Snacktivity approach helps reduce sedentary behavior, increase awareness of opportunities for movement, and provide a practical alternative for individuals experiencing time-related barriers to exercise participation through short, integrated physical activity sessions in daily life. However, the effects of short-term Snacktivity-based interventions on university students remain unclear. Therefore, this study aimed to investigate the effects of a brief Snacktivity-based training intervention on physical activity levels, exercise self-efficacy, processes of exercise behavior change, and stages of change in university students. This controlled study included 196 undergraduate students in the final analysis (Snacktivity group, n = 98; control group, n = 98). The intervention group participated in a single Snacktivity educational session and received a brochure containing practical examples of daily activity snacks. Physical activity levels were assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Exercise Processes of Change Scale (EPCS), Exercise Self-Efficacy Scale, and Exercise Stages of Change Scale were used to evaluate behavioral and psychological factors related to exercise. Assessments were completed at baseline and after a 2-week follow-up period. Moderate-intensity physical activity significantly increased, while sitting time significantly decreased in the Snacktivity group following the intervention (p = 0.007 and p = 0.030, respectively). In addition, counter conditioning scores significantly increased in the Snacktivity group (p = 0.033), whereas self re-evaluation and self-liberation scores significantly decreased in the control group (p = 0.001 and p = 0.034, respectively). Following the intervention, the Snacktivity group showed a slight increase from the preparation stage to the action stage, indicating a tendency toward more regular physical activity behavior. In contrast, the control group showed an increase in the contemplation stage. However, the between-group comparison was not statistically significant (p = 0.102). No significant changes were observed in vigorous-intensity physical activity, total physical activity, exercise self-efficacy, or total EPCS scores (p > 0.05) in the Snacktivity group. A brief Snacktivity-based educational intervention may positively influence moderate-intensity physical activity participation, sitting time, and certain behavioral processes associated with exercise behavior change among university students. These findings suggest that even a single-session Snacktivity education may support movement-oriented behavior in university students.
Physical inactivity remains a persistent global challenge with implications for physical, cognitive, emotional, and social wellbeing across the lifecourse. Physical literacy has become an influential framework for understanding lifelong engagement in movement, yet less attention has been given to how such engagement becomes sustained, interrupted, and renewed in everyday life. This conceptual paper develops a habit-informed perspective on physical literacy by examining the recurring patterns through which people come to notice, value, prioritise, and return to movement across contexts and life stages. Drawing on habit theory, identity-based motivation, and physical literacy scholarship, the paper argues that sustained engagement in movement depends not only on capability, knowledge, or motivation, but also on repeated ways of thinking, feeling, relating, and acting. Stephen Covey's Seven Habits are used as a heuristic scaffold for naming pedagogically relevant patterns, including agency, purpose, prioritisation, inclusive participation, empathy, collaboration, and renewal. The paper further situates physical literacy as relevant to the Inner Development Goals and selected United Nations Sustainable Development Goals by showing how physical education may support inner capacities and broader societal aims related to health, education, equity, and sustainable communities. Physical literacy is therefore reframed as a context-sensitive relationship with movement that is shaped by biography, social relationships, access, opportunity, and repeated educational experiences. Implications are outlined for physical education pedagogy, curriculum, and research, with emphasis on supporting lifelong movement in ways that are meaningful, inclusive, and socially responsive.
The issue of insufficient physical activity in adolescents (defined by the World Health Organization as those aged 10-19 years) is a significant worldwide health concern, as 81% do not achieve the suggested levels of physical exercise. Although digital health interventions (DHIs) present promising scalable solutions, their actual performance in practical environments often falls short of anticipated outcomes. This systematic review provides a critical analysis of the existing research on digital strategies aimed at enhancing physical activity among adolescents, emphasizing the factors that contribute to their success, user engagement, and equitable access. This systematic synthesis compiles findings from scholarly articles released from 2020 to 2026. The primary outcome was physical activity, measured by daily step counts or minutes of moderate-to-vigorous physical activity (MVPA). Secondary outcomes included engagement, adherence, motivation, psychological factors, equity, and other health-related measures. We included randomized controlled trials, cohort studies, cross-sectional studies, mixed-methods studies, systematic reviews, and meta-analyses. By examining research on a range of digital health technologies-including wearable devices (e.g., fitness trackers, smartwatches), mobile applications, gamified platforms, chatbots, and AI-driven tools-the analysis integrates quantitative data with qualitative insights from co-design studies to provide comprehensive insight into the effectiveness, timing, and target audiences of digital interventions. Methodological quality and risk of bias were assessed using study-design-specific tools: RoB 2 for randomized controlled trials, ROBINS-I for non-randomized interventional studies, AMSTAR 2 for systematic reviews and meta-analyses, NOS for cohort and longitudinal studies, AXIS for cross-sectional studies, CASP for qualitative studies, and MMAT for mixed-methods studies. The results reveal a persistent disparity between effectiveness and user involvement: while 63% of the examined DHIs demonstrated positive results in their initial assessments, adherence levels dropped from 73% at the start to just 14% by the fifth month. (The 63% = 29/48 studies reporting a significant positive effect on PA. The adherence rates are from a single cohort study tracking device usage over time, not pooled across studies). The success of these interventions is not solely dependent on advanced technology but rather on the integration of three interconnected factors: (1) developmental suitability, where younger adolescents (approximately 10-13 years) are more responsive to playful, sensorimotor activities, whereas older adolescents (approximately 14-19 years) prefer goal-setting and tracking their own progress. (2) relational design, features like team challenges, empathetic AI characters, and customizable avatars can boost confidence by 50% and motivation by 120%; and (3) contextual relevance, data indicates that moderate to vigorous physical activity (MVPA) peaks between 5 and 8 p.m., highlighting the critical difference between screen time (which can hinder activity) and the frequency of physical engagement (which encourages it). Ongoing disparities in equity-such as digital literacy gaps exceeding 35% and reduced engagement among racial and ethnic minorities-emphasize the need for intentional structural and cultural alignment to prevent digital interventions from widening existing inequalities. Effective digital solutions prioritize the needs of adolescents rather than focusing solely on technology. They emphasize tailored experiences instead of fixed features, foster meaningful connections rather than relying on precise algorithms, and adapt to specific contexts instead of aiming for one-size-fits-all scalability. Future developments should shift away from merely measuring screen time and instead embrace approaches that are rich in experience, affirm individual identities, and promote social justice while incorporating physical activity into the everyday lives of young people. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261415756.
This study aimed to compare social participation and physical activity in patients with craniopharyngioma or central nervous system germ cell tumor (CNS germ cell tumor) with those of healthy participants and examine their associations with social behavioral disorders. We recruited adult patients with either childhood- or adult-onset conditions who received treatment at the Kyoto University Hospital and healthy participants. Social participation and physical activity were assessed using the Community Integration Questionnaire (CIQ) and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Social behavioral disorders, including apathy, were evaluated using the Frontal Systems Behavior Scale (FrSBe). Data were analyzed using the Mann-Whitney U test and Spearman's rank correlation. A total of 20 patients (mean age 35.15 ± 14.00 years), comprising 14 with craniopharyngioma and 6 with CNS germ cell tumor, along with 25 healthy participants (mean age 35.52 ± 15.28 years), were recruited. The patients' total scores (CIQ) and total physical activity (IPAQ-SF) were significantly lower than those of healthy participants (p < 0.001 and p = 0.021, respectively). Significant negative correlations were found between patients' productivity (CIQ) and total scores (FrSBe), and between productivity and apathy (FrSBe) (ρ = -0.449, p = 0.047 and ρ = -0.572, p = 0.008, respectively). Patients with craniopharyngioma or CNS germ cell tumor had lower levels of social participation and physical activity than healthy participants, and greater apathy was linked to reduced productivity. These findings suggest that joint activity planning and encouragement from caregivers may promote social participation in patients with apathy.
Few studies have examined the physical complaints, emotional aspects, behavioral indicators, and quality of life associated with series watching (PCSW) across cultural contexts. This multicenter, cross-sectional study investigated latent profiles of PCSW and their associations with emotional variables, smartphone addiction, food addiction, quality of life, and series-watching intensity (SWI) among university students in Brazil (n = 1,190) and Canada (n = 306). Participants completed five author-developed PCSW self-report items, used as an operational measure rather than a validated scale, together with standardized measures of smartphone addiction (SAS-SV), emotion dysregulation (DERS-18), emotional symptoms (DASS-21), impulsivity (UPPS-P), food addiction (mYFAS 2.0; AEBS), and quality of life (WHOQOL-Bref). A latent profile analysis identified three profiles characterized by high (HPC), moderate (MPC), and low (LPC) levels of physical complaints. The HPC profile exhibited poorer emotional and behavioral indicators, higher levels of smartphone and food addiction, lower quality-of-life scores, and greater SWI. Spearman correlations revealed positive relationships between PCSW, emotional symptoms, emotion dysregulation, problematic smartphone use, and food addiction indicators, as well as negative relationships with quality of life. Network analysis indicated that depression, stress, and emotion-regulation difficulties formed a central core, with PCSW showing more peripheral connections to this core, particularly in relation to problematic smartphone use and emotion regulation. These connections were broadly similar across countries, with slightly stronger associations in Brazil and greater importance of addictive eating indicators in Canada. Our findings indicate that emotional and technological factors are associated with PCSW, underscoring the importance of emotion regulation, smartphone use, and SWI for students' wellbeing.
Aerobic exercise is a cornerstone of chronic obstructive pulmonary disease (COPD) management; however, its association with lung function parameters has remained inconsistent across prior studies, and previous studies have been limited by examining physical activity (PA) as a single intensity dimension without distinguishing specific PA types. We therefore investigated the associations between PA intensity and type with lung function outcomes (FEV1, FVC, and PEF) in COPD patients and individuals with normal spirometry (FEV1/FVC ≥ 0.7 and FVC ≥ 80% of predicted), and formally tested whether these associations differ between the two groups. This nationwide population-based cross-sectional study included data from 14,679 participants from 2014 to 2019. All participants underwent a health survey and a series of health examinations, including a pulmonary function test. Associations between lung function and PA intensity, PA types (walking, strengthening, and aerobic exercise), and PA intensity stratified by age and sex were assessed using analysis of covariance. In the COPD group, higher levels of PA were associated with increased forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) across all models. Among PA types, aerobic exercise was the only type significantly associated with improved FEV1, FVC, and PEF in COPD patients across progressively adjusted models (unadjusted; adjusted for sociodemographic and lifestyle factors; additionally adjusted for major comorbidities). Furthermore, the associations between aerobic exercise and FEV1 and FVC were significantly stronger in the COPD group than in the normal spirometry group in adjusted analyses (p for interaction = 0.0297 and 0.0069, respectively, in the fully adjusted model), whereas no significant interaction was observed in the unadjusted model. No significant associations between PA intensity and lung function were observed in COPD patients when stratified by age or sex. Among PA types, aerobic exercise was the only type significantly associated with improved FEV1, FVC, and PEF in COPD patients after full covariate adjustment, and its associations with FEV1 and FVC were significantly stronger in the COPD group than in individuals with normal lung function. These findings support the inclusion of structured aerobic exercise as a core component of COPD management.
The six-minute walk test (6MWT) is widely used to assess functional capacity in chronic heart failure (CHF) but is limited by space and logistics. The two-minute step test (2MST) is a practical alternative. This study aimed to determine an optimal 2MST cut-off for reduced functional capacity and compare its responses with the 6MWT. In this cross-sectional study, 60 clinically stable patients with CHF (mean age 51.45±12.65 years; 77% male) completed the 2MST, 6MWT, and quadriceps maximal voluntary contraction assessments. Physiological and perceptual responses were recorded at baseline, immediately after, and five minutes post-test. Receiver operating characteristic analysis determined the optimal 2MST cut-off. Adjusted regression examined functional associations, and responses were compared between tests. A 2MST cut-off of ≥94 steps showed good discrimination for reduced functional capacity (area under the curve, 0.82; 95% confidence interval, 0.71-0.92; sensitivity, 82.9%; specificity, 64.0%). In adjusted analyses, the cut-off remained independently associated with greater six-minute walk distance and lower post-exercise leg fatigue (p=0.001), but not with quadriceps strength. Compared with the 6MWT, the 2MST induced greater post-exercise leg fatigue (p<0.001), while other cardiorespiratory and perceptual responses were similar (p>0.05). The 2MST is a safe and feasible submaximal test for assessing functional capacity in CHF. A 94-step cut-off may help identify patients with reduced functional capacity, particularly when corridor-based testing is not feasible.
Despite the growing burden of prostate cancer in China and the widespread use of androgen deprivation therapy (ADT), no validated disease-specific instrument has been used to systematically characterize symptom clusters and their impact on quality of life (QoL) in this population. This exploratory application of the newly developed Prostate Cancer Endocrine Therapy Symptom Cluster Assessment Scale (PCET-SCAS) addresses this gap. To characterize symptom cluster profiles and QoL in Chinese patients with prostate cancer undergoing ADT, examine their correlations, and identify independent predictors of QoL using a disease-specific assessment instrument. This cross-sectional study consecutively enrolled 188 patients receiving ADT at one tertiary hospital in Guangzhou, China. Symptom clusters were assessed using the PCET-SCAS, and QoL was evaluated with the EORTC QLQ-C30 and QLQ-PR25. Spearman correlation and multiple linear regression were performed for statistical analysis. This exploratory application of the PCET-SCAS aimed to characterize symptom cluster profiles and their impact on QoL in this cohort. Five distinct symptom clusters were identified, including the urological-sleep, pain-digestive-nutritional, emotional-energy, endocrine therapy-related, and sexual function clusters. The sexual function cluster had the highest severity (median 2.50, IQR 2.25-3.00). Cognitive function was the lowest-scoring functional domain (median 50.00). All five clusters were significantly negatively correlated with functional domains and overall health status (r = -0.167 to -0.630, all P < 0.01), and positively correlated with symptom domains (r = 0.156 to 0.636, all P < 0.05). Univariate analysis identified age, cohabitation status, physical activity level, Karnofsky Performance Status (KPS) score, disease progression, bone metastasis, and all five symptom cluster scores as significant correlates of QoL (all P < 0.05). Multivariate regression (16 separate models, adjusted R² range: 0.139-0.541) identified symptom cluster severity as the most consistent independent predictor of QoL across domains. KPS score predicted physical, role, and social functioning but not emotional or cognitive outcomes (sexual outcomes were not analyzed in regression due to insufficient data). The emotional-energy cluster was the dominant predictor of emotional function, and the urological-sleep cluster was the strongest predictor of urinary symptoms. Chinese patients with prostate cancer undergoing ADT experience a multidimensional, co-occurring symptom burden across five distinct clusters, all significantly associated with impaired QoL. KPS predicted physical, role, and social functioning but not emotional or cognitive outcomes (sexual outcomes were not analyzed in regression due to insufficient data), underscoring its role as a physical performance measure rather than a global QoL indicator. These findings support the development of cluster-targeted supportive care interventions to optimize QoL in this population.
Young adults with stroke often experience functional impairments, which may be exacerbated by hearing loss. This study examined associations between employment disruptions and functional, physical, and mental health limitations among young stroke survivors with and without self-reported hearing difficulty. This analysis used data from the 2020 to 2023 Behavioral Risk Factor Surveillance System (BRFSS) for adults aged 18-49 with self-reported stroke. Outcome measures included functional limitations-including concentration/memory, mobility/walking, dressing/bathing, and completing errands-and the number of days with poor physical, mental, and overall health. Logistic and negative binomial regressions examined the associations between these outcomes, employment status, and hearing difficulty, controlling for sample heterogeneity. Interactions between hearing difficulty and employment status were assessed to examine potential differential effects. Respondents who reported hearing difficulty had significantly greater odds of functional limitations, including difficulty concentrating (OR = 2.60, 95% CI: 1.56-4.35), doing errands independently (OR = 3.71, 95% CI: 2.22-6.21), dressing or bathing (OR = 6.09, 95% CI: 3.30-11.24), and walking or climbing stairs (OR = 3.66, 95% CI: 1.89-7.09). Hearing difficulty was also independently associated with a greater number of poor physical health days (IRR = 1.39, 95% CI: 1.02-1.89) and poor mental health days (IRR = 1.67, 95% CI: 1.30-2.14). Being out of work or out of the labor force was independently associated with poorer functional, physical, and mental health outcomes. These findings underscore the need for integrated post-stroke rehabilitation strategies that address sensory, cognitive, and social dimensions.
To clarify the status of visitor and telephone restrictions and the factors associated with these restrictions among patients hospitalized for the treatment of mental disorders. This study included 1,998 patients hospitalized for the treatment of mental disorders at the Department of Psychiatry, Kitasato University Hospital, and the Department of Psychiatry, Kitasato University East Hospital between January 1, 2014 and December 31, 2021. The visitor and telephone restriction ratios of the participants were calculated, and their associations with demographic and clinical data and psychiatric diagnosis were comparatively examined. Of the 1998 participants, 434 (21.7%) experienced visitor restrictions and 631 (31.6%) experienced telephone restrictions. Multivariate logistic regression analysis suggested that young age, involuntary admission, seclusion, physical restraint, schizophrenia spectrum disorders, and manic episodes of bipolar I disorder were associated with visitor restrictions. Additionally, young age, hospitalization days, involuntary admission, seclusion, physical restraint, and manic episodes of bipolar I disorder were associated with telephone restrictions. The visitor and telephone restriction ratios were 21.7% and 31.6%, respectively. Age, involuntary admission, seclusion, physical restraint, schizophrenia spectrum disorders, and manic episodes of bipolar I disorder were associated with visitor restrictions, and age, hospitalization days, involuntary admission, seclusion, physical restraint, and manic episodes of bipolar I disorder were associated with telephone restrictions. Further research is required to clarify the factors related to visitor and telephone restrictions and their impact on patients to minimize their use.
Cardiomyopathies are diseases of the heart muscle (ICD-10 chapter IX, code I42). This study compared the health profiles of individuals with cardiomyopathy to age- and sex-matched controls in the UK Biobank prospective cohort to better understand health behaviours. Historical advice for patients to avoid exercise may have contributed to earlier heart failure; addressing these outdated perceptions could guide future recommendations to improve outcomes and reduce cardiovascular mortality. Data from the UK Biobank were analysed, including physical activity behaviours, body mass index (BMI), waist circumference, body composition, hand-grip strength, and lifestyle factors, such as intake of fruit, processed/red meat, oily fish, alcohol and smoking, as well as PC-sitting and TV-viewing time. Linear and logistic regression assessed associations between these exposures and cardiomyopathy, adjusting for age, sex, and deprivation index. The cohort comprised 442 individuals with cardiomyopathy and 173,429 matched controls. Significant differences were noted in age, deprivation index, alcohol intake, BMI, waist and hip circumference, physical activity levels, TV viewing, and sedentary time. Males had higher odds of cardiomyopathy than females (odds ratio [OR] 2.5, 95% confidence interval [CI] 2.04 to 3.05, p<0.0001). Obesity was strongly associated with cardiomyopathy (OR 3.7, 95%CI 2.88 to 4.76, p<0.0001). Sleep risk scores and type of physical activity risk scores were also significantly associated with cardiomyopathy. In conclusion, individuals with cardiomyopathy demonstrated poorer health profiles and more sedentary behaviours than controls. These findings highlight the need for targeted interventions and updated exercise advice to improve clinical outcomes and reduce cardiovascular mortality in this population.
Recent advances in sensing and imaging technologies have enabled the acquisition of high-dimensional spatiotemporal data from complex geometric domains. However, predictive modeling of such systems remains challenging due to irregular spatial manifolds, coupled multi-output dynamics, limited observations, and the need for reliable uncertainty quantification. This paper presents a physics-augmented, geometry-aware, multi-task Gaussian Process (P-G-MGP) framework for spatiotemporal modeling. We develop a geometry-aware multi-task GP (G-MGP) to capture spatiotemporal structures and inter-task dependencies. To enhance model fidelity and robustness, we incorporate governing physical laws through a physics-based regularization scheme, thereby constraining predictions to be consistent with governing principles. Furthermore, our framework provides closed-form estimates of posterior variance, enabling calibrated uncertainty quantification for downstream decision-making. We validate P-G-MGP on 3D cardiac electrophysiological modeling, demonstrating superior predictive performance over existing methods by effectively incorporating geometric priors, multi-task interactions, and domain-specific physical constraints.
Sleep is an important regulator of metabolic and cardiovascular health. Insufficient sleep is associated with adverse health behaviors and increased cardiovascular risk in young adults. Understanding sleep patterns and risk awareness in this group is essential for prevention. A nationally representative cross-sectional survey was conducted among 9,874 final-year Polish secondary school students. The questionnaire assessed sleep duration, physical activity, diet, alcohol and tobacco use, screen time, body mass index (BMI) and blood pressure. Associations between weekday sleep duration and lifestyle factors and cardiovascular risk were analyzed. Over 46% of students reported sleeping less than 7 h on weekdays, with longer sleep on weekends (6.7 ± 1.3 vs. 9.0 ± 1.5 h, p < 0.001). Short sleep was associated with higher consumption of processed foods, alcohol use, tobacco smoking, lower winter physical activity, and greater screen time. Students sleeping <7 h were more often underweight or obese. Awareness of short sleep as a cardiometabolic risk factor was limited. Insufficient sleep is common among Polish young adults and is associated with an unfavorable behavioral and cardiometabolic risk profile.
Glass transition temperature (T g) is a key thermophysical property in polymer informatics, yet many machine learning (ML) studies focus on point prediction accuracy without explicitly evaluating reliability under chemical novelty. Here, we evaluate two established descriptor-based regressors, gradient-boosted trees (XGBoost) and support vector regression (SVR), on a 410-sample simulation-derived polymer data set using stratified, scaffold-based, and fingerprint-clustered validation regimes. We combine learning curves, applicability-domain diagnostics, split conformal prediction (SCP), subgroup coverage analysis, model-specific descriptor-importance analysis, and interval-aware triage metrics. Performance degraded and variability increased under novelty-enforcing splits, with SVR showing more stable point-prediction behavior than XGBoost in several regimes; this trend is interpreted as benchmark-specific, not as general model-class superiority. Conformal intervals maintained near-nominal marginal coverage but were often too wide for fine-grained candidate ranking, and subgroup diagnostics revealed local reliability limitations in low-similarity, high-T g, or chemistry-specific subsets. Thus, conformal intervals are best interpreted as conservative risk indicators for uncertainty-aware triage, not as high-resolution screening tools. Descriptor-importance analyses highlighted chemically plausible feature families related to topology, polarity, surface area, heteroatom content, and electronic-state descriptors, but these attributions are treated as model-level plausibility diagnostics, not physical validation of T g mechanisms. Overall, this work provides a reproducible reliability-assessment workflow for small-data polymer T g prediction against MD-derived labels, with experimental validation required before deployment against measured T g data.
Stress fractures are overuse injuries that develops in response to repetitive loads applied to bone with normal structural integrity and is highly prevalent among physically active populations, but their underlying mechanisms remain incompletely understood. This article reviews the complex pathogenesis and healing mechanisms of stress fractures. Stress fractures develop when repetitive mechanical loading on the bone exceeds its threshold for adaptive repair, leading to the progressive accumulation of microdamage and ultimately disrupting the physiological equilibrium between bone resorption and formation. The healing of stress fractures is characterized by intramembranous ossification, a process that begins with periosteal woven bone formation to stabilize the fracture and proceeds through subsequent bone remodeling to repair the cracks. The development and repair processes of stress fractures involve dynamic alterations in cell types and tissue constituents, along with active signaling activities within and among the involved cells involved. Future research should prioritize the use of larger animal models such as rabbits and minipigs, and the development of stress fracture models that more accurately replicate the clinical pathogenesis of stress fractures. Although the efficacy of anti-osteoporotic agents, non-steroidal anti-inflammatory drugs (NSAIDs), and low-intensity pulsed ultrasound (LIPUS) have been reported, future research should explore additional physical therapy modalities to elucidate their specific role in the management of stress fractures and underlying mechanisms. Overall, by reviewing the latest research advances in the pathogenesis and treatment of stress fractures and exploring targeted therapeutic strategies, this article holds the promise to offer novel insights into their prevention and management, thereby driving improvements and innovations in clinical treatment approaches and demonstrating significant translational potential.
Childhood obesity is a serious public health crisis in the United States, affecting millions of children annually and is associated with significant, long-term physical and psychological consequences. Family-based behavioral interventions have been shown to be effective in improving obesity-related outcomes in pediatric populations. However, there is limited insight into how adult participation in medical weight management programs may impact household health behaviors. This study explores parent perception of the impact of participation in weight management programs on child health behaviors. This is a qualitative study in which semi-structured interviews were conducted by trained personnel. Adult participants who were enrolled in a medical weight management clinic, had been prescribed obesity medication(s), and had at least one child aged 18 years old or younger living in the same household were included. Interviews were conducted between December 2024 and July 2025. Data analysis was guided through a thematic process; themes were discussed by the research group for consensus. Ten interviews were conducted. Four themes emerged: (1) purposeful individual dietary choices, (2) acknowledgement of unintentional dietary changes in families secondary to program involvement, (3) consciousness of health behaviors across both individual and family levels, and (4) optimism regarding lifelong behavioral change despite concerns surrounding insurance coverage. Parents perceived that participation in medical weight management programs positively impacted household health behaviors. Participants across family systems identified both conscious and unconscious behavioral changes. These findings suggest that parent participation in weight loss programs may have broader implications beyond individual health benefits, and household health dynamics should be considered when managing pediatric obesity.
Ferroptosis is an iron-dependent, non-apoptotic form of regulated cell death driven by lethal lipid peroxidation and has emerged as a pivotal regulator of skeletal muscle physiology and pathology. This review systematically delineates the core molecular machinery of ferroptosis, including the system Xc--glutathione-GPX4 axis, dysregulated iron metabolism, and lipid peroxidation, together with key regulatory networks involving p53, Nrf2, and AMPK. We further highlight the context-dependent roles of ferroptosis in skeletal muscle: during development and regeneration, transient and moderate ferroptotic signaling may facilitate myogenesis and tissue remodeling, whereas sustained or excessive ferroptosis drives satellite cell depletion and impaired regenerative capacity. Pathologically, ferroptosis is implicated in a spectrum of muscle disorders-including sarcopenia, muscular dystrophy, sports-related injuries, and inflammatory myopathies-through mechanisms such as iron overload, oxidative stress, and mitochondrial dysfunction. Finally, we summarize emerging therapeutic strategies targeting ferroptosis, including iron chelators, GPX4 activators, natural compounds, gene-based interventions, and physical exercise, and discuss future directions toward precision medicine and combinatorial approaches. By integrating current evidence, this work provides a comprehensive framework for understanding ferroptosis in skeletal muscle homeostasis and disease and offers insights for the development of novel therapeutic interventions. This review establishes ferroptosis as a convergent pathogenic mechanism across muscle disorders, offering a framework for patient stratification by ferrototic signatures. It synthesizes preclinical evidence for pharmacologic inhibitors, natural products, and gene-based interventions, while critically evaluating clinical feasibility, safety, and dosing. A tiered translational roadmap from biomarker validation to early-phase trials is proposed to accelerate bench-to-bedside development.
Physics-based reduced-order models are one of the key enablers for improving the predictive capabilities of digital twins, offering a balance between computational efficiency and physical fidelity. However, their efficiency for nonlinear problems remains a challenge because evaluating nonlinear operators in reduced dimensions can be very costly, and offline construction often requires many high-fidelity simulations. In this paper, we address this issue with a reduced-order modeling strategy for parametrized nonlinear partial differential equations that is efficient both online and offline. Offline efficiency is achieved using a greedy algorithm for reduced basis construction combined with a quasi-optimal hyper-reduction procedure called Reduced Basis Empirical Quadrature Procedure (RBEQP) [1]. Then, Gaussian process regression is integrated into the reduced-order model to learn the reduced coefficients and enhance online efficiency. Additionally, we evaluate the effectiveness of our proposed method on two model problems: a steady-state heat conduction problem with a nonlinear, temperature-dependent conductivity, and a neo-Hookean hyperelastic beam under self-weight load.
Low moderate-to-vigorous physical activity (MVPA), high sedentary behavior (SB), and inadequate sleep are individually associated with type 2 diabetes (T2D) risk. However, the aggregate impact of these movement patterns remains unclear. Assess whether being aligned with 24-h movement guidelines of MVPA, SB, and sleep relates to cardiometabolic health, and compare this with the American Heart Association's Life's Essential 8. In a cross-sectional study, adults with obesity [n = 56 (39 F); 55.6 ± 1.1 y; 34.5 ± 0.7 kg/m2] with low 24-h movement z-scores ["aligned"; n = 28 (21 F)] were compared to those with high z-scores ["misaligned" n = 28 (18 F)]. MVPA and SB (accelerometer) and sleep (Pittsburgh Sleep Quality Index) were assessed to calculate z scores. LE8 scores were calculated according to AHA guidelines. A 120-min hyperinsulinemic-euglycemic clamp (40 mU/m2/min, 90 mg/dl) with indirect calorimetry was used to determine metabolic insulin sensitivity [glucose infusion rate (GIR)] and substrate oxidation. Pulse wave velocity and augmentation index (AIx75) were assessed at 0 and 120 min of the clamp to assess arterial stiffness. Fitness (VO2max) and body fat (DXA) were also assessed. Despite no differences in age, body fat, or VO2max, the misaligned group had higher fasting DBP, MAP, and AIx75 (P < 0.05), lower GIR (P = 0.07), and lower FFA suppression (P = 0.01). While both the z-score and LE8 related to blood pressure, only the z-score correlated with AIx75 and FFA suppression. Aligning with 24-h movement patterns related to better cardiometabolic health in people with obesity. NCT03355469.
Rotator cuff injuries often lead to impaired shoulder function, and tendon-bone healing remains challenging due to the complex structure of the enthesis and persistent remodeling-associated pro-inflammatory signaling. Low-intensity pulsed ultrasound (LIPUS) and mild hyperthermia (MH) have shown potential in tissue repair, but the molecular mechanisms underlying their combined effects are unclear. This study aimed to investigate whether LIPUS and MH synergistically promote tendon-bone healing by regulating macrophage polarization through the TRPV1/Ca2+/CaMKII/BACH2 signaling pathway. A rabbit supraspinatus tendon-bone injury model and in vitro macrophage polarization assays were employed. Histology, immunohistochemistry, MRI, and biomechanical testing were performed to assess repair outcomes. RNA-seq with qPCR and Western blot validation was used to identify key signaling pathways. Functional assays, including Ca2+ flux detection, pharmacological inhibition, and siRNA knockdown, were conducted to examine the role of TRPV1, CaMKII, and BACH2. LIPUS and MH significantly suppressed M1 polarization (CD86, iNOS) and enhanced M2 markers (CD163, Arg1), reducing ROS levels and inflammatory cytokine expression. Combined intervention yielded the most pronounced effects, showing improved fibrocartilage formation, collagen alignment, and bone remodeling, with superior biomechanical strength approaching native tissue. Transcriptomic and protein analyses revealed increased TRPV1 activation, enhanced Ca2+ influx, CaMKII phosphorylation, and promoted BACH2 nuclear translocation. Mechanistically, TRPV1 activation promoted Ca2+ entry, CaMKII activation, and BACH2 nuclear translocation, thereby inhibiting M1 polarization. Inhibition of TRPV1, Ca2+ influx, or CaMKII significantly reduced BACH2 nuclear translocation and diminished the anti-inflammatory effects. Combined LIPUS and MH synergistically enhance tendon--bone healing, potentially through modulating the TRPV1/Ca2+/CaMKII/BACH2 pathway, which appears to modulate macrophage polarization during the later stages of tendon-bone remodeling. This study identifies the TRPV1/Ca2+/CaMKII/BACH2 signaling axis as a novel mechanistic target for non-invasive physical therapy in tendon-bone healing. Our findings provide a strong preclinical rationale for combining LIPUS and mild hyperthermia as a promising, non-pharmacological strategy to improve immune microenvironment and outcomes after rotator cuff repair. This paves the way for future clinical trials to translate this combinatorial biophysical therapy into adjuvant treatment protocols.