items had often exercised in the two unscientific ways mentioned above. This paper presents an intelligent recommendation system that integrates statistical principles and natural language processing, which improves traditional recommendation systems and could provide suitable and targeted exercise suggestions for college students. The R² increased by about 27.72%. Full article

Background: Active patient participation in preparation and recovery from colorectal cancer surgery can be facilitated by timely information and care and may improve patient wellbeing and reduce hospitalizations; Methods: We aimed to identify gaps in perioperative information and care by asking colorectal cancer surgical patients to retrospectively report on their perceptions of care via a cross-sectional survey; Results: Overall, 179 (64% consent rate) patients completed one of two 64-item surveys exploring their views of ‘optimal care’ or their experiences of ‘actual care’. In total, 41 (64%) aspects of care were endorsed as optimal. Of these, almost three-quarters (73%) were received by most patients (80% or more). Gaps in care were identified from discrepancies in the endorsement of optimal versus actual survey items. Of the 41 items identified as representing ‘optimal care’, 11 items were received by fewer than 80% of patients, including the provision of information about the impact of surgical wait-times on cancer cure (69%); pre-habilitation behaviors to improve health (75%); the type of questions to ask the health care team (74%); impact of pain medications on bowel movements (73%); how to obtain medical supplies for self-care at home (67%); dietary or exercise advice after discharge (25–31%); and emotional advice after discharge (44%). Conclusions: These gaps represent patient-centered priorities and targets for supportive interventions. Full article

Sudden cardiac death (SCD) still represents an unanticipated and catastrophic event eliciting from cardiac causes. SCD is the leading cause of non-traumatic deaths during downhill skiing and mountain hiking, related to the fact that these sports are very popular among elderly people. Annually, more than 40 million downhill skiers and mountain hikers/climbers visit mountainous regions of the Alps, including an increasing number of individuals with pre-existing chronic diseases. Data sets from two previously published case-control studies have been used to draw comparisons between the SCD risk of skiers and hikers. Data of interest included demographic variables, cardiovascular risk factors, medical history, physical activity, and additional symptoms and circumstances of sudden death for cases. To establish a potential connection between the SCD risk and sport-specific physical strain, data on cardiorespiratory responses to downhill skiing and mountain hiking, assessed in middle-aged men and women, have been included. It was demonstrated that previous myocardial infarction (MI) (odds ratio; 95% CI: 92.8; 22.8–379.1; p < 0.001) and systemic hypertension (9.0; 4.0–20.6; p < 0.001) were predominant risk factors for SCD in skiers, but previous MI (10.9; 3.8–30.9; p < 0.001) and metabolic disorders like hypercholesterolemia (3.4; 2.2–5.2; p < 0.001) and diabetes (7.4; 1.6–34.3; p < 0.001) in hikers. More weekly high-intensity exercise was protective in skiers (0.17; 0.04–0.74; p = 0.02), while larger amounts of mountain sports activities per year were protective in hikers (0.23; 0.1–0.4; <0.001). In conclusion, previous MI history represents the most important risk factor for SCD in recreational skiers and hikers as well, and adaptation to high-intensity exercise is especially important to prevent SCD in skiers. Moreover, the presented differences in risk factor patterns for SCDs and discussed requirements for physical fitness in skiers and hikers will help physicians to provide specifically targeted advice. Full article

This paper addresses the problem of performance management of operate-transfer (OT) project finance for public sports and leisure centers (SLC) from the perspective of local government. This study contributes to use an evolutionary theory of competitive advantage and mixed-methods, including a modified Delphi method to develop the efficiency-based performance model (EPM) under OT project finance for the public SLCs. The total-factor framework disaggregating the efficiency into an innovative output surplus target ratio (OSTR) provides local governments with a contracted period to manage the SLCs through further specific improvement advice. This study further proposed the four-quadrant matrix formulated by long-term efficiency and short-term profitability to identify the benchmark and improvement directions. The empirical results indicated that there are fifteen SLCs located in the benchmark quadrant. This study provides policy makers in the local governments with a scientific reference to keep or drop the current operating private enterprise in the next concession period. The most underperforming SLCs could follow this proposed quadrant analysis and OSTR index, utilizing their internal resources to develop more attractive and reasonable-price exercise courses for participant growth. Full article