Associations between sugar-sweetened beverages consumption, duration of physical exercise, and depressive symptoms among Tibetan university students at high altitude.

Background: Depressive symptoms have become a public health issue of common concern in countries all over the world, and have many negative impacts on university students' study and life. Depressive symptoms are influenced by many factors, including sugar-sweetened beverages (SSBs) consumption and duration of physical activity. However, no study has been conducted on the association between sugar-sweetened beverage consumption, duration of physical exercise, and depressive symptoms among Tibetan university students at high altitudes. Methods: In this study, a self-assessment survey of SSBs consumption, duration of physical exercise, and depressive symptoms was conducted on 6,259 (2,745 boys, 43.86%) Tibetan university students aged 19-22 years in Lhasa and Ganzi areas, China, using stratified whole population sampling. The associations were also analyzed using one-way analysis of variance, binary logistic regression analysis, and ordered logistic regression analysis in the generalised linear model. Results: The proportions of mild depression symptoms, moderate depression symptoms, and major depressive symptoms among Tibetan boys university students in high-altitude areas of China were 18.0, 22.9, and 1.5%, respectively; the proportions of girls students were 20.1, 21.9, and 1.5%, respectively, 1.5%, and the differences in the detection rates of depressive symptoms between sex were statistically significant (χ 2 value = 14.253, p < 0.01). Ordered logistic regression analyses showed that using duration of physical exercise >60 min/d and SSBs ≤1 times/week as the reference group, the duration of physical exercise <30 min/d and SSBs ≥5 times/week groups had the highest risk of developing depressive symptoms was the highest risk (OR = 6.98, 95% CI: 5.05-9.65; p < 0.001). Conclusion: This study confirmed that there was a positive association between SSBs consumption and depressive symptoms and a negative association between the duration of physical exercise and depressive symptoms among Tibetan university students at high altitudes in China. In the future, SSBs consumption should be effectively controlled and the duration of physical exercise should be increased to reduce the occurrence of depressive symptoms and promote the physical and mental health of Tibetan university students in high-altitude areas.

The relationship between physical exercise and sense of social fairness among college students: the chain-mediated role of perceived social support and life satisfaction.

Background: The development of a stable society is closely linked to a prevalent sense of social fairness. Participating in physical activities, which are inherently social, plays a crucial role in fostering mental stability within social contexts. Objective: This study aims to examine how physical exercise influences the sense of social fairness among college students, focusing on the potential mediating effects of perceived social support and life satisfaction. Methods: The study surveyed 496 Chinese college students using several scales: the Physical Activity Rating Scale-3 (PARS-3), Perceived Social Support Scale (PSSS), Satisfaction with Life Scale (SWLS), and Social Justice Scale (SJS). Results: (1) A positive correlation was found between physical exercise and sense of social fairness (r = 0.151, p < 0.01). A significant direct effect of physical exercise on sense of social fairness was also observed (ß = 0.151, t = 3.971, p < 0.01). (2) Physical exercise was a positive predictor of perceived social support (ß = 0.113, t = 4.062, p < 0.01), which in turn positively influenced both life satisfaction (ß = 0.333, t = 18.047, p < 0.01) and sense of social fairness (ß = 0.485, t = 6.931, p < 0.01). Additionally, life satisfaction had a positive effect on sense of social fairness (ß = 0.431, t = 3.247, p < 0.01). (3) Both perceived social support and life satisfaction significantly mediated the relationship between physical exercise and sense of social fairness through two pathways: physical exercise → perceived social support → sense of social fairness (mediating effect: 0.055); and physical exercise → perceived social support → life satisfaction → sense of social fairness (mediating effect: 0.016). Conclusion: (1) Physical exercise enhances both perceived social support and the sense of social fairness among college students, suggesting that it not only directly contributes to an enhanced sense of social fairness but also fosters supportive social relationships. (2) The influence of physical exercise on the sense of social fairness operates both directly and indirectly through the mediating roles of perceived social support and, sequentially, life satisfaction.

Diet and physical exercise as key players to tackle MASLD through improvement of insulin resistance and metabolic flexibility.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has emerged as a prevalent health concern, encompassing a wide spectrum of liver-related disorders. Insulin resistance, a key pathophysiological feature of MASLD, can be effectively ameliorated through dietary interventions. The Mediterranean diet, rich in whole grains, fruits, vegetables, legumes, and healthy fats, has shown promising results in improving insulin sensitivity. Several components of the Mediterranean diet, such as monounsaturated fats and polyphenols, exert anti-inflammatory and antioxidant effects, thereby reducing hepatic steatosis and inflammation. Furthermore, this dietary pattern has been associated with a higher likelihood of achieving MASLD remission. In addition to dietary modifications, physical exercise, particularly resistance exercise, plays a crucial role in enhancing metabolic flexibility. Resistance exercise training promotes the utilization of fatty acids as an energy source. It enhances muscle glucose uptake and glycogen storage, thus reducing the burden on the liver to uptake excess blood glucose. Furthermore, resistance exercise stimulates muscle protein synthesis, contributing to an improved muscle-to-fat ratio and overall metabolic health. When implemented synergistically, the Mediterranean diet and resistance exercise can elicit complementary effects in combating MASLD. Combined interventions have demonstrated additive benefits, including greater improvements in insulin resistance, increased metabolic flexibility, and enhanced potential for MASLD remission. This underscores the importance of adopting a multifaceted approach encompassing dietary modifications and regular physical exercise to effectively manage MASLD. This narrative review explores the biological mechanisms of diet and physical exercise in addressing MASLD by targeting insulin resistance and decreased metabolic flexibility.

Acute and chronic effects of physical exercise in inflammatory biomarkers in people with depression: A systematic review with meta-analysis.

People with depression have increased levels of pro-inflammatory cytokines compared to healthy subjects. Physical exercise can alleviate depressive symptoms and has anti-inflammatory properties. The aim of this study was to identify the effects of exercise on inflammatory biomarkers in people with depression. Clinical trials evaluating the acute and chronic effects of exercise on inflammatory biomarkers in adults with clinical depression were included. The search was conducted on the following databases: PubMed, Embase, Web of Science, PsycINFO, and SPORTDiscus. The risk of bias was assessed with the "Risk of bias in randomized trials" (RoB2) tool. Random effects meta-analyses estimated the acute and chronic effects of exercise for each marker separately. Heterogeneity was estimated with the l2 test. A total of 10 studies (497 participants) were included. No significant acute effects interleukins (IL)-6, IL-10, and IL-8 levels were found. Chronically, exercise increased the levels of TNF-α (Standardized Mean Difference = 0.296; 0.03-0.562, p = 0.029). No chronic effects were found for IL-6 and IL-1B. Overall, 90% of the studies had a moderate or high risk of bias. Exercise seems to promote a small increase in TNF-α, but literature is scarce and with a high risk of bias.

Effects of Remote Versus In-Person Training on Metabolic Profiles and Body Composition of Physically Inactive Adults: Randomized Clinical Trial.

The COVID-19 pandemic has pushed the population to adopt increasingly sedentary lifestyles. Faced with this problem, remote training appears as a practical and inexpensive strategy to promote physically active lifestyles. The aim of this research was to compare the effects of remote versus in-person training on metabolic profiles and body composition of physically inactive adults. This research was conducted through a randomized, single-blind clinical trial with balanced block randomization. The sample consisted of 30 physically inactive subjects of both sexes between 18 and 30 years of age. The sample was selected using a voluntary public call. The 30 subjects were randomized into three groups of 10 people each. One group trained for 36 sessions remotely, and the other did so in person. The control group did not have a training plan. The variables evaluated pre- and post-intervention were body composition by bioimpedance, grip strength through dynamometry, primary outcome, and metabolic profile assessed from a capillary sample using the CARDIOCHEK equipment. In the remote training group, significant gains were evident in the variables of weight (p = 0.042, d = 1.119), muscle percentage (p = 0.032, d = 0.499), and fat percentage (p = 0.001, d = 1.132), visceral fat (p = 0.032, d = 0.424), total cholesterol (p = 0.001, d = 1.213), HDL (p = 0.001, d = 0.534), LDL (p = 0.001, d = 0.973), triglycerides (p = 0.001, d = 0.583), and grip strength (p = 0.001, d = 1.201). When comparing the effects between the remote and in-person training groups, it is evident that the improvements were similar in all variables, except for glucose, in which the in-person group had a greater value reduction.

Optimizing antidepressant benefits: Effect of theta burst stimulation treatment in physically active people with treatment-resistant depression.

Theta burst stimulation (TBS) is a promising therapy for treatment-resistant major depressive disorder (MDD), but a significant proportion of individuals do not respond adequately, necessitating alternative approaches. This study explores whether individuals meeting minimum recommended physical activity levels demonstrate better responses to TBS compared to physically inactive individuals. Using data from a randomized controlled trial (n = 43), participants were categorized as physically active or inactive based on baseline International Physical Activity Questionnaire (IPAQ) scores. Depression scores (Hamilton Rating Scale for Depression, 17-item; HRSD-17) were assessed at baseline, 4, and 6 weeks of TBS treatment. A significant Time X Group effect adjusted for age and baseline depression was observed. Physically active individuals consistently exhibited lower depression scores across time points. At 4 and 6 weeks, there was a significant increase in between-group differences, indicating that the physically active group derived greater benefits from treatment. At 6 weeks, a significantly higher proportion of responders (≥50 % HRSD-17 reduction) were observed in the physically active compared to inactive group. Physical activity significantly contributed to regression and logistic models predicting treatment response. These findings support the potential role of baseline physical activity in enhancing TBS therapy for MDD.

Evaluation of the usability and acceptability of the P-STEP® mobile app: feasibility study protocol.

BACKGROUND: The new P-STEP® (Personalised Space Technology Exercise Platform) app is designed to bring together tailored exercise guidance and up-to-date air quality information. The app allows individuals to plan outdoor exercise walking routes while minimising their exposure to air pollution. Individuals with chronic long-term conditions, particularly respiratory and cardiovascular conditions, can use the app in order to minimise the risk of their symptoms being exacerbated by pollution, while still gaining the benefits of outdoor exercise. METHODS: This study will measure the usability and acceptability of the P-STEP® app. The study will take the form of a single-arm 12-week app pilot study based in Leicestershire, United Kingdom (UK). We will recruit a maximum of 380 participants from an existing cohort study to pilot the app for 12 weeks. Questionnaire data will be collected at three timepoints, baseline, 6 weeks and 12 weeks. The primary outcome is the System Usability Scale at 12 weeks. Secondary outcomes include the User Engagement Scale Short Form, SF-12, Recent Physical Activity Questionnaire (RPAQ), bespoke, app specific usability questions, and feasibility outcomes. Additional data collected includes participant demographic information, technology self-efficacy and adverse events. Weekly anonymised usage data from the app will also be collected by the app team and analysed separately to complement the questionnaire data. DISCUSSION: This study will help us better understand the feasibility and acceptability of using the P-STEP® in the community. The results will also help inform future studies. ETHICS AND DISSEMINATION: This study has received ethical approval from the South West Frenchay Research Ethics (23/SW/0060) Committee. There is no need for further approval from the Health Research Authority as the study is not taking place in the NHS. The ClinicalTrials.gov ID number is NCT05830318.

Physical Exercise Prevents the Cognitive Decline among Older Adults in Romania.

Cognitive decline is one of the most important challenges related to the aging process, due to its important impact on individuals. Several studies have reported that physical exercise with a specific intensity and frequency is beneficial for maintaining cognitive health in the ageing population. The present study investigated the impact of general physical exercise on cognitive health in the older population in Romania. The study involved 60 individuals (60% male, 40% female), with a mean age of 60.78 years (SD = 2.97). The Health Interview Survey and The Minnesota Heart Survey assessed exercise frequency and intensity, while the Montreal Cognitive Assessment (MoCA) determined mild cognitive impairment (MCI) levels. The results of the statistical analysis showed that high-intensity physical exercise at a frequency of three to four times a week at the age of 40-50 years is recommended in order to significantly reduce cognitive decline. In addition, for the age of 60 years old, the results established that engaging in physical activities of a moderate intensity with a frequency of 2-3 times per month is sufficient to maintain healthy cognition. The findings suggest that exercise can serve as a behavioral intervention to mitigate cognitive dysfunction and complement past research on its cognitive health advantages.

The impact of physical exercise on neuroinflammation mechanism in Alzheimer's disease.

Introduction: Alzheimer's disease (AD), a major cause of dementia globally, imposes significant societal and personal costs. This review explores the efficacy of physical exercise as a non-pharmacological intervention to mitigate the impacts of AD. Methods: This review draws on recent studies that investigate the effects of physical exercise on neuroinflammation and neuronal enhancement in individuals with AD. Results: Consistent physical exercise alters neuroinflammatory pathways, enhances cognitive functions, and bolsters brain health among AD patients. It favorably influences the activation states of microglia and astrocytes, fortifies the integrity of the blood-brain barrier, and attenuates gut inflammation associated with AD. These changes are associated with substantial improvements in cognitive performance and brain health indicators. Discussion: The findings underscore the potential of integrating physical exercise into comprehensive AD management strategies. Emphasizing the necessity for further research, this review advocates for the refinement of exercise regimens to maximize their enduring benefits in decelerating the progression of AD.

Menstrual Dysfunction in Adolescent Female Athletes.

Despite the benefits of exercise on mental and physical health, excessive training loads can lead to health problems in the long term, including a wide spectrum of menstrual dysfunction (MD). This narrative review aims to analyze the relationship between physical exercise and MD in adolescent female athletes to support regular menstrual health monitoring and promote educational programs on reproductive risks. When dealing with MD in young athletes, several factors entangled with maturation of the hypothalamus-pituitary-ovarian axis should be considered. Firstly, some disciplines seem to have a higher prevalence of MD due to the high loads of training regimes and the early introduction of athletes to a competitive career. Moreover, low energy intake and a low body mass index appear to exacerbate existing MD. Lastly, disordered eating behaviors and psychological stress can contribute to MD in female athletes. The type of sport, influencing the intensity and duration of exercise, as well as individual psycho-physiological and environmental factors, may influence the role of physical activity in the manifestation of MD. Early recognition and management of MD, along with collaboration between sports organizations and health professionals, are crucial to minimize risks, ensure proper nutrition, and balance training with recovery. Keeping an open discussion on the topic may prospectively improve awareness, early diagnosis, and treatment strategies, as well as reduce injury risk and enhance sports performance.

An embedded qualitative study of the experiences of people with dementia, their caregivers and volunteer older adults who participated in the CREST resilience-building psychosocial intervention.

BACKGROUND: A novel Complex REsilience-building psychoSocial intervenTion (CREST) targeted at people with dementia, their informal carers, general practitioners and the wider community with the aim of increasing resilience and strengthening the personal attributes or external assets of people with dementia living at home, in the community, was developed. It included three components: cognitive stimulation therapy (CST), physical exercise and dementia education. A non-randomised feasibility study was conducted of the CREST intervention, the aim of which was to inform the design of a future randomised controlled trial. This article presents the findings from the qualitative component of the CREST intervention feasibility study, describing the experience of the people with dementia and their caregivers who participated and the volunteer older adults who supported the intervention. METHODS: A descriptive qualitative research approach using semi-structured interviews was undertaken. Key stakeholders (people with dementia (n = 9), their caregivers (n = 9) and the volunteer older adults from the physical exercise component (n = 9)) were interviewed about the intervention and the perceived impact of their participation. RESULTS: The social aspect of the CREST intervention proved to be important for all three groups. Attendance remained high throughout the intervention. The people with dementia spoke positively about their participation in the CST and exercise components of the CREST intervention. The caregivers liked receiving coping strategies focused on how to communicate better with the person they cared for and how to better manage their own self-care and they liked the group element of the programme. The volunteer older adults supported the people with dementia in taking part in the exercise component, motivating them to do the exercises and helping with social interaction within the group. The volunteers gained exposure to the illness and as a result understood more about dementia and felt better equipped to communicate and deal with people with dementia. CONCLUSION: Participation in the CREST intervention produced a positive impact on all three groups. The social element of the intervention was noted by everybody and was regarded as being beneficial. Qualitative insights emphasised the value of embedding qualitative research within feasibility studies to inform future intervention design. Further research should focus on conducting a full-scale randomised controlled trial to evaluate CREST's effectiveness and explore its application to individuals with more advanced dementia. TRIAL REGISTRATION: ISRCTN25294519.

Pregnant women's knowledge, attitude, and practice toward physical exercise during pregnancy and its associated factors at Dessie town health institutions, Ethiopia.

BACKGROUND: Physical exercise consists of planned, repetitive, and intentional movements that reduce the risk of pregnancy-related complications. Worldwide, there is a high rate of physical inactivity during pregnancy, including in Ethiopia, which has detrimental effects on both pregnant women and their developing fetus. OBJECTIVE: This study aimed to assess pregnant women's knowledge, attitude, and practice toward physical exercise during pregnancy and its associated factors among antenatal care attendants at health institutions in Dessie, South Wollo Zone, Amhara Region, Ethiopia, in 2023. STUDY DESIGN: An institutional-based cross-sectional study was conducted among 614 pregnant women receiving antenatal care between January 18, 2023, and February 25, 2023. The study participants were selected using systematic random sampling technique. Data were collected using a pretested, face-to-face interviewer-administered, and semistructured questionnaire. The data were cleaned, coded, and entered into EpiData (version 4.6; www.epidata.dk) and analyzed using SPSS (version 25; SPSS Inc, Chicago, IL). Bivariate and multivariate binary logistic regression analyses were performed to identify factors associated with knowledge, attitude, and practice toward physical exercise during pregnancy. Variables with a P value of <.2 in the bivariate analysis were transferred to the multivariate analysis. Finally, the adjusted odds ratio and 95% confidence interval with a P value of <.05 in the multivariate analysis were considered statistically significant. RESULTS: The study found that 56.3% of participants had good knowledge, 51.5% of participants had a favorable attitude, and 32.2% of participants practiced physical exercise during pregnancy. Age, educational level, and heard about physical exercise during pregnancy were positively associated with pregnant women's knowledge and attitude. In addition, age, antenatal care follow-up, no history of abortion, ever done physical exercise before becoming pregnant, and good knowledge were positively associated with pregnant women's practice of physical exercise during pregnancy. CONCLUSION: Our findings indicate that approximately half of the participants had good knowledge and a favorable attitude. However, almost one-third of the participants practiced physical exercise during their pregnancy. It is recommended that antenatal care providers advise pregnant women to strengthen their antenatal care follow-up and offer health education and counseling about the benefits of physical exercise during pregnancy.

How physical exercise with others and prioritizing positivity contribute to (work) wellbeing: a cross-sectional and diary multilevel study.

Introduction: This work is a dual study employing a cross-sectional approach and a diary method to investigate how physical exercise can become a habit. Guided by the Upward Spiral Theory of Lifestyle Change, we examined the role of prioritizing positivity and engaging in physical exercise with others as advantageous resources and their impact on the relational loop of physical exercise behavior, emotions, and engagement. Methods: The first study involved a sample of 553 participants, and the second study included 146 participants, all of whom were employed and regularly engaged in physical exercise. We utilized structural equation modeling and multilevel analysis for the respective studies. Results: The results of the first study indicate that individuals exercise more when they experience higher levels of engagement and positive emotions, particularly when exercising with others and prioritizing positivity. The findings of the second study reveal that prioritizing positivity acts as a precursor to positive emotions during physical exercise, which in turn reinforces the relational loop between emotions and exercise behavior. Discussion: Both studies conclude that individuals who prioritize positivity experience better psychological wellbeing and higher engagement in physical exercise.

Body composition in a pediatric population with type-1 diabetes - the importance of planned physical exercise.

OBJECTIVE AND METHODS: This study aimed to assess the body composition of pediatric patients with type-1 diabetes (T1D) in a Portuguese pediatric endocrinology/diabetic clinic, using the InBody 570 bioimpedance system. Preschool children (< 6 years) and those recently diagnosed (< 6 months) were excluded. RESULTS: The study included 78 patients (53% female). Median age at assessment was 14 years, with 81% pubertal children. 87% were using continuous subcutaneous insulin infusion (CSII), 25% with an automated closed-loop model. Median HbA1c was 7.3%. Most had an adequate body mass index (BMI) standard deviation score (62%), and 48% engaged in regular physical exercise (PE) outside of school. Median percentage body fat (PBF) was 21.5% and was abnormal in 48%, with median visceral adiposity of 4. Despite adequate BMI, 11% had excessive PBF. PBF was significantly associated with visceral fat (r=0.79; p<0.001), female gender (p<0.001) and PE performed out of school (p=0.005). PE was associated with lower PBF (p=0.005), lower visceral fat (p=0.002), and higher muscle-to-fat ratio (p=0.006). CONCLUSION: Engaging in physical exercise out of school correlated significantly with improved body composition, characterized by reduced PBF and diminished visceral adiposity. Considering the known benefits of physical exercise for metabolic and glycemic control, this study highlights the importance of promoting regular physical exercise in T1D patients.

Effects of a motor and cognitive training program on executive function and different biomarkers related to muscle-brain crosstalk in breast cancer survivors: 3-arm randomised controlled BRAINonFIT study protocol.

INTRODUCTION: Cancer-related cognitive impairment (CRCI) is a significant but often neglected issue for breast cancer survivors that reduces their quality of life. Physical exercise and cognitive training have emerged as promising strategies for CRCI; however, evidence regarding its effectiveness is still unknown. A recently developed motor-cognitive training (dual-tasks) is proposed to examine its efficacy on executive function, physical fitness, emotional symptomatology, and important muscle-brain crosstalk biomarkers. METHODS: The BRAINonFIT study is a randomised, controlled, longitudinal (20 weeks), three-arm, parallel study with a follow-up phase (12 weeks). Breast cancer survivors (stage I-IIIA) with completed chemotherapy are recruited from QuirónSalud Hospital in Seville. Principal outcomes are executive functions, measured by the Trail Making Test, Stroop and Digit Span Backwards; physical fitness, assessed by muscle strength, cardiorespiratory fitness, and body composition; and several muscle-brain biomarkers analysed by immunoenzymatic assay (ELISA). Secondary endpoints are memory function, intelligence, learning ability, self-reported cognitive function, and emotional symptomatology. Assessments take place after the enrolment (baseline; T1), after completing the interventions (5 months after baseline; T2), and after completing the follow-up period (8 months after baseline; T3). DISCUSSION: Given the importance of improving care for breast cancer survivors, this study will provide preliminary evidence for the effectiveness of cognitive-motor training (dual task) as a therapeutic strategy to improve CRCI. Moreover, addressing muscle-brain crosstalk by representative biomarkers will help to elucidate the underlying mechanisms by which this intervention may beneficially impact CRCI. CLINICALTRIALS: gov: NCT06073717.

The Impact of Physical Activity and Lifestyle on Mental Health: A Network Analysis.

AIM: This study aimed to investigate the association between physical activity (PA), lifestyle, and symptoms of depression, anxiety, and stress. METHODS: A cross-sectional study was carried out using an online questionnaire. PA (International Physical Activity Questionnaire), lifestyle (Short Multidimensional Inventory Lifestyle Evaluation), and mental health (Depression, Anxiety, and Stress Scale-21) were assessed. Mean scores were compared between groups of physically active and inactive participants, controlling for gender, education, and income. Furthermore, associations were made between the variables, and individual network analyses were carried out for each mental health domain. The sample consisted of 353 individuals (age = 33.8 [12.2], 59.2% women). RESULTS: In network analyses, PA was indirectly related to depression and stress through the relationship with other lifestyle domains such as diet and nutrition or through stress management and social support. The same path was observed for anxiety; however, a direct partial correlation was also observed between PA and anxiety, suggesting that PA seems to intervene more directly in this aspect of mental health. CONCLUSION: It is concluded that PA is indirectly (via stress management, diet and nutrition, and social support) associated with depression and stress and has direct and indirect associations (via stress management and social support) with anxiety.

Complementary App-Based Yoga Home Exercise Therapy for Patients With Axial Spondyloarthritis: Usability Study.

BACKGROUND: Axial spondyloarthritis (AS) is a chronic inflammatory rheumatic disease characterized by potentially disabling inflammation of the spine and adjacent joints. Regular exercise is a cornerstone of treatment. However, patients with AS currently have little support. YogiTherapy (MaD Lab) is an app developed to support patients with AS by providing instructions for yoga-based home exercise therapy. OBJECTIVE: This study aimed to evaluate the usability and acceptance of the newly designed YogiTherapy app for patients with AS. METHODS: Patients completed the User Version of the Mobile Application Rating Scale (uMARS) and net promoter score (NPS) questionnaires after the app introduction. Wilcoxon Mann-Whitney rank sum test, chi-square test for count data, and correlation analysis were conducted to examine the usability of the app, acceptance, and patient characteristics. RESULTS: A total of 65 patients with AS (33, 51% female; age: mean 43.3, SD 13.6 years) were included in the study from May 2022 to June 2023. Subsequently, the data were analyzed. Usability was rated moderate, with a mean uMARS of 3.35 (SD 0.47) points on a scale from 0 to 5. The highest-rated uMARS dimension was information (mean 3.88, SD 0.63), followed by functionality (mean 3.84, SD 0.87). Females reported a significantly higher uMARS total score than males (mean 3.47, SD 0.48 vs mean 3.23, SD 0.45; P=.03, Vargha and Delaney A [VDA] 0.66, 95% CI 0.53-0.77). The mean average of the NPS was 6.23 (SD 2.64) points (on a scale from 0 to 10), based on 43% (26/65 nonpromoters, 42% (25/65) indifferent, and 15% (9/65) promoters. A total of 7% (5/65) of those surveyed did not answer the question. When applying the NPS formula, the result is -26%. The NPS showed a positive correlation with the usage of mobile apps (r=0.39; P=.02). uMARS functionality was significantly higher rated by patients younger than 41 years (mean 4.17, SD 0.55 vs mean 3.54, SD 1; P<.001; VDA 0.69, 95% CI 0.56-0.80). Patients considering mobile apps as useful reported higher uMARS (r=0.38, P=.02). The uMARS app quality mean score was correlated with the frequency of using apps (r=-0.21, P<.001). CONCLUSIONS: The results revealed moderate acceptance and usability ratings, prompting further app improvement. Significant differences were observed between age and gender. Our results emphasize the need for further improvements in YogiTherapy.

Association of physical activity and sitting time with tobacco and alcohol use in 222,495 adolescents from 66 countries.

BACKGROUND: The prevalence of tobacco and alcohol use among adolescents is alarming, and these substances are among the leading risk factors for current and future health among adolescents. Physical activity has the potential to help prevent substance use among adolescents. The objective of this study was to evaluate the association between physical activity, modes of transportation to or from school, and sitting time with tobacco and alcohol use among 222,495 adolescents. METHODS: This cross-sectional study used data from national surveys conducted in 66 countries, obtained through the Global School-based Student Health Survey, and included adolescents aged 11 to 17 years. Information on physical activity, transportation to or from school, sitting time, and tobacco and alcohol use was collected through self-report questionnaires. Generalized linear models were employed to estimate the associations between these variables. RESULTS: The analysis, adjusted for sex, age, and region, revealed that being physically active was associated with lower odds of smoking (OR: 0.86, 95%CI: 0.83-0.89), alcohol use (OR: 0.74, 95%CI: 0.72-0.76), binge drinking (OR: 0.66, 95%CI: 0.62-0.69), and drunkenness (OR: 0.85, 95%CI: 0.83-0.88) compared to inactivity. Insufficiently active participants also had lower odds of tobacco use (OR: 0.83, 95%CI: 0.80-0.85), alcohol use (OR: 0.77, 95%CI: 0.75-0.79), binge drinking (OR: 0.91, 95%CI: 0.87-0.96), and drunkenness (OR: 0.88, 95%CI: 0.85-0.90) compared to inactive participants. Additionally, active transportation to or from school was associated with lower odds of tobacco use (OR: 0.97, 95%CI: 0.95-0.99), alcohol use (OR: 0.94, 95%CI: 0.92-0.96), and binge drinking (OR: 0.78, 95%CI: 0.75-0.81) compared to those using passive transportation. Participants with acceptable sitting time, however, were more likely to use tobacco (OR: 1.48, 95%CI: 1.45-1.52), use alcohol (OR: 1.68, 95%CI: 1.64-1.72), binge drink (OR: 1.68, 95%CI: 1.62-1.75), and experience drunkenness (OR: 1.66, 95%CI: 1.62-1.69) compared to those with excessive sitting time. CONCLUSION: Being physically active, even at insufficient levels, may have beneficial effects on tobacco and alcohol use in adolescents. Acceptable sedentary time, on the other hand, was positively associated with tobacco and alcohol use.

Exercise, autoimmune diseases and T-regulatory cells.

Diverse forms of physical activities contribute to improvement of autoimmune diseases and may prevent disease burst. T regulatory cells (Tregs) maintain tolerance in autoimmune condition. Physical activity is one of the key factors causing enhancement of Tregs number and functions, keeping homeostatic state by its secrotome. Muscles secrete myokines like IL-6, PGC1α (PPARγ coactivator-1 α), myostatin, transforming growth factor ß (TGF-ß) superfamily), IL-15, brain derived neurotrophic factor (BDNF) and others. The current concept points to the role of exercise in induction of highly functional and stable muscle Treg phenotype. The residing-Tregs require IL6Rα signaling to control muscle function and regeneration. Skeletal muscle Tregs IL-6Rα is a key target for muscle-Tregs cross-talk. Thus, interplay between the Tregs-skeletal muscle, following exercise, contribute to the balance of immune tolerance and autoimmunity. The cargo delivery, in the local environment and periphery, is performed by extracellular vesicles (EVs) secreted by muscle and Tregs, which deliver proteins, lipids and miRNA during persistent exercise protocols. It has been suggested that this ensemble induce protection against autoimmune diseases.

Testosterone and resistance training improved physical performance and reduced fatigue in frail older men: 1 year follow-up of a randomized clinical trial.

OBJECTIVE: To improve health conditions among hypogonadal men ≥70 years of age using testosterone undecanoate (TU) injections, progressive strength training, and oral supplements of vitamin D, calcium, and protein. METHODS: This study is a 1-year follow-up of a double-blind RCT lasting 20 weeks, including 148 older men ≥70 years old with low testosterone levels and mobility problems. During 52 weeks, 4 groups received either testosterone therapy (TU) or progressive resistance training (Training), both (Combo), or no intervention (Controls). Physiotherapists supported the training groups until week 20, while these participants continued trained on their own during weeks 21 to 52. The main outcome measure was the 30-s chair stand test. RESULTS: The following numbers of participants completed the trial: 20 (Combo), 20 (Controls), 24 (TU), and 14 (Training). When examining 30-s chair stand test performance within each group at baseline, and at weeks 4, 20 and 52, only the Combo group improved (p = 0.001, Friedman Test). Compared to controls, only the Combo group experienced reduced fatigue and tiredness (p < 0.05). CONCLUSIONS: Fifty-two weeks of testosterone supplementation combined with progressive resistance training may enhance physical performance, alleviate fatigue, and had no notable detrimental impacts among males aged ≥70 suffering from mobility issues and testosterone insufficiency.Trial registration - Clinical Trials NCT02873559.